Wysoki poziom cholesterolu

Wysoki poziom cholesterolu
Epidemiologia

Hipercholesterolemia stanowi istotny, modyfikowalny czynnik ryzyka chorób sercowo-naczyniowych (CVD), z globalną częstością występowania podwyższonego całkowitego cholesterolu (≥5,0 mmol/l lub ≥190 mg/dl) u dorosłych na poziomie 39% (37% mężczyzn, 40% kobiet). Wysoki poziom cholesterolu LDL odpowiada za około 24% zgonów z powodu CVD, co przekłada się na 4,4 miliona zgonów rocznie globalnie. W USA około 31,7% dorosłych ma podwyższony LDL-C, a tylko 48,1% z nich jest leczonych, co wskazuje na niedostateczną kontrolę tej patologii. Epidemiologia hipercholesterolemii wykazuje zróżnicowanie geograficzne, wiekowe i etniczne, z wyższą częstością u osób w wieku 40-59 lat oraz u kobiet w porównaniu do mężczyzn. Rodzinna hipercholesterolemia (FH) występuje z częstością 1/250 dla postaci heterozygotycznej i 1/300 000 dla homozygotycznej, z poziomami LDL-C odpowiednio 200-450 mg/dl i 450-1000 mg/dl, co wiąże się z wczesnym rozwojem choroby wieńcowej i wysoką śmiertelnością bez leczenia.

Epidemiologia wysokiego poziomu cholesterolu

Globalne rozpowszechnienie hipercholesterolemii
Rozpowszechnienie hipercholesterolemii w Stanach Zjednoczonych
Trendy czasowe w hipercholesterolemii
Hipercholesterolemia rodzinna
Różnice geograficzne, etniczne i płciowe
Związek hipercholesterolemii z wiekiem
Hipercholesterolemia a choroby układu krążenia
Czynniki ryzyka i prewencja
Nadzór i monitorowanie hipercholesterolemii
Wkład badawczy w epidemiologię hipercholesterolemii
Implikacje zdrowotne i znaczenie dla zdrowia publicznego
Kolejne rozdziały

Epidemiologia wysokiego poziomu cholesterolu

Wysoki poziom cholesterolu stanowi jedno z głównych globalnych wyzwań zdrowia publicznego i istotny modyfikowalny czynnik ryzyka chorób sercowo-naczyniowych. Dokładne zrozumienie epidemiologii hipercholesterolemii jest kluczowe dla opracowania skutecznych strategii profilaktycznych i terapeutycznych. Dane epidemiologiczne wskazują na szeroki zakres występowania tego schorzenia w populacjach na całym świecie, z istotnymi różnicami geograficznymi, płciowymi, wiekowymi i etnicznymi.¹²

Globalne rozpowszechnienie hipercholesterolemii

Według danych Światowej Organizacji Zdrowia, w 2008 roku globalna częstość występowania podwyższonego całkowitego cholesterolu wśród osób dorosłych wynosiła 39% (37% u mężczyzn i 40% u kobiet). Definiuje się to jako poziom całkowitego cholesterolu ≥5,0 mmol/l lub ≥190 mg/dl.¹ World Heart Federation informuje, że wysoki poziom cholesterolu powoduje 4,4 miliona zgonów rocznie, co stanowi 7,8% wszystkich zgonów na świecie.¹ Co istotne, około 24% zgonów związanych z chorobami układu sercowo-naczyniowego można przypisać wysokiemu poziomowi cholesterolu LDL.²

Z globalnej perspektywy, około jednej trzeciej przypadków choroby niedokrwiennej serca można przypisać wysokiemu poziomowi cholesterolu. Szacunkowo podwyższony poziom cholesterolu całkowitego powoduje 2,6 miliona zgonów (4,5% wszystkich zgonów) i 29,7 miliona DALY (Disability-Adjusted Life Years – lat życia skorygowanych niepełnosprawnością), co stanowi 2% wszystkich DALY.¹ W 2019 roku liczba DALY z powodu wysokiego cholesterolu nie-HDL osiągnęła 98,6 miliona.¹

Rozpowszechnienie hipercholesterolemii w Stanach Zjednoczonych

W Stanach Zjednoczonych dane z lat 2017-2020 wskazują, że około 10% dorosłych w wieku 20 lat lub starszych miało poziom cholesterolu całkowitego powyżej 240 mg/dl. W tym samym okresie około 17% miało poziom cholesterolu HDL (lipoproteiny wysokiej gęstości, „dobrego” cholesterolu) poniżej 40 mg/dl.¹ Według CDC, około 86 milionów dorosłych Amerykanów w wieku 20 lat lub starszych ma poziom cholesterolu całkowitego powyżej 200 mg/dl, a prawie 25 milionów ma poziom cholesterolu całkowitego powyżej 240 mg/dl.¹

Nowsze dane z okresu sierpień 2021-sierpień 2023 pokazują, że częstość występowania wysokiego poziomu cholesterolu całkowitego wynosiła 11,3% u dorosłych, bez istotnej różnicy między mężczyznami (10,6%) a kobietami (11,9%). Częstość występowania niskiego poziomu cholesterolu HDL u dorosłych wynosiła 13,8% i była wyższa u mężczyzn (21,5%) niż u kobiet (6,6%), przy czym malała wraz z wiekiem.¹

Według Center for Disease Control and Prevention (CDC), 73,5 miliona, czyli 31,7% dorosłych w Stanach Zjednoczonych ma wysoki poziom LDL-C i są oni narażeni na dwukrotnie większe ryzyko chorób serca niż osoby z normalnym poziomem. Tylko 48,1% z nich otrzymuje leczenie w celu obniżenia poziomu LDL-C.¹ Szacuje się, że ponad 50% dorosłych Amerykanów ma podwyższony poziom LDL, a mniej niż 35% tych pacjentów odpowiednio kontroluje swój wysoki poziom LDL, co wyraźnie wskazuje na niedostatecznie leczoną chorobę.¹

Wśród amerykańskich dzieci i młodzieży w wieku 6-19 lat, około 7% ma wysoki poziom cholesterolu całkowitego.¹ W populacji młodzieży w USA częstość występowania hipercholesterolemii zmniejszyła się z 9,2% w latach 2007-2010 do 6,4% w latach 2013-2016.¹

Trendy czasowe w hipercholesterolemii

Obserwuje się zmieniające się trendy w częstości występowania hipercholesterolemii na przestrzeni lat. W Stanach Zjednoczonych częstość występowania wysokiego cholesterolu całkowitego u dorosłych w wieku 20 lat i starszych zmniejszyła się z 18,3% w latach 1999-2000 do 10,5% w latach 2017-2018.¹ Dane NHANES wskazują, że średni poziom LDL-C w populacji USA spada od 1999 roku, z 127,9 mg/dl w latach 1999-2000 do 111,7 mg/dl w latach 2017-2018.¹

Częstość występowania wysokiego cholesterolu całkowitego zmniejszyła się od lat 1999-2000 do 2013-2014, a następnie nie zmieniała się znacząco. Z kolei częstość występowania niskiego poziomu HDL-C zmniejszyła się od lat 2007-2008 do sierpnia 2021-sierpnia 2023.¹ W Wielkiej Brytanii w 2010 roku częstość występowania wysokiego cholesterolu całkowitego wynosiła nieco ponad 13%, spadając z 17% w 2000 roku.¹

Analiza przeprowadzona przez NCD Risk Factor Collaboration, obejmująca 458 badań populacyjnych (obejmujących 23 kraje azjatyckie i zachodnie), wykazała postępujący spadek średniego stosunku cholesterolu całkowitego do HDL od 1980 roku.¹ Prawdopodobnie jest to spowodowane zwiększonym stosowaniem statyn, szczególnie od 1990 roku.¹

Hipercholesterolemia rodzinna

Najnowsze dane sugerują, że klasyczne zaburzenie, hipercholesterolemia rodzinna, ma szacunkową częstość występowania 1/300 000 jako homozygotyczna i 1/250 jako heterozygotyczna. W niektórych populacjach, takich jak Kanadyjczycy francuskiego pochodzenia, Libańczycy i Afrykanerzy, może ona sięgać nawet 1/100.¹ Hipercholesterolemia rodzinna jest jedną z najczęstszych chorób genetycznych, dotykającą 1 na 250 osób jako stan heterozygotyczny i 1 na 300 000 w bardziej ciężkiej postaci homozygotycznej.¹

W Stanach Zjednoczonych częstość występowania hipercholesterolemii rodzinnej nie różni się w zależności od płci, ale różni się wśród grup etnicznych, przy czym najniższa częstość występuje wśród Amerykanów pochodzenia meksykańskiego, a najwyższa wśród białych, czarnych i innych Latynosów.¹

Istnieją dwa typy hipercholesterolemii rodzinnej: homozygotyczna (HoFH) i heterozygotyczna (HeFH). W Stanach Zjednoczonych HeFH jest bardziej powszechna, dotykając około 1 na 500 osób, i jest związana z poziomem LDL-C wynoszącym 200-450 mg/dl. Pacjenci z HeFH często rozwijają chorobę wieńcową przed 60. rokiem życia. HoFH jest rzadsza, dotykając około 1 na 300 000 do 1 000 000 osób, ale jest związana z znacznie wyższym poziomem LDL-C w porównaniu z HeFH (450-1000 mg/dl). Nieleczeni pacjenci z HoFH mogą umrzeć przed ukończeniem 20 lat.¹

Różnice geograficzne, etniczne i płciowe

Stężenia cholesterolu w surowicy różnią się znacznie na całym świecie. Generalnie kraje związane z niskim stężeniem cholesterolu w surowicy (np. Japonia) mają niższe wskaźniki zdarzeń choroby wieńcowej (CHD), podczas gdy kraje związane z bardzo wysokim stężeniem cholesterolu w surowicy (np. Finlandia) mają bardzo wysokie wskaźniki zdarzeń CHD.¹ Średni cholesterol całkowity w Wielkiej Brytanii wynosi 5,9 mmol/l, natomiast na wiejskich obszarach Chin i Japonii średni cholesterol całkowity wynosi 4 mmol/l. Wskaźniki choroby wieńcowej są wysokie w Wielkiej Brytanii, ale niskie na wiejskich obszarach Chin i Japonii.¹

W Stanach Zjednoczonych najwyższy poziom cholesterolu LDL występuje u Latynosów, następnie u Afroamerykanów i białych mężczyzn. Ogólnie podwyższony LDL-C jest częstszy u kobiet (32%) niż u mężczyzn (31%), według danych NHANES (2011-2012).¹ Według danych z badania NHANES (2011-2012), wyższy poziom cholesterolu LDL występował u Latynosów (38,8%) niż u Afroamerykanów (30,7%) i białych mężczyzn (29,4%).²

W USA poziom HDL jest wyższy u kobiet niż u mężczyzn i wyższy u czarnoskórych niż u białych, jak wykazali Ozaki i współpracownicy u pacjentów z ostrymi zespołami wieńcowymi.² Japonia ma najwyższą częstość występowania pierwotnej hiperalfalipoproteinemii, a niedobór CETP został tam po raz pierwszy opisany w 1985 roku.¹

Badanie przeprowadzone przez Mrquez Contreras i wsp. wykazało, że w Hiszpanii hiperalfalipoproteinemia ma ogólny wskaźnik częstości występowania wynoszący 7,8% w populacji ogólnej, przy czym 92% takich przypadków jest spowodowanych chorobą pierwotną (rodzinną), a następnie 7,9% przypadków stanowi choroba wtórna.¹

Związek hipercholesterolemii z wiekiem

U dorosłych hipercholesterolemia wzrasta wraz z wiekiem.³ Częstość występowania wysokiego cholesterolu całkowitego była wyższa u dorosłych w wieku 40-59 lat (16,7%) niż u dorosłych w wieku 20-39 lat (6,0%) i 60 lat i starszych (11,3%).¹ Wśród mieszkańców Utah w wieku 65 lat i starszych, 49,1% zdiagnozowano wysoki poziom cholesterolu, w porównaniu do 7,3% dorosłych w wieku 18-34 lat.¹

W odniesieniu do wieku, badania populacyjne wykazują postępujący spadek hiperalfalipoproteinemii, co pokazuje: wiek 20-29 lat – częstość występowania 15%; wiek 30-39 lat – częstość występowania 8,4%.¹

Całkowity cholesterol jest związany z ryzykiem miażdżycy naczyń (ASCVD) w każdym wieku u mężczyzn i kobiet. Chociaż względne ryzyko ASCVD związane z rosnącym poziomem cholesterolu całkowitego jest najwyższe w średnim wieku, ryzyko bezwzględne jest najwyższe w starszych grupach wiekowych ze względu na ekspozycję przez całe życie na nawet umiarkowanie podwyższony poziom cholesterolu we krwi.¹

Hipercholesterolemia a choroby układu krążenia

Hipercholesterolemia stanowi istotny czynnik ryzyka chorób sercowo-naczyniowych, które są główną przyczyną zgonów na całym świecie. W 2008 roku 30% wszystkich zgonów na świecie przypisano chorobom układu krążenia.¹ Szacuje się, że do 2030 roku ponad 23 miliony osób umrze z powodu chorób układu krążenia każdego roku.¹

Badanie Atherosclerosis Risk in Communities (ARIC) wykazało malejący wpływ hipercholesterolemii jako czynnika przyczyniającego się do ryzyka chorób układu krążenia.¹ Inne badanie oszacowało, że 13% chorób układu krążenia w Stanach Zjednoczonych w latach 2007-2015 można przypisać wysokiemu poziomowi cholesterolu, w porównaniu z 6,9% w Iranie i 20% w Hiszpanii.²

Na całym świecie cholesterol LDL był trzecim najwyższym czynnikiem przyczyniającym się do lat życia skorygowanych niepełnosprawnością związanych z chorobami układu krążenia w 2019 roku, po wysokim ciśnieniu skurczowym krwi i czynnikach dietetycznych, według danych z badania Global Burden of Disease.³ Największą rolę przyczynową odgrywa w chorobie niedokrwiennej serca, przy czym 44% globalnych zgonów z tej przyczyny można przypisać wysokiemu cholesterolowi LDL.⁴

Czynniki ryzyka i prewencja

Na wysoki poziom cholesterolu wpływają modyfikowalne czynniki ryzyka, takie jak zła dieta (spożywanie pokarmów o wysokiej zawartości tłuszczów nasyconych i cholesterolu), nadwaga i otyłość, brak aktywności fizycznej oraz palenie tytoniu.¹

Według analizy America’s Health Rankings, częstość występowania wysokiego cholesterolu jest wyższa wśród:

Mężczyzn niż kobiet
Dorosłych w wieku 65 lat i starszych w porównaniu z dorosłymi w wieku 18-44 lat
Nie-latynoskich białych dorosłych w porównaniu z wielorasowymi i hawajskimi/pacyficznymi dorosłymi
Dorosłych z wykształceniem niższym niż średnie w porównaniu z absolwentami uczelni
Dorosłych z rocznym dochodem gospodarstwa domowego poniżej 25 000 USD w porównaniu z osobami o wyższych poziomach dochodów
Dorosłych mieszkających na obszarach niemetropolitalnych w porównaniu z dorosłymi na obszarach metropolitalnych
Dorosłych, którzy mają trudności z samodzielną opieką i dorosłych, którzy mają trudności z poruszaniem się, w porównaniu z dorosłymi bez niepełnosprawności
Heteroseksualnych dorosłych w porównaniu z dorosłymi LGBQ+
Dorosłych, którzy służyli w siłach zbrojnych USA, w porównaniu z tymi, którzy nie służyli

Wysoki poziom cholesterolu jest idealnym celem dla strategii profilaktyki i kontroli, ponieważ jest modyfikowalnym czynnikiem ryzyka, którym można zarządzać poprzez terapeutyczne zmiany stylu życia i interwencje opieki zdrowotnej, w tym:

Zwiększenie aktywności fizycznej
Rzucenie palenia
Kontrola wagi
Spożywanie zdrowej żywności

Dieta o niskiej zawartości tłuszczów nasyconych została zidentyfikowana przez Wytyczne Dietetyczne 2020-2025 jako jedna z najbardziej skutecznych zmian stylu życia w celu zmniejszenia wysokiego poziomu cholesterolu.¹

Nadzór i monitorowanie hipercholesterolemii

Aby zidentyfikować wysoki poziom cholesterolu, który zwykle nie ma objawów ani symptomów, American Heart Association zaleca dorosłym w wieku 20 lat i starszym kontrolowanie poziomu cholesterolu za pomocą badania krwi co cztery do sześciu lat.² Większość zdrowych dorosłych powinna kontrolować swój cholesterol co 4 do 6 lat. Niektóre osoby, takie jak osoby z chorobami serca, cukrzycą lub historią rodzinną wysokiego cholesterolu, muszą sprawdzać swój cholesterol częściej.¹

Behavioral Risk Factor Surveillance System (BRFSS) jest trwającym badaniem dorosłych na temat zachowań związanych ze zdrowiem, stanów zdrowia i usług profilaktycznych. Dane są zbierane we wszystkich 50 stanach, Dystrykcie Kolumbia i terytoriach USA.¹

Między 1991 a 2003 rokiem częstość występowania badań przesiewowych cholesterolu w ciągu ostatnich pięciu lat i odsetek pacjentów, którym powiedziano, że mają wysoki poziom cholesterolu we krwi (tj. ≥240 mg/dl [6,2 mmol/l]), wzrosły we wszystkich grupach wiekowych, płciowych, rasowych i etnicznych.¹

W 2003 roku najniższą częstość występowania badań przesiewowych cholesterolu stwierdzono wśród Latynosów (65,5%; 95% CI, 64,1 do 67,0) i Azjatów/mieszkańców wysp Pacyfiku (69,6%; 95% CI, 66,9 do 72,4). Ogólnie największy wzrost nastąpił wśród Latynosów. Dane pokazują również, że ogólnie kobiety były bardziej skłonne niż mężczyźni do badania przesiewowego cholesterolu w ciągu ostatnich pięciu lat.¹

Wkład badawczy w epidemiologię hipercholesterolemii

Po II wojnie światowej liczne modele zwierzęce diet o wysokiej zawartości tłuszczów i wysokiej zawartości cholesterolu wykazały inicjację i progresję miażdżycy oraz regresję miażdżycy przy dietach o niskiej zawartości tłuszczów.¹ W badaniu Seven Countries i innych badaniach stwierdzono związek między cholesterolem we krwi a wskaźnikiem zgonów z powodu choroby wieńcowej w różnych krajach.²

Do lat 90. XX wieku ponad 65 kohort na czterech kontynentach opisało wyraźny i spójny związek między poziomem cholesterolu we krwi przez całe życie, liczbą innych czynników ryzyka sercowo-naczyniowego a późniejszym rozwojem choroby wieńcowej i innych ASCVD.³ Wcześniejsze badania epidemiologiczne mierzyły cholesterol całkowity. Późniejsze badania wykazały ten sam silny związek między poziomem cholesterolu lipoprotein o niskiej gęstości (LDL-C) a ryzykiem ASCVD.⁴

Pierwszy opis odwrotnej zależności między cholesterolem HDL a niekorzystnymi zdarzeniami wieńcowymi został udokumentowany w badaniu Framingham, które skorelowało każdy 1% wzrost HDL z 2% spadkiem zdarzeń wieńcowych. Dalsze badania wykazały, że wzrost HDL o 1 mg/dl był związany ze zmniejszeniem zdarzeń sercowo-naczyniowych o 2% u mężczyzn i 3% u kobiet, a także ze zmniejszeniem śmiertelności odpowiednio o 3,7% i 4,7%.²

Badanie przeprowadzone przez Stanforda pokazuje, że używanie genomów zróżnicowanej puli ludzi poprawia zdolność przewidywania ryzyka wysokiego cholesterolu u danej osoby. „Stwierdzamy, że dywersyfikacja badanych populacji, a nie po prostu zwiększanie wielkości próby, jest najbardziej skutecznym podejściem do tworzenia wielogenowych wyników ryzyka, które działają równie dobrze w przewidywaniu wysokiego cholesterolu we wszystkich populacjach”.¹

Implikacje zdrowotne i znaczenie dla zdrowia publicznego

Zbyt wysoki poziom cholesterolu prowadzi do poważnych konsekwencji zdrowotnych. Nieleczony wysoki poziom cholesterolu umożliwia gromadzenie się płytki miażdżycowej w naczyniach krwionośnych, co może prowadzić do zawału serca lub udaru mózgu, ponieważ krew ma trudności z przepływem przez naczynia krwionośne. To pozbawia mózg i serce składników odżywczych i tlenu potrzebnych do funkcjonowania.¹

Choroba sercowo-naczyniowa jest główną przyczyną śmierci Amerykanów.² Szacuje się, że 60% światowego obciążenia chorobami układu krążenia wystąpi w podkontynencie południowoazjatyckim, mimo że stanowi on tylko 20% światowej populacji. Może to być spowodowane kombinacją predyspozycji genetycznych i czynników środowiskowych.²

Chociaż hipercholesterolemia i związana z nią miażdżyca mogą się poprawiać w Stanach Zjednoczonych, trend ten nie jest tak korzystny dla większości reszty świata niezachodniego.² Poziom cholesterolu w krajach rozwijających się ma tendencję do wzrostu, gdy zachodnie nawyki żywieniowe (syndrom McDonald’s) zastępują tradycyjne diety.²

W Kanadzie przeprowadzono badanie mające na celu określenie rozpowszechnienia niekontrolowanego LDL-C u pacjentów z wysokim ryzykiem chorób sercowo-naczyniowych i zbadanie związanych z tym czynników. Całkowita liczba 6 405 pacjentów z wysokim ryzykiem została włączona do badania i z tej populacji 68% miało suboptymalny LDL-C, który był istotnie związany z płcią żeńską (OR: 3,26; 95% CI: 2,63-4,05, p≤0,0001) i brakiem terapii lekowej (OR: 6,31, 95% CI: 5,21-7,65, p≤0,0001).¹ Kobiety z wysokim ryzykiem mają wyższy wskaźnik niekontrolowanego LDL-C (77%) w porównaniu z mężczyznami z wysokim ryzykiem (66%).²

Badanie kohortowe dotyczące cholesterolu i demencji sugeruje, że wysokie poziomy cholesterolu w średnim wieku są związane ze zwiększonym ryzykiem rozwoju demencji i choroby Alzheimera. Badania te sugerują, że wysokie poziomy lipoprotein o niskiej gęstości (LDL) były związane ze zwiększonym ryzykiem rozwoju tych stanów.¹ Cholesterol LDL powinien zostać dodany do listy modyfikowalnych czynników ryzyka demencji.¹

Wysokie stężenie cholesterolu jest idealnym celem dla strategii zapobiegania i kontroli, ponieważ jest modyfikowalnym czynnikiem ryzyka, którym można zarządzać poprzez terapeutyczne zmiany stylu życia i interwencje opieki zdrowotnej. Cele Healthy People 2030 związane z chorobami serca i udarem obejmują: zmniejszenie poziomu cholesterolu u dorosłych oraz zwiększenie leczenia cholesterolu u dorosłych.¹

Badania wykazały, że posiadanie podwyższonego poziomu cholesterolu LDL w młodym wieku zwiększa ryzyko rozwoju chorób serca, a podwyższone ryzyko utrzymuje się nawet u tych, którzy byli w stanie później obniżyć poziom cholesterolu LDL. Uszkodzenie tętnic we wczesnym okresie życia może być nieodwracalne i wydaje się być kumulatywne.¹ Chociaż środowisko medyczne rozumie znaczenie zarządzania wysokim poziomem cholesterolu LDL w celu obniżenia ryzyka sercowego, istnieje niewielki konsensus co do tego, jak agresywnie interweniować u młodych dorosłych, którzy mogą nie doświadczyć zawału serca lub udaru przez dziesięciolecia.¹

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Materiały źródłowe

#1 Hyperlipidemia – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK559182/
There are over three million adults throughout the United States and Europe that currently have a diagnosis of hyperlipidemia, and that number continues to rise at a drastic pace. Hyperlipidemia is typically a chronic, progressive disease process that demands lifestyle and dietary changes, with the potential need for additional lipid-lowering medications. The degree of hyperlipidemia is highest in patients with premature coronary artery disease (CAD), defined as CAD arising in males before age 55 to 60 years and females before age 65 years. Under the prior specified circumstances, the incidence of hyperlipidemia is around 75-85%, opposed to roughly 40 to 48% in the control population of comparable age, but without the presence of premature coronary artery disease. […] Estimates are that over 50% of American adults have elevated LDL levels, and it is speculated that under 35% of those patients adequately manage their high LDL levels, clearly depicting an undertreated disease. […] Intuitively, in countries with lower overall rates of obesity and saturated fat consumption, the prevalence of hyperlipidemia and subsequent coronary artery disease is lower, when contrasted to rates in Europe and throughout the United States.
#1
https://www.who.int/data/gho/indicator-metadata-registry/imr-details/3236
Raised cholesterol levels increase the risks of heart disease and stroke. Globally, a third of ischaemic heart disease is attributable to high cholesterol. Overall, raised cholesterol is estimated to cause 2.6 million deaths (4.5% of total) and 29.7 million DALYS, or 2% of total DALYS. Raised total cholesterol is a major cause of disease burden in both the developed and developing world as a risk factor for ischemic heart disease and stroke. In 2008, the global prevalence of raised total cholesterol among adults was 39% (37% for males and 40% for females). […] Definition: Age-standardized prevalence of raised total cholesterol among persons aged 18+ years (defined as total cholesterol 5.0 mmol/l or 190mg/dl).
#1 Cholesterol | What We Do | World Heart Federation
https://world-heart-federation.org/what-we-do/cholesterol/
High cholesterol causes 3.6 million deaths every year. […] High cholesterol causes 4.4 million deaths every year, or 7.8% of all deaths. […] 24% of CVD-related deaths are attributable to high LDL cholesterol. […] In 2008, 39% of adults around the world had high total cholesterol. […] High blood cholesterol is one of the major controllable risk factors for heart disease, heart attack and stroke. […] High cholesterol can be inherited, but its often the result of unhealthy lifestyle choices, such as inactivity, smoking and an unhealthy diet. […] High cholesterol is also in itself a risk factor for serious health conditions. If left untreated, it can lead to atherosclerosis. This, in turn, may lead to heart disease, stroke, and other vascular diseases. The higher the LDL, the higher the risk.
#1 Cholesterol | What We Do | World Heart Federation
https://world-heart-federation.org/what-we-do/cholesterol/
Globally, raised total cholesterol affects approximately 39% of adults. In 2019, the number of DALYs (disability-adjusted life years) due to high non-HDL cholesterol reached 98.6 million. It also caused an estimated 4.4 million deaths. […] According to the Global Burden of Disease Study, approximately 4.4 million deaths were attributable to elevated LDL cholesterol in 2019. […] The updated World Heart Federation Roadmap for Cholesterol delves into the epidemiology, diagnosis, treatment, and policies for better outcomes and highlights implementation case studies.
#1 High Cholesterol Facts | Cholesterol | CDC
https://www.cdc.gov/cholesterol/data-research/facts-stats/index.html
High total cholesterol is 240 mg/dL or more. High cholesterol has no symptoms, so many people dont know that their cholesterol is too high. A simple blood test can check cholesterol levels. […] Between 2017 and 2020, 10% of adults age 20 or older had total cholesterol levels above 240 mg/dL. About 17% had high-density lipoprotein (HDL, or „good”) cholesterol levels below 40 mg/dL. […] About 86 million US adults age 20 or older have total cholesterol levels above 200 mg/dL. Nearly 25 million adults in the United States have total cholesterol levels above 240 mg/dL. […] About 7% of US children and adolescents ages 6 to 19 have high total cholesterol. […] The chart below shows the prevalence of high total cholesterol (240 mg/dL or more) among adults age 20 and older in the United States from 2017 to 2020.
#1 Products – Data Briefs – Number 515 – November 2024
https://www.cdc.gov/nchs/products/databriefs/db515.htm
During August 2021August 2023, the prevalence of high total cholesterol was 11.3% in adults, with no significant difference between men (10.6%) and women (11.9%). […] The prevalence of low high-density lipoprotein cholesterol (HDL-C) for adults was 13.8%, was higher in men (21.5%) than women (6.6%), and declined with increasing age. […] High total cholesterol prevalence declined from 19992000 to 20132014 and then did not change significantly. Low HDL-C prevalence declined from 20072008 to August 2021August 2023. […] The prevalence of high total cholesterol was higher in adults ages 4059 (16.7%) than in adults ages 2039 (6.0%) and 60 and older (11.3%). […] The prevalence of low HDL-C was 13.8% in adults and was higher in men (21.5%) than in women (6.6%), overall and within each age group. […] The prevalence of high total cholesterol declined from 19992000 to 20132014 and then did not change significantly. The prevalence of low HDL-C declined from 20072008 to August 2021August 2023.
#1 Hypercholesterolemia – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK459188/
According to the Center for Disease Control and Prevention (CDC), 73.5 million or 31.7% of adults in the United States have high levels of LDL-C and are at twice the risk for heart disease than people with normal levels. Only 48.1% are receiving treatment to lower LDL-C levels. Recent data suggests that the classic disorder, familial hypercholesterolemia has a prevalence of estimate of 1/300,000 as homozygous and 1/250 as a heterozygote. In certain populations such as the French Canadians, Lebanese, and Afrikaners it could be as high as 1/100. […] In the US, the highest level of LDL cholesterol occurs in Hispanic males, followed by African Americans and white males. Overall, elevated LDL-C is more common in females than in males.
#1 The Shifting Epidemiology of Hypercholesterolemia | MedPage Today
https://www.medpagetoday.com/medical-journeys/hypercholesterolemia/110599
The epidemiology of hypercholesterolemia has been shifting in recent years. […] While that is nowhere near the case, hypercholesterolemia as a contributor has shown improvement in recent years as measured in U.S. population-level prevalence in the U.S. National Health and Nutrition Examination Survey (NHANES). […] The prevalence of hypercholesterolemia in U.S. youth declined from 9.2% in 2007-2010 to 6.4% in 2013-2016. For U.S. adults age 20 and older, the prevalence of high total cholesterol declined from 18.3% in 1999-2000 to 10.5% in 2017-2018. […] Familial hypercholesterolemia, one of the most common genetic diseases, affects 1 in 250 individuals as a heterozygous condition and 1 in 300,000 in its more severe homozygous form. […] While hypercholesterolemia and consequent atherosclerosis might be improving in the United States, the trend is not so rosy for much of the rest of the non-Western world.
#1 Polygenic Hypercholesterolemia: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/121424-overview
Based on data from the 2009-2012 National Health and Nutrition Examination Survey (NHANES), an estimated 73.5 million (31.7%) US adults aged 20 years or older has high LDL-C (130 mg/dL), but only 48.1% are treated and 29.5% have their LDL-C controlled. A person with high LDL-C is defined as either a person whose LDL-C levels were above the LDL-C goal levels or a person who reported currently taking cholesterol-lowering medication. The proportion of adults with high LDL-C who are treated increased from 28.4% to 48.1% between the 1999-2002 and 2005-2008 study periods. Among adults with high LDL-C, the prevalence of LDL-C control increased from 14.6% to 33.2% between the periods. […] In the overall US population, NHANES data show that the mean LDL-C level has been declining since 1999, from 127.9 mg/dL in 1999-2000 to 111.7 mg/dL in 2017-2018.
#1 Hypercholesterolemia – Wikipedia
https://en.wikipedia.org/wiki/Hypercholesterolemia
Rates of high total cholesterol in the United States in 2010 are just over 13%, down from 17% in 2000. […] Average total cholesterol in the United Kingdom is 5.9 mmol/L, while in rural China and Japan, average total cholesterol is 4 mmol/L. […] Rates of coronary artery disease are high in Great Britain, but low in rural China and Japan.
#1 High HDL Cholesterol (Hyperalphalipoproteinemia): Practice Essentials, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/121187-overview
Currently, there are not enough data to provide an estimate of the prevalence of hyperalphalipoproteinemia in the United States. […] A study by Mrquez Contreras et al noted that in Spain, hyperalphalipoproteinemia has an overall prevalence rate of 7.8% in the general population, with 92% of such cases being due to primary (familial) disease, followed by a further 7.9% of cases constituting secondary disease. […] A pooled analysis from the NCD Risk Factor Collaboration incorporating 458 population-based studies (covering 23 Asian and Western countries) noted a progressive decline in the mean ratio of total-to-HDL cholesterol since 1980. […] Japan harbors the highest prevalence of primary hyperalphalipoproteinemia, and CETP deficiency was first described there in 1985. […] In the United States, HDL levels are higher in women than in men, and are higher in Blacks than in Whites, as demonstrated by Ozaki and colleagues in patients with acute coronary syndromes.
#1 The Shifting Epidemiology of Hypercholesterolemia | MedPage Today
https://www.medpagetoday.com/medical-journeys/hypercholesterolemia/110599
Another review showed a constant reduction in non-HDL cholesterol in the last four decades in high-income countries, „especially starting from 1990, likely due to an increase in the use of statins.” […] The Atherosclerosis Risk in Communities (ARIC) study showed the declining influence of hypercholesterolemia as a contributor to cardiovascular disease risk. […] Another study estimated that 13% of cardiovascular disease in the United States in 2007-2015 was attributable to high cholesterol, compared with 6.9% in Iran and 20% in Spain. […] Worldwide, LDL cholesterol was the third highest contributor to years of disability-adjusted life years related to cardiovascular disease in 2019, after high systolic blood pressure and dietary risks, according to the Global Burden of Disease study data. […] The biggest causal role is in ischemic heart disease, with 44% of global deaths from that cause attributable to high LDL cholesterol, according to one review.
#1 Epidemiology and Management of Hyperlipidemia
https://www.ajmc.com/view/epidemiology-and-management-of-hyperlipidemia-article
In the United States, more than 100 million, or roughly 53% of adults, have elevated LDL-C levels. Yet, fewer than 50% of patients with high LDL-C receive treatment to reduce their levels, and among those receiving treatment, fewer than 35% achieve adequate control. Further, approximately 31 million American adults have total cholesterol levels that exceed 240 mg/dL, placing them at about twice the risk of ASCVD compared to those with total cholesterol levels that are at goal. […] Genetics can also play a role in the development of elevated cholesterol in the form of FH. FH is an autosomal dominant trait characterized by significant elevations in total cholesterol and LDL-C from birth and premature ASCVD. […] A recent analysis by the National Health and Nutrition Examination Survey (NHANES) noted that although the prevalence of FH did not differ based on gender, the prevalence of FH did vary among ethnic groups, with the lowest prevalence among Mexican Americans and the highest prevalence among whites, blacks, and other Hispanics.
#1 Epidemiology and Management of Hyperlipidemia
https://www.ajmc.com/view/epidemiology-and-management-of-hyperlipidemia-article
There are 2 types of FH: homozygous (HoFH) and heterozygous FH (HeFH). In the United States, HeFH is more common, affecting approximately 1 in 500 people, and is associated with LDL-C levels of 200 to 450 mg/dL. Patients with HeFH often develop coronary artery disease before the age of 60 years. HoFH is rarer, affecting roughly 1 in 300,000 to 1,000,000 people, but is associated with much higher LDL-C levels compared with HeFH (450 to 1000 mg/dL). If left untreated, patients with HoFH may die before the age of 20 years. […] High-intensity statin therapy is recommended in patients with FH by the ACC/AHA as well as by the Canadian Cardiovascular Society (CCS) and the European Atherosclerosis Society (EAS). Moderate-intensity therapy is recommended in patients who cannot tolerate high-intensity treatment. All guidelines for the treatment of FH recommend initiating treatment as soon as possible. In addition to statins, ezetimibe and PCSK9 inhibitors are recommended in patients who have an insufficient response to statins.
#1 Polygenic Hypercholesterolemia: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/121424-overview
Serum cholesterol concentrations vary widely throughout the world. Generally, countries associated with low serum cholesterol concentrations (eg, Japan) have lower CHD event rates, whereas countries associated with very high serum cholesterol concentrations (eg, Finland) have very high CHD event rates. However, some populations with similar total cholesterol levels have very different CHD event rates, as would be expected given that other risk factors (eg, prevalence of smoking or diabetes mellitus) also influence CHD risk. The cholesterol levels in developing countries tend to increase as western dietary habits (McDonald’s syndrome) replace traditional diets. […] Among adults, NHANES data (2011-2012) showed higher LDL cholesterol level among Hispanic males (38.8%), than non-Hispanic Black males (30.7%) and than non-Hispanic White males (29.4%) […] Elevated LDL-C is more common in females (32%) than in males (31%), based on NHANES data (2011-2012). […] In adults, hypercholesterolemia increases with advancing age.
#1
https://ibis.utah.gov/ibisph-view/indicator/view/BloCholDrDiag.Age_Sex.html
High blood cholesterol is a major risk factor for heart disease and stroke. It is preventable. If identified early, it can be controlled with medication and lifestyle changes, such as eating a diet low in saturated fat and cholesterol, increasing physical activity, and reducing excess weight. […] Because high blood cholesterol does not produce obvious symptoms, experts recommend that all adults aged 20 years and older have their cholesterol levels checked at least once every five years to help them take action to prevent or lower their risk of cardiovascular disease. […] In 2021, the age-adjusted percentage of Utah adults who reported being told they had high cholesterol was 25.4% (approximately 1 in 4 adults). In 2021 doctor-diagnosed high cholesterol was different by gender (23.7% for females and 27.0% for males). High cholesterol prevalence increased with age. Among Utahns aged 65 and over, 49.1% were diagnosed with high cholesterol, compared to 7.3% of adults aged 18 to 34.
#1 High HDL Cholesterol (Hyperalphalipoproteinemia): Practice Essentials, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/121187-overview
Concerning age, population surveys demonstrate a progressive decline in hyperalphalipoproteinemia, as demonstrated by the following: Ages 20-29 years – Prevalence rate of 15%; Ages 30-39 years – Prevalence rate of 8.4%. […] As reported by the National Cholesterol Education Program Adult Treatment Panel III, an HDL cholesterol level below 40 mg/dL is an independent risk factor for coronary heart disease. […] The first description of an inverse relationship between HDL cholesterol and adverse coronary events was documented in the Framingham study, which correlated each 1% increase in HDL with a 2% decline in coronary events. […] Further studies demonstrated that a 1 mg/dL increase in HDL was associated with a reduction in cardiovascular events of 2% in men and 3% in women, alongside mortality reductions of 3.7% and 4.7%, respectively.
#1
https://www.healio.com/clinical-guidance/lipid-management/epidemiology-of-cholesterol-and-cardiovascular-disease
Total cholesterol is associated with ASCVD risk at every age in men and women. […] While the relative risk of ASCVD associated with increasing total cholesterol levels is highest in middle age, the absolute risk is highest in older age groups due to the lifetime exposure to even modestly elevated blood cholesterol levels.
#1 Cardiovascular disease – Wikipedia
https://en.wikipedia.org/wiki/Cardiovascular_disease
Cardiovascular diseases are the leading cause of death worldwide and in all regions except Africa. In 2008, 30% of all global death was attributed to cardiovascular diseases. Death caused by cardiovascular diseases are also higher in low- and middle-income countries as over 80% of all global deaths caused by cardiovascular diseases occurred in those countries. It is also estimated that by 2030, over 23 million people will die from cardiovascular diseases each year. […] It is estimated that 60% of the world’s cardiovascular disease burden will occur in the South Asian subcontinent despite only accounting for 20% of the world’s population. This may be secondary to a combination of genetic predisposition and environmental factors.
#1 Explore High Cholesterol in the United States | AHR
https://www.americashealthrankings.org/explore/measures/High_Chol
36.9% […] Percentage of adults who reported having their cholesterol checked and being told by a health professional that it was high […] High cholesterol is a major and modifiable risk factor for heart disease and stroke, the leading and fifth-leading causes of death in the United States, respectively. Excess low-density lipoprotein cholesterol (also known as LDL or bad cholesterol) creates a plaque that narrows arteries and reduces oxygen-rich blood flow. […] An estimated 24.7 million U.S. adults have high total cholesterol (240 mg/dL). […] High cholesterol is influenced by modifiable risk factors like poor diet (eating foods high in saturated fat and cholesterol), overweight and obesity, physical inactivity and smoking. […] According to Americas Health Rankings analysis, the prevalence of high cholesterol is higher among: Men than women. Adults age 65 and older compared with adults ages 18-44. Non-Hispanic white adults compared with multiracial and Hawaiian/Pacific Islander adults. Adults with less than a high school education compared with college graduates. Adults with an annual household income less than $25,000 compared with those with higher income levels. Adults living in nonmetropolitan areas compared with adults in metropolitan areas. Adults who have difficulty with self-care and adults who have difficulty with mobility compared with adults without a disability. Straight adults compared with lesbian, gay, bisexual and queer (LGBQ+) adults. Adults who have served in the U.S. armed forces compared with those who have not served.
#1 Explore High Cholesterol in the United States | AHR
https://www.americashealthrankings.org/explore/measures/High_Chol
High cholesterol is an ideal target for prevention and control strategies because it is a modifiable risk factor that can be managed through therapeutic lifestyle changes and health care interventions, including: Increasing physical activity. Quitting smoking. Managing weight. Eating healthy foods. A diet low in saturated fats has been identified by the 2020-2025 Dietary Guidelines as one of the most effective lifestyle changes to decrease high cholesterol. […] To identify high cholesterol, which usually has no signs or symptoms, the American Heart Association recommends adults age 20 and older have their cholesterol checked with a blood test every four to six years. […] Healthy People 2030 has many objectives related to heart disease and stroke, including: Reducing cholesterol levels in adults. Increasing cholesterol treatment in adults.
#1 High Cholesterol Facts | Cholesterol | CDC
https://www.cdc.gov/cholesterol/data-research/facts-stats/index.html
Most healthy adults should have their cholesterol checked every 4 to 6 years. Some people, such as those who have heart disease, diabetes, or a family history of high cholesterol, need to get their cholesterol checked more often. […] Too much cholesterol puts you at risk for heart disease and stroke, two leading causes of death in the United States.
#1 Prevalence of Diagnosed High Cholesterol among Adults by Year, New Mexico and U.S., Odd Years, 2005 to 2017
https://ibis.doh.nm.gov/indicator/view/CardioVasDiseaseHighChol.Year.html
High cholesterol is a risk factor for cardiovascular disease (i.e., heart attack, heart failure, or stroke). […] Estimated percentage of New Mexican adults (ages 18 and over) who have ever been told by a doctor, nurse or other health professional that they have high cholesterol. […] The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing survey of adults about health-related behaviors, health conditions, and preventive services. Data are collected in all 50 states, D.C., and U.S. territories. […] Beginning with 2011, the BRFSS updated its surveillance methods by adding in calls to cell phones and changing its weighting methods.
#1 CDC Reports on Trends in Cholesterol Screening and Awareness | AAFP
https://www.aafp.org/pubs/afp/issues/2006/0401/p1284a.html
The Centers for Disease Control and Prevention (CDC) has published a report on the prevalence of cholesterol screening and awareness using data from the Behavioral Risk Factor Surveillance System. […] Between 1991 and 2003, the prevalence of cholesterol screening in the preceding five years and the percentage of patients who were told that they had high blood cholesterol levels (i.e., 240 mg per dL [6.2 mmol per L] or greater) increased among all age, sex, racial, and ethnic groups. […] In 2003, the prevalence of cholesterol screenings was found to be lowest among Hispanics (65.5 percent; 95% CI, 64.1 to 67.0) and Asians/Pacific islanders (69.6 percent; 95% CI, 66.9 to 72.4). […] Overall, the greatest increase occurred in Hispanics. The data also show that, overall, women were more likely than men to have a cholesterol screening within the preceding five years.
#1
https://www.healio.com/clinical-guidance/lipid-management/epidemiology-of-cholesterol-and-cardiovascular-disease
Humans appear predisposed to atherosclerosis. Cholesterol was implicated in the pathogenesis of atherosclerosis over 150 years ago. […] Following World War II, numerous animal models of high-fat and high-cholesterol diets demonstrated atherosclerosis initiation and progression and regression of atherosclerosis with low-fat diets. […] An association between blood cholesterol and the rate of coronary death was found across countries in the Seven Countries and other studies. […] Through the 1990s, more than 65 cohorts on four continents have reported a clear and consistent relationship between lifetime blood cholesterol levels, the number of other CV risk factors and the subsequent development of CAD and other ASCVD. […] Earlier epidemiologic studies measured total cholesterol. Later studies have found the same robust relationship between low-density lipoprotein cholesterol (LDL-C) levels and ASCVD risk.
#1 Diversity in genetic research key to predicting risk of high cholesterol | News Center
https://med.stanford.edu/news/all-news/2021/12/ancestral-diversity-genetic-research.html
A Stanford study shows that using genomes from a diverse pool of people improves the ability to predict an individual’s risk of having high cholesterol. […] Including data from people of diverse ancestries substantially improves certain genetic risk predictions in all populations, according to a study that examined the genes responsible for regulating blood cholesterol levels. […] „We find that diversifying the populations under study, rather than simply increasing sample size, is the most effective approach to creating polygenic risk scores that work equally well in predicting high cholesterol in all populations,” said Assimes, who is also a co-director of VA Palo Alto Epidemiology and Informatics Center for Genomics. […] The study, which examined the genetic variants associated with cholesterol levels for more than 1.65 million people, also showed that by including population samples from a wide variety of ancestry groups, the critical gene variants involved with bad cholesterol were found more quickly.
#1 Hyperlipidemia (High Cholesterol): Levels, Causes, Symptoms & Diagnosis
https://my.clevelandclinic.org/health/diseases/21656-hyperlipidemia
Hyperlipidemia is very common. Ninety-three million American adults (age 20 and older) have a total cholesterol count above the recommended limit of 200 mg/dL. […] Hyperlipidemia can be very serious if its not managed. As long as high cholesterol is untreated, youre letting plaque accumulate inside of your blood vessels. This can lead to a heart attack or stroke because your blood has a hard time getting through your blood vessels. This deprives your brain and heart of the nutrients and oxygen they need to function. […] Cardiovascular disease is the leading cause of death in Americans. […] If you have hyperlipidemia, youll need to keep using healthy lifestyle habits for years to come. Youll also need to keep follow-up appointments with your provider and continue to take your medicine. If you and your provider are able to manage your cholesterol level, you may not have serious health problems as a result of it. […] Although high cholesterol puts you at risk for heart attacks and stroke, you can protect yourself by living a healthier lifestyle and taking medicine if needed.
#1 Low density lipoprotein cholesterol control status among Canadians at risk for cardiovascular disease: findings from the Canadian Primary Care Sentinel Surveillance Network Database | Lipids in Health and Disease | Full Text
https://lipidworld.biomedcentral.com/articles/10.1186/s12944-015-0056-8
To determine the prevalence of uncontrolled LDL-C in patients with high cardiovascular disease (CVD) risks across Canada and to examine its related factors. […] A total of 6,405 high-risk patients were included in the study and, of this population, 68 % had a suboptimal LDL-C, which was significantly associated with the female gender (OR: 3.26; 95 % CI: 2.634.05, p0.0001) and no medication therapy (OR: 6.31, 95 % CI: 5.217.65, p0.0001). […] A high proportion of high-cardiac risk patients in Canadian primary care settings have suboptimal LDL-C control. A lack of medication therapy appears to be the major contributing factor to this situation. […] The prevalence of those with uncontrolled LDL-C was 68 % and 29 % were determined to be in need of secondary prevention. […] High-risk females have a higher rate of uncontrolled LDL-C (77 %) compared to high-risk males with 66 %.
#1 Cholesterol and risk of dementia | OXON Epidemiology
https://oxonepi.com/cholesterol-and-risk-of-dementia
Cholesterol-dementia cohort study suggests that high levels of cholesterol in middle-age are associated with an increased risk of developing dementia and Alzheimers disease. […] This research suggests that high levels of low-density lipoprotein (LDL) were linked to an increased risk of developing the conditions. […] While elevated levels of total cholesterol were also associated with an increased risk, this link was weaker, suggesting it is largely driven by LDL cholesterol. […] The strength of this association is comparable with other modifiable risk factors such as alcohol consumption and greater than for blood pressure. […] This large study adds to our understanding of how our lifestyle can impact our risk of developing these diseases in later life, and to help inform potential preventative therapies to reduce this risk.
#1 Cholesterol and risk of dementia | OXON Epidemiology
https://oxonepi.com/cholesterol-and-risk-of-dementia
This large and robust study, funded by Alzheimers Society, adds weight to the evidence there is a connection between high levels of particular types of cholesterol and the risk of developing dementia. […] Establishing modifiable risk factors of dementia risk is a global priority. […] LDL cholesterol should be added to the list of modifiable risk factors for dementia.
#1 Explore High Cholesterol in Georgia | AHR
https://www.americashealthrankings.org/explore/measures/High_Chol/GA
Georgia Value: 36.9% […] Percentage of adults who reported having their cholesterol checked and being told by a health professional that it was high […] High cholesterol is a major and modifiable risk factor for heart disease and stroke, the leading and fifth-leading causes of death in the United States, respectively. […] An estimated 24.7 million U.S. adults have high total cholesterol (240 mg/dL). […] High cholesterol is influenced by modifiable risk factors like poor diet (eating foods high in saturated fat and cholesterol), overweight and obesity, physical inactivity and smoking. […] According to Americas Health Rankings analysis, the prevalence of high cholesterol is higher among: Men than women. […] High cholesterol is an ideal target for prevention and control strategies because it is a modifiable risk factor that can be managed through therapeutic lifestyle changes and health care interventions. […] Healthy People 2030 has many objectives related to heart disease and stroke, including: Reducing cholesterol levels in adults. […] Increasing cholesterol treatment in adults.
#1 2020 Archive – Having High Cholesterol Levels Early in Life Leads to Heart Problems by Middle Age, UM School of Medicine Study Finds | University of Maryland School of Medicine
https://www.medschool.umaryland.edu/news/2020/having-high-cholesterol-levels-early-in-life-leads-to-heart-problems-by-middle-age-um-school-of-medicine-study-finds.html
Having elevated cholesterol during the teens or early twenties increases a persons risk of having a heart attack, stroke or other cardiovascular event during middle age. […] This increased risk persists even in those who were able to get their cholesterol levels down to a healthy level before reaching their late thirties. […] We found having an elevated LDL cholesterol level at a young age raises the risk of developing heart disease, and the elevated risk persists even in those who were able to later lower their LDL cholesterol levels said study leader Michael Domanski, MD, a Professor of Medicine at UMSOM. […] Damage to the arteries done early in life may be irreversible and appears to be cumulative, Dr. Domanski said. […] Interestingly and importantly, we also found it was not just the area under the curve that accounted for the difference in risk but also the time course of the exposure, study co-author Charles Hong, MD, PhD, the Melvin Sharoky, MD, Professor in Medicine at UMSOM.
#1 2020 Archive – Having High Cholesterol Levels Early in Life Leads to Heart Problems by Middle Age, UM School of Medicine Study Finds | University of Maryland School of Medicine
https://www.medschool.umaryland.edu/news/2020/having-high-cholesterol-levels-early-in-life-leads-to-heart-problems-by-middle-age-um-school-of-medicine-study-finds.html
While the medical establishment understands the importance of managing high LDL cholesterol levels to lower heart risks, there is little consensus on how aggressively to intervene in young adults who may not experience a heart attack or stroke for decades. […] The American College of Cardiologys current cholesterol management guidelines recommends using lifestyle measures to lower high LDL levels during the teenage years. […] The guidelines recommend that doctors consider prescribing cholesterol-lowering medications like statins to prevent heart disease in those ages 20 to 39 who have elevated cholesterol levels, especially if they have a family history of early-onset heart disease. […] Cardiovascular disease remains the biggest killer in the world, and this new finding provides a potential way to save many lives, said E. Albert Reece, MD, PhD, MBA, Executive Vice President for Medical Affairs, UM Baltimore, and the John Z. and Akiko K. Bowers Distinguished Professor and Dean, University of Maryland School of Medicine.
#2 Hypercholesterolemia – StatPearls – NCBI Bookshelf
https://www.ncbi.nlm.nih.gov/books/NBK459188/
According to the Center for Disease Control and Prevention (CDC), 73.5 million or 31.7% of adults in the United States have high levels of LDL-C and are at twice the risk for heart disease than people with normal levels. Only 48.1% are receiving treatment to lower LDL-C levels. Recent data suggests that the classic disorder, familial hypercholesterolemia has a prevalence of estimate of 1/300,000 as homozygous and 1/250 as a heterozygote. In certain populations such as the French Canadians, Lebanese, and Afrikaners it could be as high as 1/100. […] In the US, the highest level of LDL cholesterol occurs in Hispanic males, followed by African Americans and white males. Overall, elevated LDL-C is more common in females than in males.
#2 Cholesterol | What We Do | World Heart Federation
https://world-heart-federation.org/what-we-do/cholesterol/
High cholesterol causes 3.6 million deaths every year. […] High cholesterol causes 4.4 million deaths every year, or 7.8% of all deaths. […] 24% of CVD-related deaths are attributable to high LDL cholesterol. […] In 2008, 39% of adults around the world had high total cholesterol. […] High blood cholesterol is one of the major controllable risk factors for heart disease, heart attack and stroke. […] High cholesterol can be inherited, but its often the result of unhealthy lifestyle choices, such as inactivity, smoking and an unhealthy diet. […] High cholesterol is also in itself a risk factor for serious health conditions. If left untreated, it can lead to atherosclerosis. This, in turn, may lead to heart disease, stroke, and other vascular diseases. The higher the LDL, the higher the risk.
#2 Polygenic Hypercholesterolemia: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/121424-overview
Serum cholesterol concentrations vary widely throughout the world. Generally, countries associated with low serum cholesterol concentrations (eg, Japan) have lower CHD event rates, whereas countries associated with very high serum cholesterol concentrations (eg, Finland) have very high CHD event rates. However, some populations with similar total cholesterol levels have very different CHD event rates, as would be expected given that other risk factors (eg, prevalence of smoking or diabetes mellitus) also influence CHD risk. The cholesterol levels in developing countries tend to increase as western dietary habits (McDonald’s syndrome) replace traditional diets. […] Among adults, NHANES data (2011-2012) showed higher LDL cholesterol level among Hispanic males (38.8%), than non-Hispanic Black males (30.7%) and than non-Hispanic White males (29.4%) […] Elevated LDL-C is more common in females (32%) than in males (31%), based on NHANES data (2011-2012). […] In adults, hypercholesterolemia increases with advancing age.
#2 High HDL Cholesterol (Hyperalphalipoproteinemia): Practice Essentials, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/121187-overview
Currently, there are not enough data to provide an estimate of the prevalence of hyperalphalipoproteinemia in the United States. […] A study by Mrquez Contreras et al noted that in Spain, hyperalphalipoproteinemia has an overall prevalence rate of 7.8% in the general population, with 92% of such cases being due to primary (familial) disease, followed by a further 7.9% of cases constituting secondary disease. […] A pooled analysis from the NCD Risk Factor Collaboration incorporating 458 population-based studies (covering 23 Asian and Western countries) noted a progressive decline in the mean ratio of total-to-HDL cholesterol since 1980. […] Japan harbors the highest prevalence of primary hyperalphalipoproteinemia, and CETP deficiency was first described there in 1985. […] In the United States, HDL levels are higher in women than in men, and are higher in Blacks than in Whites, as demonstrated by Ozaki and colleagues in patients with acute coronary syndromes.
#2 The Shifting Epidemiology of Hypercholesterolemia | MedPage Today
https://www.medpagetoday.com/medical-journeys/hypercholesterolemia/110599
Another review showed a constant reduction in non-HDL cholesterol in the last four decades in high-income countries, „especially starting from 1990, likely due to an increase in the use of statins.” […] The Atherosclerosis Risk in Communities (ARIC) study showed the declining influence of hypercholesterolemia as a contributor to cardiovascular disease risk. […] Another study estimated that 13% of cardiovascular disease in the United States in 2007-2015 was attributable to high cholesterol, compared with 6.9% in Iran and 20% in Spain. […] Worldwide, LDL cholesterol was the third highest contributor to years of disability-adjusted life years related to cardiovascular disease in 2019, after high systolic blood pressure and dietary risks, according to the Global Burden of Disease study data. […] The biggest causal role is in ischemic heart disease, with 44% of global deaths from that cause attributable to high LDL cholesterol, according to one review.
#2 Explore High Cholesterol in the United States | AHR
https://www.americashealthrankings.org/explore/measures/High_Chol
High cholesterol is an ideal target for prevention and control strategies because it is a modifiable risk factor that can be managed through therapeutic lifestyle changes and health care interventions, including: Increasing physical activity. Quitting smoking. Managing weight. Eating healthy foods. A diet low in saturated fats has been identified by the 2020-2025 Dietary Guidelines as one of the most effective lifestyle changes to decrease high cholesterol. […] To identify high cholesterol, which usually has no signs or symptoms, the American Heart Association recommends adults age 20 and older have their cholesterol checked with a blood test every four to six years. […] Healthy People 2030 has many objectives related to heart disease and stroke, including: Reducing cholesterol levels in adults. Increasing cholesterol treatment in adults.
#2
https://www.healio.com/clinical-guidance/lipid-management/epidemiology-of-cholesterol-and-cardiovascular-disease
Humans appear predisposed to atherosclerosis. Cholesterol was implicated in the pathogenesis of atherosclerosis over 150 years ago. […] Following World War II, numerous animal models of high-fat and high-cholesterol diets demonstrated atherosclerosis initiation and progression and regression of atherosclerosis with low-fat diets. […] An association between blood cholesterol and the rate of coronary death was found across countries in the Seven Countries and other studies. […] Through the 1990s, more than 65 cohorts on four continents have reported a clear and consistent relationship between lifetime blood cholesterol levels, the number of other CV risk factors and the subsequent development of CAD and other ASCVD. […] Earlier epidemiologic studies measured total cholesterol. Later studies have found the same robust relationship between low-density lipoprotein cholesterol (LDL-C) levels and ASCVD risk.
#2 High HDL Cholesterol (Hyperalphalipoproteinemia): Practice Essentials, Pathophysiology, Epidemiology
https://emedicine.medscape.com/article/121187-overview
Concerning age, population surveys demonstrate a progressive decline in hyperalphalipoproteinemia, as demonstrated by the following: Ages 20-29 years – Prevalence rate of 15%; Ages 30-39 years – Prevalence rate of 8.4%. […] As reported by the National Cholesterol Education Program Adult Treatment Panel III, an HDL cholesterol level below 40 mg/dL is an independent risk factor for coronary heart disease. […] The first description of an inverse relationship between HDL cholesterol and adverse coronary events was documented in the Framingham study, which correlated each 1% increase in HDL with a 2% decline in coronary events. […] Further studies demonstrated that a 1 mg/dL increase in HDL was associated with a reduction in cardiovascular events of 2% in men and 3% in women, alongside mortality reductions of 3.7% and 4.7%, respectively.
#2 Hyperlipidemia (High Cholesterol): Levels, Causes, Symptoms & Diagnosis
https://my.clevelandclinic.org/health/diseases/21656-hyperlipidemia
Hyperlipidemia is very common. Ninety-three million American adults (age 20 and older) have a total cholesterol count above the recommended limit of 200 mg/dL. […] Hyperlipidemia can be very serious if its not managed. As long as high cholesterol is untreated, youre letting plaque accumulate inside of your blood vessels. This can lead to a heart attack or stroke because your blood has a hard time getting through your blood vessels. This deprives your brain and heart of the nutrients and oxygen they need to function. […] Cardiovascular disease is the leading cause of death in Americans. […] If you have hyperlipidemia, youll need to keep using healthy lifestyle habits for years to come. Youll also need to keep follow-up appointments with your provider and continue to take your medicine. If you and your provider are able to manage your cholesterol level, you may not have serious health problems as a result of it. […] Although high cholesterol puts you at risk for heart attacks and stroke, you can protect yourself by living a healthier lifestyle and taking medicine if needed.
#2 Cardiovascular disease – Wikipedia
https://en.wikipedia.org/wiki/Cardiovascular_disease
Cardiovascular diseases are the leading cause of death worldwide and in all regions except Africa. In 2008, 30% of all global death was attributed to cardiovascular diseases. Death caused by cardiovascular diseases are also higher in low- and middle-income countries as over 80% of all global deaths caused by cardiovascular diseases occurred in those countries. It is also estimated that by 2030, over 23 million people will die from cardiovascular diseases each year. […] It is estimated that 60% of the world’s cardiovascular disease burden will occur in the South Asian subcontinent despite only accounting for 20% of the world’s population. This may be secondary to a combination of genetic predisposition and environmental factors.
#2 The Shifting Epidemiology of Hypercholesterolemia | MedPage Today
https://www.medpagetoday.com/medical-journeys/hypercholesterolemia/110599
The epidemiology of hypercholesterolemia has been shifting in recent years. […] While that is nowhere near the case, hypercholesterolemia as a contributor has shown improvement in recent years as measured in U.S. population-level prevalence in the U.S. National Health and Nutrition Examination Survey (NHANES). […] The prevalence of hypercholesterolemia in U.S. youth declined from 9.2% in 2007-2010 to 6.4% in 2013-2016. For U.S. adults age 20 and older, the prevalence of high total cholesterol declined from 18.3% in 1999-2000 to 10.5% in 2017-2018. […] Familial hypercholesterolemia, one of the most common genetic diseases, affects 1 in 250 individuals as a heterozygous condition and 1 in 300,000 in its more severe homozygous form. […] While hypercholesterolemia and consequent atherosclerosis might be improving in the United States, the trend is not so rosy for much of the rest of the non-Western world.
#2 Low density lipoprotein cholesterol control status among Canadians at risk for cardiovascular disease: findings from the Canadian Primary Care Sentinel Surveillance Network Database | Lipids in Health and Disease | Full Text
https://lipidworld.biomedcentral.com/articles/10.1186/s12944-015-0056-8
To determine the prevalence of uncontrolled LDL-C in patients with high cardiovascular disease (CVD) risks across Canada and to examine its related factors. […] A total of 6,405 high-risk patients were included in the study and, of this population, 68 % had a suboptimal LDL-C, which was significantly associated with the female gender (OR: 3.26; 95 % CI: 2.634.05, p0.0001) and no medication therapy (OR: 6.31, 95 % CI: 5.217.65, p0.0001). […] A high proportion of high-cardiac risk patients in Canadian primary care settings have suboptimal LDL-C control. A lack of medication therapy appears to be the major contributing factor to this situation. […] The prevalence of those with uncontrolled LDL-C was 68 % and 29 % were determined to be in need of secondary prevention. […] High-risk females have a higher rate of uncontrolled LDL-C (77 %) compared to high-risk males with 66 %.
#3 Polygenic Hypercholesterolemia: Practice Essentials, Pathophysiology, Etiology
https://emedicine.medscape.com/article/121424-overview
Serum cholesterol concentrations vary widely throughout the world. Generally, countries associated with low serum cholesterol concentrations (eg, Japan) have lower CHD event rates, whereas countries associated with very high serum cholesterol concentrations (eg, Finland) have very high CHD event rates. However, some populations with similar total cholesterol levels have very different CHD event rates, as would be expected given that other risk factors (eg, prevalence of smoking or diabetes mellitus) also influence CHD risk. The cholesterol levels in developing countries tend to increase as western dietary habits (McDonald’s syndrome) replace traditional diets. […] Among adults, NHANES data (2011-2012) showed higher LDL cholesterol level among Hispanic males (38.8%), than non-Hispanic Black males (30.7%) and than non-Hispanic White males (29.4%) […] Elevated LDL-C is more common in females (32%) than in males (31%), based on NHANES data (2011-2012). […] In adults, hypercholesterolemia increases with advancing age.
#3 The Shifting Epidemiology of Hypercholesterolemia | MedPage Today
https://www.medpagetoday.com/medical-journeys/hypercholesterolemia/110599
Another review showed a constant reduction in non-HDL cholesterol in the last four decades in high-income countries, „especially starting from 1990, likely due to an increase in the use of statins.” […] The Atherosclerosis Risk in Communities (ARIC) study showed the declining influence of hypercholesterolemia as a contributor to cardiovascular disease risk. […] Another study estimated that 13% of cardiovascular disease in the United States in 2007-2015 was attributable to high cholesterol, compared with 6.9% in Iran and 20% in Spain. […] Worldwide, LDL cholesterol was the third highest contributor to years of disability-adjusted life years related to cardiovascular disease in 2019, after high systolic blood pressure and dietary risks, according to the Global Burden of Disease study data. […] The biggest causal role is in ischemic heart disease, with 44% of global deaths from that cause attributable to high LDL cholesterol, according to one review.
#3
https://www.healio.com/clinical-guidance/lipid-management/epidemiology-of-cholesterol-and-cardiovascular-disease
Humans appear predisposed to atherosclerosis. Cholesterol was implicated in the pathogenesis of atherosclerosis over 150 years ago. […] Following World War II, numerous animal models of high-fat and high-cholesterol diets demonstrated atherosclerosis initiation and progression and regression of atherosclerosis with low-fat diets. […] An association between blood cholesterol and the rate of coronary death was found across countries in the Seven Countries and other studies. […] Through the 1990s, more than 65 cohorts on four continents have reported a clear and consistent relationship between lifetime blood cholesterol levels, the number of other CV risk factors and the subsequent development of CAD and other ASCVD. […] Earlier epidemiologic studies measured total cholesterol. Later studies have found the same robust relationship between low-density lipoprotein cholesterol (LDL-C) levels and ASCVD risk.
#4 The Shifting Epidemiology of Hypercholesterolemia | MedPage Today
https://www.medpagetoday.com/medical-journeys/hypercholesterolemia/110599
Another review showed a constant reduction in non-HDL cholesterol in the last four decades in high-income countries, „especially starting from 1990, likely due to an increase in the use of statins.” […] The Atherosclerosis Risk in Communities (ARIC) study showed the declining influence of hypercholesterolemia as a contributor to cardiovascular disease risk. […] Another study estimated that 13% of cardiovascular disease in the United States in 2007-2015 was attributable to high cholesterol, compared with 6.9% in Iran and 20% in Spain. […] Worldwide, LDL cholesterol was the third highest contributor to years of disability-adjusted life years related to cardiovascular disease in 2019, after high systolic blood pressure and dietary risks, according to the Global Burden of Disease study data. […] The biggest causal role is in ischemic heart disease, with 44% of global deaths from that cause attributable to high LDL cholesterol, according to one review.
#4
https://www.healio.com/clinical-guidance/lipid-management/epidemiology-of-cholesterol-and-cardiovascular-disease
Humans appear predisposed to atherosclerosis. Cholesterol was implicated in the pathogenesis of atherosclerosis over 150 years ago. […] Following World War II, numerous animal models of high-fat and high-cholesterol diets demonstrated atherosclerosis initiation and progression and regression of atherosclerosis with low-fat diets. […] An association between blood cholesterol and the rate of coronary death was found across countries in the Seven Countries and other studies. […] Through the 1990s, more than 65 cohorts on four continents have reported a clear and consistent relationship between lifetime blood cholesterol levels, the number of other CV risk factors and the subsequent development of CAD and other ASCVD. […] Earlier epidemiologic studies measured total cholesterol. Later studies have found the same robust relationship between low-density lipoprotein cholesterol (LDL-C) levels and ASCVD risk.