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Lifestyle changes led to improved cholesterol for high CV risk patients
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From 1994 to 2014, adults at high risk for ischemic heart disease lowered their total cholesterol, driven by changes in diet and increased use of statins, according to results from the Northern Sweden MONICA study.
In the study, 4,546 women and 4,349 men aged 25 to 74 years at baseline answered surveys at five points between 1994 and 2014. At each visit, participants were tested for total cholesterol and BP, and self-reported diabetes, MI and stroke.
In the overall cohort, mean total cholesterol declined from 6.2 mmol/L (95% CI, 6.1-6.2) in 1994 to 5.5 mmol/L (95% CI, 5.4-5.5) in 2014, Mats Eliasson, MD, PhD, and colleagues found.
Mats Eliasson
The decline occurred in both sexes and in all age groups (P < .001 for all) and did not differ by sex, but it was more pronounced in older participants (women aged 65-74 years, 1.1 mmol/L; 95% CI, 0.9-1.3; men aged 65-74 years, 1 mmol/L; 95% CI, 0.8-1.2) than in younger ones (women aged 25-34 years, 0.5 mmol/L; 95% CI, 0.4-0.7; men aged 25-34 years, 0.6 mmol/L; 95% CI, 0.3-0.8; P for year-by-age group interaction < .001), they found.
In 1994, those with prior CVD, diabetes or hypertension had cholesterol levels similar to or higher than the general population, but in 2014, the high-risk group had lower cholesterol levels compared with the general population, the researchers wrote, noting that cholesterol levels declined faster in those with CVD than in those without it (P < .001).
Lipid-lowering drugs were used by 1.4% (95% CI, 0.8-1.9) of the cohort in 1994 but by 14.3% (95% CI, 12.6-16.1) in 2014, according to the researchers.
Eliasson and colleagues estimated that lipid-lowering drugs accounted for approximately 31% of the decline in cholesterol levels in the overall cohort, and approximately 44% of the decline in the group aged 65 to 74 years.
“The most important reason for the decreased cholesterol in the population of Norrbotten and Västerbotten counties in northern Sweden is most likely a change in lifestyle, such as a reduced intake of fat, together with an increased intake in fiber from fruit, vegetables and grains,” Eliasson, professor in the department of public health and clinical medicine, Umeå University, Sweden, and physician at Sunderby Hospital in Luleå, Sweden, said in a press release. – by Erik Swain
Disclosure: The researchers report no relevant financial disclosures.
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