Trends in serum total cholesterol since 1980

January 01, 0001

Trends in serum total cholesterol since 1980

Data for trends in serum cholesterol are needed to understand the effects of its dietary, lifestyle, and pharmacological determinants; set intervention priorities; and evaluate national programmes. Previous analyses of trends in serum cholesterol were limited to a few countries, with no consistent and comparable global analysis. The researchers from USA, Switzerland and UK estimated worldwide trends and their uncertainties in mean serum total cholesterol for adults 25 years and older in 199 countries and territories. They obtained data from published and unpublished health examination surveys and epidemiological studies (321 country-years and 3.0 million participants).

In 2008, age-standardised mean total cholesterol worldwide was 4.64 mmol/L for men and 4.76 mmol/L for women. Globally, mean total cholesterol changed little between 1980 and 2008, falling by less than 0.1 mmol/L per decade in men and women. Total cholesterol fell in the high-income region consisting of Australasia, North America, and western Europe, and in central and eastern Europe; the regional declines were about 0.2 mmol/L per decade for both sexes, with posterior probabilities of these being true declines 0.99 or greater. Mean total cholesterol increased in east and southeast Asia and Pacific by 0.08 mmol/L per decade in men and 0.09 mmol/L per decade in women. Despite converging trends, serum total cholesterol in 2008 was highest in the high-income region consisting of Australasia, North America, and western Europe; the regional mean was 5.24 mmol/L for men and 5.23 mmol/L for women. It was lowest in sub-Saharan Africa at 4.08 mmol/L for men and 4.27 mmol/L for women.

The researchers concluded: "Nutritional policies and pharmacological interventions should be used to accelerate improvements in total cholesterol in regions with decline and to curb or prevent the rise in Asian populations and elsewhere. Population-based surveillance of cholesterol needs to be improved in low-income and middle-income countries."

It is important to consider this abstract along with the other two posted today from the Lancet. All is related to consideration of normal values. Clinical implications will be more important.

For the full abstract, click here.

The Lancet 377(9765):578-586, 12 February 2011
© 2011 Elsevier Limited
National, regional, and global trends in serum total cholesterol since 1980: systematic analysis of health examination surveys and epidemiological studies with 321 country-years and 3.0 million participants. Farshad Farzadfar, Mariel M Finucane, Goodarz Danaei et al on behalf of the Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Cholesterol). Correspondence to Majid Ezzati:

Category: GH. Global Health. Keywords: trends, blood pressure, surveys, epidemiological studies, systematic analysis, journal watch.
Synopsis edited by Dr Stephen Wilkinson, Melbourne, Australia. Posted on Global Family Doctor 8 March 2011

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