High cholesterol levels
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High Cholesterol Levels: Risks, Trends, and Implications
High Cholesterol and Cardiovascular Disease Risk
High levels of total cholesterol and low levels of high-density lipoprotein (HDL) cholesterol are well-established risk factors for coronary heart disease and cardiovascular disease (CVD) . Regular cholesterol screening is recommended for adults to identify those at risk and to implement preventive measures.
Trends in Cholesterol Levels
Recent studies have shown a decline in the prevalence of high total cholesterol and low HDL cholesterol in the United States from 2007 to 2016. This trend suggests that public health interventions and increased awareness may be contributing to better cholesterol management.
Extremely High HDL Cholesterol: A Double-Edged Sword
While HDL cholesterol is often termed "good cholesterol" due to its protective effects against heart disease, extremely high levels of HDL cholesterol have been associated with increased risks of atherosclerotic CVD mortality, coronary heart disease, and ischemic stroke . This paradoxical effect was particularly evident in current drinkers and varied by gender, with men showing a higher risk of all-cause mortality at very high HDL levels .
Global Shifts in Cholesterol-Related Risks
The global landscape of cholesterol-related health risks has shifted over the past few decades. High non-HDL cholesterol, a marker of cardiovascular risk, has decreased in high-income Western countries but increased in low- and middle-income countries, particularly in East and Southeast Asia. This shift underscores the need for global public health strategies to address cholesterol management.
Cholesterol and Multiple Diseases
Excess cholesterol is not only a risk factor for cardiovascular diseases but also plays a critical role in the pathogenesis of various other conditions, including liver diseases, diabetes, chronic kidney disease, Alzheimer's disease, and even COVID-19. This broad impact of cholesterol highlights the importance of maintaining optimal cholesterol levels for overall health.
Isolated Low HDL Cholesterol in Asian Populations
Isolated low HDL cholesterol, a condition where low HDL levels occur without other lipid abnormalities, is more prevalent in Asian populations and is strongly associated with an increased risk of coronary heart disease. This unique lipid phenotype warrants further investigation to develop targeted interventions for these populations.
Conclusion
High cholesterol levels, particularly high total cholesterol and low HDL cholesterol, remain significant risk factors for cardiovascular disease. While trends in cholesterol levels show improvement in some regions, the global shift in cholesterol-related risks and the complex role of HDL cholesterol necessitate ongoing public health efforts and research to optimize cholesterol management and reduce the burden of related diseases.
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