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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.

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Title: 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.
Authors: Farzadfar F (AUTHOR), Finucane MM (AUTHOR), Danaei G (AUTHOR), Pelizzari PM (AUTHOR), Cowan MJ (AUTHOR), Paciorek CJ (AUTHOR), Singh GM (AUTHOR), Lin JK (AUTHOR), Stevens GA (AUTHOR), Riley LM (AUTHOR), Ezzati M (AUTHOR), Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Cholesterol) (CORPORATE AUTHOR), Farzadfar, Farshad (AUTHOR), Finucane, Mariel M (AUTHOR), Danaei, Goodarz (AUTHOR), Pelizzari, Pamela M (AUTHOR), Cowan, Melanie J (AUTHOR), Paciorek, Christopher J (AUTHOR), Singh, Gitanjali M (AUTHOR), Lin, John K (AUTHOR)
Source: Lancet. 2/12/2011, Vol. 377 Issue 9765, p578-586. 9p.
Abstract: Background: 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. We estimated worldwide trends in population mean serum total cholesterol.Methods: We estimated trends and their uncertainties in mean serum total cholesterol for adults 25 years and older in 199 countries and territories. We obtained data from published and unpublished health examination surveys and epidemiological studies (321 country-years and 3·0 million participants). For each sex, we used a Bayesian hierarchical model to estimate mean total cholesterol by age, country, and year, accounting for whether a study was nationally representative.Findings: In 2008, age-standardised mean total cholesterol worldwide was 4·64 mmol/L (95% uncertainty interval 4·51-4·76) for men and 4·76 mmol/L (4·62-4·91) 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 (-0·06 to 0·22, posterior probability=0·86) in men and 0·09 mmol/L per decade (-0·07 to 0·26, posterior probability=0·86) 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 (5·08-5·39) for men and 5·23 mmol/L (5·03-5·43) for women. It was lowest in sub-Saharan Africa at 4·08 mmol/L (3·82-4·34) for men and 4·27 mmol/L (3·99-4·56) for women.Interpretation: 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.Funding: Bill & Melinda Gates Foundation and WHO. [ABSTRACT FROM AUTHOR]
Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: 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.
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  Data: <searchLink fieldCode="AR" term="%22Farzadfar+F%22">Farzadfar F</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Finucane+MM%22">Finucane MM</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Danaei+G%22">Danaei G</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pelizzari+PM%22">Pelizzari PM</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cowan+MJ%22">Cowan MJ</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Paciorek+CJ%22">Paciorek CJ</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Singh+GM%22">Singh GM</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lin+JK%22">Lin JK</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Stevens+GA%22">Stevens GA</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Riley+LM%22">Riley LM</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Ezzati+M%22">Ezzati M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Global+Burden+of+Metabolic+Risk+Factors+of+Chronic+Diseases+Collaborating+Group+%28Cholesterol%29%22">Global Burden of Metabolic Risk Factors of Chronic Diseases Collaborating Group (Cholesterol)</searchLink> (CORPORATE AUTHOR)<br /><searchLink fieldCode="AR" term="%22Farzadfar%2C+Farshad%22">Farzadfar, Farshad</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Finucane%2C+Mariel+M%22">Finucane, Mariel M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Danaei%2C+Goodarz%22">Danaei, Goodarz</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Pelizzari%2C+Pamela+M%22">Pelizzari, Pamela M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cowan%2C+Melanie+J%22">Cowan, Melanie J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Paciorek%2C+Christopher+J%22">Paciorek, Christopher J</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Singh%2C+Gitanjali+M%22">Singh, Gitanjali M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lin%2C+John+K%22">Lin, John K</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Lancet%22">Lancet</searchLink>. 2/12/2011, Vol. 377 Issue 9765, p578-586. 9p.
– Name: Abstract
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  Data: <bold>Background: </bold>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. We estimated worldwide trends in population mean serum total cholesterol.<bold>Methods: </bold>We estimated trends and their uncertainties in mean serum total cholesterol for adults 25 years and older in 199 countries and territories. We obtained data from published and unpublished health examination surveys and epidemiological studies (321 country-years and 3·0 million participants). For each sex, we used a Bayesian hierarchical model to estimate mean total cholesterol by age, country, and year, accounting for whether a study was nationally representative.<bold>Findings: </bold>In 2008, age-standardised mean total cholesterol worldwide was 4·64 mmol/L (95% uncertainty interval 4·51-4·76) for men and 4·76 mmol/L (4·62-4·91) 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 (-0·06 to 0·22, posterior probability=0·86) in men and 0·09 mmol/L per decade (-0·07 to 0·26, posterior probability=0·86) 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 (5·08-5·39) for men and 5·23 mmol/L (5·03-5·43) for women. It was lowest in sub-Saharan Africa at 4·08 mmol/L (3·82-4·34) for men and 4·27 mmol/L (3·99-4·56) for women.<bold>Interpretation: </bold>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.<bold>Funding: </bold>Bill & Melinda Gates Foundation and WHO. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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