Time trends in population cholesterol levels 1986-2004: influence of lipid-lowering drugs, obesity, smoking and educational level. The northern Sweden MONICA study.
OBJECTIVE
To explore time trends in population total cholesterol.


METHODS
Five population-based cross-sectional surveys, 1986-2004 in the northern Sweden MONICA study included 8827 men and women.


RESULTS
Age-adjusted cholesterol level declined in men, 25-64 years old, from 6.38 to 5.78 mmol L(-1) and in women from 6.32 to 5.51 mmol L(-1). Between 1994 and 2004, subjects 65-74 years old were included, and their levels also decreased, in men from 6.35 to 5.76 mmol L(-1) and in women from 7.11 to 6.24 mmol L(-1). The decrease was continuous over surveys and age groups, except in young and middle-aged men where no further decline was found after 1999. Cohorts born 1920-1939 showed decreased cholesterol over the period, whilst no change was noted for those born thereafter. In 2004, one-fourth of men and one-third of women 25-74 years achieved levels below 5.0 mmol L(-1). Subjects with low educational level, body mass index > or =25 or smokers all had higher cholesterol levels which persisted during the 18-year period. In 2004, the 9% who used lipid-lowering drugs are estimated to contribute, at most, to 0.13 mmol L(-1) lower cholesterol in the population.


CONCLUSIONS
Large decreases in cholesterol levels occurred in the 18-year period. Less smoking may contribute to, and increasing obesity attenuate, this trend whilst lipid-lowering drugs have had little effect until recently. Socio-economic inequalities persist.
Eliasson
M
M
Department of Medicine, Sunderby Hospital, Luleå, Sweden. mats.eliasson@nll.se
Janlert
U
U
Jansson
J-H
JH
Stegmayr
B
B
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D015992:Body Mass Index; D002784:Cholesterol / Q000097:blood*; D003430:Cross-Sectional Studies; D004522:Educational Status; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000453:epidemiology; D011159:Population Surveillance / Q000379:methods; D017678:Sex Distribution; D012907:Smoking / Q000097:blood; D013548:Sweden / Q000453:epidemiology
D000960:Hypolipidemic Agents; D002784:Cholesterol