Elevated total cholesterol: its prevalence and population attributable fraction for mortality from coronary heart disease and ischaemic stroke in the Asia-Pacific region

Woodward, Mark, Martiniuk, Alexandra, Lee, Crystal Man Ying, Lam, Tai Hing, Vanderhoorn, Stephen, Ueshimaf, Hirotsugu, Fang, Xianghua, Kim, Hyeon Chang, Rodgers, Anthony, Patel, Anushka, Jamrozik, Konrad and Huxley, Rachel (2008) Elevated total cholesterol: its prevalence and population attributable fraction for mortality from coronary heart disease and ischaemic stroke in the Asia-Pacific region. European Journal of Cardiovascular Prevention and Rehabilitation, 15 4: 397-401. doi:10.1097/HJR.0b013e3282fdc967


Author Woodward, Mark
Martiniuk, Alexandra
Lee, Crystal Man Ying
Lam, Tai Hing
Vanderhoorn, Stephen
Ueshimaf, Hirotsugu
Fang, Xianghua
Kim, Hyeon Chang
Rodgers, Anthony
Patel, Anushka
Jamrozik, Konrad
Huxley, Rachel
Title Elevated total cholesterol: its prevalence and population attributable fraction for mortality from coronary heart disease and ischaemic stroke in the Asia-Pacific region
Journal name European Journal of Cardiovascular Prevention and Rehabilitation   Check publisher's open access policy
ISSN 1741-8267
2047-4881
Publication date 2008-08
Sub-type Article (original research)
DOI 10.1097/HJR.0b013e3282fdc967
Volume 15
Issue 4
Start page 397
End page 401
Total pages 5
Place of publication London , United Kingdom
Publisher Sage Publications
Language eng
Abstract Background: About half of the world s cases of cardiovascular disease occur in the Asia-Pacific region. The contribution of serum total cholesterol (TC) to this burden is poorly quantified. Design: The most recent nationally representative data on TC distributions for countries in the region were sought. Individual participant data from 380 483 adults in the Asia Pacific Cohort Studies Collaboration were used to estimate associations between TC and cardiovascular disease. Methods: High TC was defined as ≥6.2mmol/l, and nonoptimal TC as ≥ 3.8mmol/l. Hazard ratios for fatal coronary heart disease (CHD) and ischaemic stroke (IS) were found from Cox models. Sex-specific population attributable fractions for high TC and nonoptimal TC were estimated for each country. The former used conventional methods, based on single measures of TC and a fixed dichotomy of risk strata; the latter took account of the continuous positive association between TC and both CHD and IS and regression dilution. Results: Data were available from 16 countries. Where reported, the prevalence of high TC ranged from 4 to 27%. The fraction of fatal CHD and IS attributable to high TC ranged from 0 to 14% and 0 to 15%, respectively. Although leaving the relative ranking of countries much the same, the fractions estimated for nonoptimal TC were typically at least twice as big, ranging from 0 to 47% and 0 to 35%, respectively. Conclusion: Conventional methods for estimating disease burden severely underestimate the effect of TC. Cholesterol-lowering strategies could have a tremendous effect in reducing cardiovascular deaths in this populous region.
Keyword Asia Pacific
Attributable fraction
Cholesterol
Heart disease
Stroke
Cardiovascular disease
Metabolic syndrome
Risk factors
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Public Health Publications
 
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