Cholesterol Drops in the West and Rises in the East

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Cardiovascular risk from the accumulation of “bad” cholesterol in blood vessels is shifting from high-income Western countries, especially those in Europe, to low- and middle-income countries, particularly in East and Southeast Asia. A meta-analysis of 1,127 studies comprising 102.6 million people worldwide shows a significant drop in bad cholesterol from 1980 to 2018 in countries such as Finland, Belgium and the U.S. and a strong rise in Thailand, Malaysia, Nigeria and Malawi. Two major factors in high-income populations are less consumption of saturated fats and widespread use of lipid-lowering medications, notably statins, says study co-leader Majid Ezzati of Imperial College London. In lower-income populations, eating saturated fats is rising, and statins are not common. Researchers had limited evidence about an emerging shift a decade ago, but Ezzati is surprised to see “just how far it has gone.”