Dean Karlan Usaid

Posted: Thu 16 Feb 2001

- Last Updated: Sat 24 Jul 2007

The impact of high cholesterol has moved from a focus on heart failure to one on hypercholesterolemia, and the burden is rising fastest among adults. According to the National Health and Examination Examination Study, a 26-year follow-up cohort from the Framingham heart study, 38% of men and 53% of women had blood lipids that were elevated [pdf]. In the 1990-1993, when Framingham was still struggling to be diagnosed, 54% of women and almost as many men complained of excessive cholesterol. By 2007, the prevalence had risen significantly in all three cohorts, with those ages 50-69 and those with high concentrations in both genders. And while these high levels are still far below "normal" levels - 125 and 130 respectively - the increase in all three groups is close to 400.

What do we have to do to lower cholesterol levels? Early identification and prevention of high cholesterol has now become more than a science (where public health specialists will tell the public what to do - cutting down on intake of saturated fat and adopting low-fat diets), but a public health strategy which is fit for global governments. Will such measures now help improve the world's population?

Why is this so relevant?

Titles and definitions. The first national Cholesterol, Atherosclerosis, and Cardiovascular Disease Prevention Program (CHANG) took place at the 1975 AGA summit in Baltimore, Maryland. It came after nearly 30 years of research into all aspects of atherosclerosis, and it used the efforts of epidemiologists and pathologists; specialists at the Harvard School of Public Health [1], the Johns Hopkins School of Medicine [2], and the Division of Epidemiology and Endocrinology [3]. The United States was the initial forum. The first national action plan based on guidelines for low-fat diets was announced in 1989, followed by the United States Bipolard in 1992.

Today, as noted, there are additional reports [4] of US and European interventions, and more than 75% of adults are now using a diet including at least 10% of calories from saturated fat. However, the public has accepted or barely accepted the statement "total cholesterol should be below 200 mg/dl.