TY - JOUR
T1 - Repositioning of the global epicentre of non-optimal cholesterol
AU - NCD Risk Factor Collaboration (NCD-RisC)
AU - Taddei, Cristina
AU - Zhou, Bin
AU - Bixby, Honor
AU - Carrillo-Larco, Rodrigo M.
AU - Danaei, Goodarz
AU - Jackson, Rod T.
AU - Farzadfar, Farshad
AU - Sophiea, Marisa K.
AU - Di Cesare, Mariachiara
AU - Iurilli, Maria Laura Caminia
AU - Martinez, Andrea Rodriguez
AU - Asghari, Golaleh
AU - Dhana, Klodian
AU - Gulayin, Pablo
AU - Kakarmath, Sujay
AU - Santero, Marilina
AU - Voortman, Trudy
AU - Riley, Leanne M.
AU - Cowan, Melanie J.
AU - Savin, Stefan
AU - Bennett, James E.
AU - Stevens, Gretchen A.
AU - Paciorek, Christopher J.
AU - Aekplakorn, Wichai
AU - Cifkova, Renata
AU - Giampaoli, Simona
AU - Kengne, Andre Pascal
AU - Khang, Young Ho
AU - Kuulasmaa, Kari
AU - Laxmaiah, Avula
AU - Margozzini, Paula
AU - Mathur, Prashant
AU - Nordestgaard, Børge G.
AU - Zhao, Dong
AU - Aadahl, Mette
AU - Abarca-Gómez, Leandra
AU - Rahim, Hanan Abdul
AU - Abu-Rmeileh, Niveen M.
AU - Acosta-Cazares, Benjamin
AU - Adams, Robert J.
AU - Agdeppa, Imelda A.
AU - Aghazadeh-Attari, Javad
AU - Aguilar-Salinas, Carlos A.
AU - Agyemang, Charles
AU - Ahluwalia, Tarunveer S.
AU - Ahmad, Noor Ani
AU - Ahmadi, Ali
AU - Ahmadi, Naser
AU - Ahmed, Soheir H.
AU - Shin, Dong Wook
N1 - Publisher Copyright:
© 2020, The Author(s), under exclusive licence to Springer Nature Limited.
PY - 2020/6/4
Y1 - 2020/6/4
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/85085994877
U2 - 10.1038/s41586-020-2338-1
DO - 10.1038/s41586-020-2338-1
M3 - Article
C2 - 32494083
AN - SCOPUS:85085994877
SN - 0028-0836
VL - 582
SP - 73
EP - 77
JO - Nature
JF - Nature
IS - 7810
ER -