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Publication
Repositioning of the global epicentre of non-optimal cholesterol
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Advisor(s)
Abstract(s)
High blood cholesterol is typically considered a feature of wealthy western
countries1,2
. However, dietary and behavioural determinants of blood cholesterol are
changing rapidly throughout the world3
and countries are using lipid-lowering
medications at varying rates. These changes can have distinct effects on the levels of
high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have
different effects on human health4,5
. However, the trends of HDL and non-HDL
cholesterol levels over time have not been previously reported in a global analysis.
Here we pooled 1,127 population-based studies that measured blood lipids in
102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018
in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there
was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net
effect of increases in low- and middle-income countries, especially in east and
southeast Asia, and decreases in high-income western countries, especially those in
northwestern Europe, and in central and eastern Europe. As a result, countries with
the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—
changed from those in western Europe such as Belgium, Finland, Greenland, Iceland,
Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific,
such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL
cholesterol was responsible for an estimated 3.9 million (95% credible interval
3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast
and south Asia. The global repositioning of lipid-related risk, with non-optimal
cholesterol shifting from a distinct feature of high-income countries in northwestern
Europe, north America and Australasia to one that affects countries in east and
southeast Asia and Oceania should motivate the use of population-based policies and
personal interventions to improve nutrition and enhance access to treatment
throughout the world.
Description
Keywords
Cholesterol Non-optimal cholesterol Non-HDL cholesterol HDL cholesterol Blood cholesterol . Faculdade de Ciências Sociais
Citation
NCD Risk Factor Collaboration. (2020). Repositioning of the global epicentre of non-optimal cholesterol. Nature, 582(7810), 73-77. https://doi.org/10.1038/s41586-020-2338-1
Publisher
Nature Research