UCL Institute of Cardiovascular Science


Cholesterol levels dropping in Western nations – but rising in Asia

11 June 2020

Data from the MRC NSHD has been included in a large study involving hundreds of researchers across the world which suggests that cholesterol levels are declining sharply in western nations, but rising in low- and middle-income nations – particularly in Asia.

Hamburger and fries

The new study was led by Imperial College London and used data from 102.6 million individuals and examined cholesterol levels in 200 countries, across a 39-year time period, from 1980 to 2018.

Cholesterol is a waxy substance found in the blood. The body needs cholesterol to build healthy cells, but too much can lead to a build-up in the blood vessels. Cholesterol comes in different types. High-density lipoprotein (HDL) ‘good’ cholesterol, is thought to have a protective effect against heart attack and stroke, by mopping up excess ‘bad’ cholesterol.

Non-HDL ‘bad’ cholesterol, which should be as low as possible, can block blood supply and lead to heart attacks and strokes. This type of cholesterol is usually raised by diets high in saturated and trans fats, which is found in many processed foods, instead of healthier unsaturated fats. It can be lowered effectively through the use of statins.

Countries with the highest levels 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 Pacific, such as Tokelau, Malaysia, the Philippines and Thailand.

In the UK, non-HDL cholesterol for men dropped from 18th highest in the world to 106th in 2018 and for women non-HDL cholesterol dropped from 18th highest in the world in 1980 to 130th in 2018.

Lead author, Professor Ezzati states that some of the reduction in non-HDL cholesterol levels in western nations are due to increased use of statins in western countries, which are not yet used widely in low- and middle-income countries.

The team point out that some countries had less data compared to others, which could also influence how certain we are about cholesterol levels and changes over time.