Repositioning of the global epicentre of non-optimal cholesterol

Taddei, Cristina, Zhou, Bin, Bixby, Honor, Carrillo-Larco, Rodrigo M., Jackson, Rod T., Farzadfar, Farshad, Sophiea, Marisa K., Di Cesare, Mariachiara ORCID: https://orcid.org/0000-0002-3934-3364 and NCD Risk Factor Collaboration, (NCD-RisC) (2020) Repositioning of the global epicentre of non-optimal cholesterol. Nature, 582 . pp. 73-77. ISSN 0028-0836 (doi:10.1038/s41586-020-2338-1)

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Abstract

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.

Item Type: Article
Additional Information: Online content:
Any methods, additional references, Nature Research reporting summaries, source data, extended data, supplementary information, acknowledgements, peer review information; details of author contributions and competing interests; and statements of data and code availability are available at https://doi.org/10.1038/s41586-020-2338-1
[see also the useful links section of this record for Data or Supplementary Material links]
Keywords (uncontrolled): Cardiovascular diseases, Risk factors
Research Areas: A. > School of Science and Technology > Natural Sciences
Item ID: 29626
Notes on copyright: © The Author(s), under exclusive licence to Springer Nature Limited 2020
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
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Depositing User: Mariachiara Di Cesare
Date Deposited: 04 Jun 2020 07:57
Last Modified: 10 Jul 2020 10:23
URI: https://eprints.mdx.ac.uk/id/eprint/29626

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