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Cristina Bin Honor Rodrigo M. Goodarz Rod T. Farshad Marisa Taddei Zhou Bixby Carrillo-Larco Danaei Jackson Fa, C. Taddei, Bin Zhou, Honor Bixby, R. Carrillo-Larco, G. Danaei, Rod Jackson, F. Farzadfar, Marisa K. Sophiea, M. di Cesare, M. Iurilli, A. R. Martinez, G. Asghari, K. Dhana, P. Gulayin, Sujay S Kakarmath, M. Santero, T. Voortman, L. Riley, Melanie J. Cowan, S. Savin, James E. Bennett, Gretchen A. Stevens, C. Paciorek, W. Aekplakorn, R. Cífková, S. Giampaoli, A. Kengne, Y. Khang, K. Kuulasmaa, A. Laxmaiah, P. Margozzini, Prashant Mathur, B. Nordestgaard, Dong Zhao, M. Aadahl, Leandra Abarca-Gómez, H. A. Rahim, Niveen M. E. Abu-Rmeileh, Benjamín Acosta-Cázares, R. Adams, I. Agdeppa, J. Aghazadeh-Attari, C. Aguilar-Salinas, C. Agyemang, T. Ahluwalia, Noor Ani Ahmad, A. Ahmadi, N. Ahmadi, Soheir H Ahmed, W. Ahrens, K. Ajlouni, Monira Alarouj, F. Albuhairan, Shahla Aldhukair, Mohamed M. Ali, Abdullah Alkandari, A. Alkerwi, Eman Aly, D. Amarapurkar, P. Amouyel, L. Andersen, S. Anderssen, R. Anjana, A. Ansari-Moghaddam, H. Aounallah-Skhiri, J. Araújo, I. Ariansen, T. Aris, Raphael E. Arku, N. Arlappa, K. Aryal, T. Aspelund, M. Assunção, J. Auvinen, M. Avdičová, A. Azevedo, Fereidoun Azizi, M. Azmin, Nagalla Balakrishna, M. Bamoshmoosh, Maciej Banach, P. Bandosz, J. Banegas, C. Barbagallo, A. Barceló, A. Barkat, I. Bata, A. Batieha, Assembekov Batyrbek, L. Baur, R. Beaglehole, A. Belavendra, H. Ben Romdhane, M. Benet, M. Benn, S. Berkinbayev, A. Bernabé-Ortiz, G. Bernotiene, H. Bettiol, S. Bhargava, Y. Bi, A. Bienek, M. Bikbov, B. Bista, P. Bjerregaard, E. Bjertness, M. B. Bjertness, C. Björkelund, K. Bloch, A. Blokstra, Simona Bo, B. Boehm, J. Boggia, C. Boissonnet, M. Bonaccio, V. Bongard, R. Borchini, H. Borghs, P. Bovet, I. Brajkovich, Juergen Breckenkamp, H. Brenner, L. Brewster, Graziella Bruno, Anna Bugge, M. Busch, A. C. de León, J. Cacciottolo, G. Can, A. P. Cândido, M. Capanzana, E. Capuano, V. Capuano, V. Cardoso, J. Carvalho, F. Casanueva, L. Censi, C. Chadjigeorgiou, S. Chamukuttan, N. Chaturvedi, Chien-Jen Chen, Fangfang Chen, Shuohua Chen, Ching-Yu Cheng, B. Cheraghian, A. Chetrit, S. Chiou, M. Chirlaque, B. Cho, Yumi Cho, J. Chudek, F. Claessens, J. Clarke, E. Clays, H. Concin, S. C. Confortin, C. Cooper, S. Costanzo, D. Cottel, C. Cowell, A. Crujeiras, S. Csilla, L. Cui, F. Cureau, G. D’Arrigo, E. d’Orsi, J. Dallongeville, A. Damasceno, R. Dankner, T. Dantoft, L. Dauchet, K. Davletov, G. De Backer, D. De Bacquer, G. de Gaetano, S. de Henauw, P. D. de Oliveira, David De Ridder, D. De Smedt, M. Deepa, A. Deev, A. Dehghan, H. Delisle, E. Dennison, V. Deschamps, M. Dhimal, A. Di Castelnuovo, Ž. Dika, S. Djalalinia, A. Dobson, C. Donfrancesco, Silvana P. Donoso, A. Döring, M. Dorobanțu, N. Dragano, W. Drygas, Yong Du, C. Duante, R. Duda, V. Dzērve, E. Dziankowska-Zaborszczyk, Ricky Eddie, E. Eftekhar, R. Eggertsen, S. Eghtesad, G. Eiben, U. Ekelund, J. El Ati, D. Eldemire-Shearer, M. Eliasen, R. Elosúa, R. Erasmus, R. Erbel, C. Erem, L. Eriksen, J. Eriksson, J. Escobedo-de la Peña, Saeid Eslami, A. Esmaeili, A. Evans, D. Faeh, Caroline H. D. Fall, E. Faramarzi, M. Farjam, M. Fattahi, F. Félix-Redondo, T. Ferguson, D. Fernández-Bergés, D. Ferrante, M. Ferrari, C. Ferreccio, J. Ferrières, B. Föger, L. Foo, Ann‐Sofie Forslund, M. Forsner, H. Fouad, Damian K. Francis, Maria do Carmo Franco, O. Franco, G. Frontera, Y. Fujita, Matsuda Fumihiko, Takuro Furusawa, Z. Gaciong, F. Galvano, Jingli Gao, M. García-de-la-Hera, S. Garnett, J. Gaspoz, Magda Gasull, A. Gazzinelli, J. Geleijnse, A. Ghanbari, E. Ghasemi, O. Gheorghe-Fronea, Anup Ghimire, F. Gianfagna, T. Gill, J. Giovannelli, G. Gironella, A. Giwercman, D. Goltzman, H. Gonçalves, D. González-Chica, M. González-Gross, J. González-Rivas, C. González‐Villalpando, M. González-Villalpando, Angel R Gonzalez, F. Gottrand, S. Graff-Iversen, Dušan Grafnetter, R. D. Gregor, T. Grodzicki, A. Grøntved, G. Grosso, G. Gruden, D. Gu, P. Guallar-Castillón, Ong Peng Guan, E. Gudmundsson, V. Gudnason, Ramiro Guerrero, I. Guessous, Johanna Gunnlaugsdottir, R. Gupta, L. Gutierrez, F. Gutzwiller, Seongjun Ha, F. Hadaegh, Rosa Haghshenas, H. Hakimi, I. Hambleton, B. Hamzeh, S. Hantunen, R. H. Kumar, Seyed Mohammad Hashemi-Shahri, J. Hata, T. Haugsgjerd, Anthony Joseph Hayes, Jiang He, Yu-na He, M. Hendriks, A. Henriques, S. Herrala, R. Heshmat, A. Hill, Sai Yin Ho, Suzanne C. Ho, M. Hobbs, A. Hofman, Reza Homayounfar, W. Hopman, A. Horimoto, Claudia M. Hormiga, B. Horta, L. Houti, C. Howitt, T. Htay, A. Htet, M. Htike, J. Huerta, I. Huhtaniemi, M. Huisman, M. Hunsberger, A. Husseini, I. Huybrechts, N. Hwalla, L. Iacoviello, A. Iannone, M. Ibrahim, N. Wong, I. Iglesia, Nayu Ikeda, M. A. Ikram, V. Iotova, V. Irazola, Takafumi Ishida, Muhammad Islam, Aziz al-Safi Ismail, Masanori Iwasaki, Jeremy Michael Jacobs, H. Jaddou, T. Jafar, K. James, K. Jamrozik, I. Janszky, E. Janus, M. Jarvelin, G. Jasienska, A. Jelaković, B. Jelaković, Garry L R Jennings, G. Jensen, Seung-lyeal Jeong, A. Jha, C. Jiang, Ramon O Jimenez, K. Jöckel, M. Joffres, J. Jokelainen, J. Jonas, T. Jørgensen, Pradeep Joshi, F. Joukar, J. Jozwiak, A. Juolevi, A. Kafatos, E. Kajantie, O. Kalter‐Leibovici, N. Kamaruddin, P. Kamstrup, K. Karki, Joanne Katz, J. Kauhanen, P. Kaur, M. Kavousi, G. Kazakbaeva, U. Keil, S. Keinänen-Kiukaanniemi, R. Kelishadi, Maryam Keramati, A. Kerimkulova, M. Kersting, Yousef S. Khader, D. Khalili, M. Khateeb, Motahareh Kheradmand, A. Khosravi, U. Kiechl-Kohlendorfer, S. Kiechl, J. Killewo, H. Kim, Jeongseon Kim, Yeon-Yong Kim, J. Klumbienė, M. Knoflach, S. Ko, H. Kohler, I. Kohler, E. Kolle, P. Kolsteren, J. König, R. Korpelainen, P. Korrovits, J. Kos, S. Koskinen, K. Kouda, S. Kowlessur, W. Kratzer, S. Kriemler, P. Kristensen, Steiner Krokstad, D. Kromhout, U. Kujala, P. Kurjata, C. Kyobutungi, F. Z. Laamiri, T. Laatikainen, C. Lachat, Y. Laid, T. Lam, C. Lambrinou, V. Lánská, G. Lappas, B. Larijani, T. Latt, L. E. Laugsand, M. Lazo-Porras, Jeannette Lee, Jeonghee Lee, N. Lehmann, T. Lehtimäki, N. Levitt, Yanping Li, C. Lilly, W. Lim, M. F. Lima-Costa, Hsien-Ho Lin, Xu Lin, Yi-Ting Lin, L. Lind, A. Linneberg, L. Lissner, Jing Liu, H. Loit, E. López-García, T. López, P. Lotufo, J. Lozano, D. Lukšienė, A. Lundqvist, R. Lundqvist, N. Lunet, G. Ma, G. Machado-Coelho, A. Machado‐Rodrigues, S. Machi, A. Madar, S. Maggi, D. Magliano, E. Magriplis, G. Mahasampath, B. Maire, Marcia Makdisse, F. Malekzadeh, R. Malekzadeh, Kodavanti Mallikharjuna Rao, Y. Manios, J. Mann, F. Mansour-Ghanaei, E. Manzato, P. Marques-Vidal, R. Martorell, Luis P Mascarenhas, E. Mathiesen, T. Matsha, C. Mavrogianni, S. McFarlane, S. Mcgarvey, S. McLachlan, R. McLean, Scott B. McLean, B. McNulty, S. Médiène-Benchekor, P. Mehdipour, K. Mehlig, A. Mehrparvar, A. Meirhaeghe, C. Meisinger, Ana M. B. Menezes, G. Menon, S. Merat, Alibek Mereke, I. Meshram, P. Metcalf, H. Meyer, J. Mi
202 1. 6. 2020.

Repositioning of the global epicentre of non-optimal cholesterol

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. From 1980 to 2018, the levels of total and non-high-density lipoprotein cholesterol increased in low- and middle-income countries, especially in east and southeast Asia, and decreased in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe.


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