Repositioning of the global epicentre of non-optimal cholesterol

• Published in: Nature
• Main Authors: Taddei, Cristina, Zhou, Bin, Bixby, Honor, Carrillo-Larco, Rodrigo M., Danaei, Goodarz, Jackson, Rod T., Farzadfar, Farshad, Sophiea, Marisa K., Di Cesare, Mariachiara, Iurilli, Maria Laura Caminia, Martinez, Andrea Rodriguez, Asghari, Golaleh, Dhana, Klodian, Gulayin, Pablo, Kakarmath, Sujay, Santero, Marilina, Voortman, Trudy, Riley, Leanne M., Cowan, Melanie J., Savin, Stefan, Bennett, James E., Stevens, Gretchen A., Paciorek, Christopher J., Aekplakorn, Wichai, Cifkova, Renata, Giampaoli, Simona, Kengne, Andre Pascal, Khang, Young-Ho, Kuulasmaa, Kari, Laxmaiah, Avula, Margozzini, Paula, Mathur, Prashant, Nordestgaard, Børge G., Zhao, Dong, Aadahl, Mette, Abarca-Gómez, Leandra, Rahim, Hanan Abdul, Abu-Rmeileh, Niveen M., Acosta-Cazares, Benjamin, Adams, Robert J., Agdeppa, Imelda A., Aghazadeh-Attari, Javad, Aguilar-Salinas, Carlos A., Agyemang, Charles, Ahluwalia, Tarunveer S., Ahmad, Noor Ani, Ahmadi, Ali, Ahmadi, Naser, Ahmed, Soheir H., Ahrens, Wolfgang, Ajlouni, Kamel, Alarouj, Monira, AlBuhairan, Fadia, AlDhukair, Shahla, Ali, Mohamed M., Alkandari, Abdullah, Alkerwi, Ala’a, Aly, Eman, Amarapurkar, Deepak N., Amouyel, Philippe, Andersen, Lars Bo, Anderssen, Sigmund A., Anjana, Ranjit Mohan, Ansari-Moghaddam, Alireza, Aounallah-Skhiri, Hajer, Araújo, Joana, Ariansen, Inger, Aris, Tahir, Arku, Raphael E., Arlappa, Nimmathota, Aryal, Krishna K., Aspelund, Thor, Assunção, Maria Cecília F., Auvinen, Juha, Avdicová, Mária, Azevedo, Ana, Azizi, Fereidoun, Azmin, Mehrdad, Balakrishna, Nagalla, Bamoshmoosh, Mohamed, Banach, Maciej, Bandosz, Piotr, Banegas, José R., Barbagallo, Carlo M., Barceló, Alberto, Barkat, Amina, Bata, Iqbal, Batieha, Anwar M., Batyrbek, Assembekov, Baur, Louise A., Beaglehole, Robert, Belavendra, Antonisamy, Ben Romdhane, Habiba, Benet, Mikhail, Benn, Marianne, Berkinbayev, Salim, Bernabe-Ortiz, Antonio, Bernotiene, Gailute, Bettiol, Heloisa, Bhargava, Santosh K., Bi, Yufang, Bienek, Asako, Bikbov, Mukharram, Bista, Bihungum, Bjerregaard, Peter, Bjertness, Espen, Bjertness, Marius B., Björkelund, Cecilia, Bloch, Katia V., Blokstra, Anneke, Bo, Simona, Boehm, Bernhard O., Boggia, Jose G., Boissonnet, Carlos P., Bonaccio, Marialaura, Bongard, Vanina, Borchini, Rossana, Borghs, Herman, Bovet, Pascal, Brajkovich, Imperia, Breckenkamp, Juergen, Brenner, Hermann, Brewster, Lizzy M., Bruno, Graziella, Bugge, Anna, Busch, Markus A., de León, Antonio Cabrera, Cacciottolo, Joseph, Can, Günay, Cândido, Ana Paula C., Capanzana, Mario V., Capuano, Eduardo, Capuano, Vincenzo, Cardoso, Viviane C., Carvalho, Joana, Casanueva, Felipe F., Censi, Laura, Chadjigeorgiou, Charalambos A., Chamukuttan, Snehalatha, Chaturvedi, Nish, Chen, Chien-Jen, Chen, Fangfang, Chen, Shuohua, Cheng, Ching-Yu, Cheraghian, Bahman, Chetrit, Angela, Chiou, Shu-Ti, Chirlaque, María-Dolores, Cho, Belong, Cho, Yumi, Chudek, Jerzy, Claessens, Frank, Clarke, Janine, Clays, Els, Concin, Hans, Confortin, Susana C., Cooper, Cyrus, Costanzo, Simona, Cottel, Dominique, Cowell, Chris, Crujeiras, Ana B., Csilla, Semánová, Cui, Liufu, Cureau, Felipe V., D’Arrigo, Graziella, d’Orsi, Eleonora, Dallongeville, Jean, Damasceno, Albertino, Dankner, Rachel, Dantoft, Thomas M., Dauchet, Luc, Davletov, Kairat, De Backer, Guy, De Bacquer, Dirk, de Gaetano, Giovanni, De Henauw, Stefaan, de Oliveira, Paula Duarte, De Ridder, David, De Smedt, Delphine, Deepa, Mohan, Deev, Alexander D., Dehghan, Abbas, Delisle, Hélène, Dennison, Elaine, Deschamps, Valérie, Dhimal, Meghnath, Di Castelnuovo, Augusto F., Dika, Zivka, Djalalinia, Shirin, Dobson, Annette J., Donfrancesco, Chiara, Donoso, Silvana P., Döring, Angela, Dorobantu, Maria, Dragano, Nico, Drygas, Wojciech, Du, Yong, Duante, Charmaine A., Duda, Rosemary B., Dzerve, Vilnis, Dziankowska-Zaborszczyk, Elzbieta, Eddie, Ricky, Eftekhar, Ebrahim, Eggertsen, Robert, Eghtesad, Sareh, Eiben, Gabriele, Ekelund, Ulf, El Ati, Jalila, Eldemire-Shearer, Denise, Eliasen, Marie, Elosua, Roberto, Erasmus, Rajiv T., Erbel, Raimund, Erem, Cihangir, Eriksen, Louise, Eriksson, Johan G., Escobedo-de la Peña, Jorge, Eslami, Saeid, Esmaeili, Ali, Evans, Alun, Faeh, David, Fall, Caroline H., Faramarzi, Elnaz, Farjam, Mojtaba, Fattahi, Mohammad Reza, Felix-Redondo, Francisco J., Ferguson, Trevor S., Fernández-Bergés, Daniel, Ferrante, Daniel, Ferrari, Marika, Ferreccio, Catterina, Ferrieres, Jean, Föger, Bernhard, Foo, Leng Huat, Forslund, Ann-Sofie, Forsner, Maria, Fouad, Heba M., Francis, Damian K., do Carmo Franco, Maria, Franco, Oscar H., Frontera, Guillermo, Fujita, Yuki, Fumihiko, Matsuda, Furusawa, Takuro, Gaciong, Zbigniew, Galvano, Fabio, Gao, Jingli, Garcia-de-la-Hera, Manoli, Garnett, Sarah P., Gaspoz, Jean-Michel, Gasull, Magda, Gazzinelli, Andrea, Geleijnse, Johanna M., Ghanbari, Ali, Ghasemi, Erfan, Gheorghe-Fronea, Oana-Florentina, Ghimire, Anup, Gianfagna, Francesco, Gill, Tiffany K., Giovannelli, Jonathan, Gironella, Glen, Giwercman, Aleksander, Goltzman, David, Gonçalves, Helen, Gonzalez-Chica, David A., Gonzalez-Gross, Marcela, González-Rivas, Juan P., González-Villalpando, Clicerio, González-Villalpando, María-Elena, Gonzalez, Angel R., Gottrand, Frederic, Graff-Iversen, Sidsel, Grafnetter, Dušan, Gregor, Ronald D., Grodzicki, Tomasz, Grøntved, Anders, Grosso, Giuseppe, Gruden, Gabriella, Gu, Dongfeng, Guallar-Castillón, Pilar, Guan, Ong Peng, Gudmundsson, Elias F., Gudnason, Vilmundur, Guerrero, Ramiro, Guessous, Idris, Gunnlaugsdottir, Johanna, Gupta, Rajeev, Gutierrez, Laura, Gutzwiller, Felix, Ha, Seongjun, Hadaegh, Farzad, Haghshenas, Rosa, Hakimi, Hamid, Hambleton, Ian R., Hamzeh, Behrooz, Hantunen, Sari, Kumar, Rachakulla Hari, Hashemi-Shahri, Seyed Mohammad, Hata, Jun, Haugsgjerd, Teresa, Hayes, Alison J., He, Jiang, He, Yuna, Hendriks, Marleen Elisabeth, Henriques, Ana, Herrala, Sauli, Heshmat, Ramin, Hill, Allan G., Ho, Sai Yin, Ho, Suzanne C., Hobbs, Michael, Hofman, Albert, Homayounfar, Reza, Hopman, Wilma M., Horimoto, Andrea R. V. R., Hormiga, Claudia M., Horta, Bernardo L., Houti, Leila, Howitt, Christina, Htay, Thein Thein, Htet, Aung Soe, Htike, Maung Maung Than, Huerta, José María, Huhtaniemi, Ilpo Tapani, Huisman, Martijn, Hunsberger, Monica L., Husseini, Abdullatif S., Huybrechts, Inge, Hwalla, Nahla, Iacoviello, Licia, Iannone, Anna G., Ibrahim, Mohsen M., Wong, Norazizah Ibrahim, Iglesia, Iris, Ikeda, Nayu, Ikram, M. Arfan, Iotova, Violeta, Irazola, Vilma E., Ishida, Takafumi, Islam, Muhammad, al-Safi Ismail, Aziz, Iwasaki, Masanori, Jacobs, Jeremy M., Jaddou, Hashem Y., Jafar, Tazeen, James, Kenneth, Jamrozik, Konrad, Janszky, Imre, Janus, Edward, Jarvelin, Marjo-Riitta, Jasienska, Grazyna, Jelakovic, Ana, Jelakovic, Bojan, Jennings, Garry, Jensen, Gorm B., Jeong, Seung-lyeal, Jha, Anjani Kumar, Jiang, Chao Qiang, Jimenez, Ramon O., Jöckel, Karl-Heinz, Joffres, Michel, Jokelainen, Jari J., Jonas, Jost B., Jørgensen, Torben, Joshi, Pradeep, Joukar, Farahnaz, Józwiak, Jacek, Juolevi, Anne, Kafatos, Anthony, Kajantie, Eero O., Kalter-Leibovici, Ofra, Kamaruddin, Nor Azmi, Kamstrup, Pia R., Karki, Khem B., Katz, Joanne, Kauhanen, Jussi, Kaur, Prabhdeep, Kavousi, Maryam, Kazakbaeva, Gyulli, Keil, Ulrich, Keinänen-Kiukaanniemi, Sirkka, Kelishadi, Roya, Keramati, Maryam, Kerimkulova, Alina, Kersting, Mathilde, Khader, Yousef Saleh, Khalili, Davood, Khateeb, Mohammad, Kheradmand, Motahareh, Khosravi, Alireza, Kiechl-Kohlendorfer, Ursula, Kiechl, Stefan, Killewo, Japhet, Kim, Hyeon Chang, Kim, Jeongseon, Kim, Yeon-Yong, Klumbiene, Jurate, Knoflach, Michael, Ko, Stephanie, Kohler, Hans-Peter, Kohler, Iliana V., Kolle, Elin, Kolsteren, Patrick, König, Jürgen, Korpelainen, Raija, Korrovits, Paul, Kos, Jelena, Koskinen, Seppo, Kouda, Katsuyasu, Kowlessur, Sudhir, Kratzer, Wolfgang, Kriemler, Susi, Kristensen, Peter Lund, Krokstad, Steiner, Kromhout, Daan, Kujala, Urho M., Kurjata, Pawel, Kyobutungi, Catherine, Laamiri, Fatima Zahra, Laatikainen, Tiina, Lachat, Carl, Laid, Youcef, Lam, Tai Hing, Lambrinou, Christina-Paulina, Lanska, Vera, Lappas, Georg, Larijani, Bagher, Latt, Tint Swe, Laugsand, Lars E., Lazo-Porras, Maria, Lee, Jeannette, Lee, Jeonghee, Lehmann, Nils, Lehtimäki, Terho, Levitt, Naomi S., Li, Yanping, Lilly, Christa L., Lim, Wei-Yen, Lima-Costa, M. Fernanda, Lin, Hsien-Ho, Lin, Xu, Lin, Yi-Ting, Lind, Lars, Linneberg, Allan, Lissner, Lauren, Liu, Jing, Loit, Helle-Mai, Lopez-Garcia, Esther, Lopez, Tania, Lotufo, Paulo A., Lozano, José Eugenio, Luksiene, Dalia, Lundqvist, Annamari, Lundqvist, Robert, Lunet, Nuno, Ma, Guansheng, Machado-Coelho, George L. L., Machado-Rodrigues, Aristides M., Machi, Suka, Madar, Ahmed A., Maggi, Stefania, Magliano, Dianna J., Magriplis, Emmanuella, Mahasampath, Gowri, Maire, Bernard, Makdisse, Marcia, Malekzadeh, Fatemeh, Malekzadeh, Reza, Rao, Kodavanti Mallikharjuna, Manios, Yannis, Mann, Jim I., Mansour-Ghanaei, Fariborz, Manzato, Enzo, Marques-Vidal, Pedro, Martorell, Reynaldo, Mascarenhas, Luis P., Mathiesen, Ellisiv B., Matsha, Tandi E., Mavrogianni, Christina, McFarlane, Shelly R., McGarvey, Stephen T., McLachlan, Stela, McLean, Rachael M., McLean, Scott B., McNulty, Breige A., Mediene-Benchekor, Sounnia, Mehdipour, Parinaz, Mehlig, Kirsten, Mehrparvar, Amir Houshang, Meirhaeghe, Aline, Meisinger, Christa, Menezes, Ana Maria B., Menon, Geetha R., Merat, Shahin, Mereke, Alibek, Meshram, Indrapal I., Metcalf, Patricia, Meyer, Haakon E., Mi, Jie, Michels, Nathalie, Miller, Jody C., Minderico, Cláudia S., Mini, G. K., Miquel, Juan Francisco, Miranda, J. Jaime, Mirjalili, Mohammad Reza, Mirrakhimov, Erkin, Modesti, Pietro A., Moghaddam, Sahar Saeedi, Mohajer, Bahram, Mohamed, Mostafa K., Mohammad, Kazem, Mohammadi, Zahra, Mohammadifard, Noushin, Mohammadpourhodki, Reza, Mohan, Viswanathan, Mohanna, Salim, Yusoff, Muhammad Fadhli Mohd, Mohebbi, Iraj, Mohebi, Farnam, Moitry, Marie, Møllehave, Line T., Møller, Niels C., Molnár, Dénes, Momenan, Amirabbas, Mondo, Charles K., Monterrubio-Flores, Eric, Moosazadeh, Mahmood, Morejon, Alain, Moreno, Luis A., Morgan, Karen, Morin, Suzanne N., Moschonis, George, Mossakowska, Malgorzata, Mostafa, Aya, Mota, Jorge, Motlagh, Mohammad Esmaeel, Motta, Jorge, Msyamboza, Kelias P., Muiesan, Maria L., Müller-Nurasyid, Martina, Mursu, Jaakko, Mustafa, Norlaila, Nabipour, Iraj, Naderimagham, Shohreh, Nagel, Gabriele, Naidu, Balkish M., Najafi, Farid, Nakamura, Harunobu, Námešná, Jana, Nang, Ei Ei K., Nangia, Vinay B., Nauck, Matthias, Neal, William A., Nejatizadeh, Azim, Nenko, Ilona, Nervi, Flavio, Nguyen, Nguyen D., Nguyen, Quang Ngoc, Nieto-Martínez, Ramfis E., Nihal, Thomas, Niiranen, Teemu J., Ning, Guang, Ninomiya, Toshiharu, Noale, Marianna, Noboa, Oscar A., Noto, Davide, Nsour, Mohannad Al, Nuhoğlu, Irfan, O’Neill, Terence W., O’Reilly, Dermot, Ochoa-Avilés, Angélica M., Oh, Kyungwon, Ohtsuka, Ryutaro, Olafsson, Örn, Olié, Valérie, Oliveira, Isabel O., Omar, Mohd Azahadi, Onat, Altan, Ong, Sok King, Ordunez, Pedro, Ornelas, Rui, Ortiz, Pedro J., Osmond, Clive, Ostojic, Sergej M., Ostovar, Afshin, Otero, Johanna A., Owusu-Dabo, Ellis, Paccaud, Fred Michel, Pahomova, Elena, Pajak, Andrzej, Palmieri, Luigi, Pan, Wen-Harn, Panda-Jonas, Songhomitra, Panza, Francesco, Parnell, Winsome R., Patel, Nikhil D., Peer, Nasheeta, Peixoto, Sergio Viana, Peltonen, Markku, Pereira, Alexandre C., Peters, Annette, Petersmann, Astrid, Petkeviciene, Janina, Peykari, Niloofar, Pham, Son Thai, Pichardo, Rafael N., Pigeot, Iris, Pilav, Aida, Pilotto, Lorenza, Piwonska, Aleksandra, Pizarro, Andreia N., Plans-Rubió, Pedro, Plata, Silvia, Pohlabeln, Hermann, Porta, Miquel, Portegies, Marileen L. P., Poudyal, Anil, Pourfarzi, Farhad, Poustchi, Hossein, Pradeepa, Rajendra, Price, Jacqueline F., Providencia, Rui, Puder, Jardena J., Puhakka, Soile E., Punab, Margus, Qorbani, Mostafa, Bao, Tran Quoc, Radisauskas, Ricardas, Rahimikazerooni, Salar, Raitakari, Olli, Rao, Sudha Ramachandra, Ramachandran, Ambady, Ramos, Elisabete, Ramos, Rafel, Rampal, Lekhraj, Rampal, Sanjay, Redon, Josep, Reganit, Paul Ferdinand M., Revilla, Luis, Rezaianzadeh, Abbas, Ribeiro, Robespierre, Richter, Adrian, Rigo, Fernando, Rinke de Wit, Tobias F., Rodríguez-Artalejo, Fernando, del Cristo Rodriguez-Perez, María, Rodríguez-Villamizar, Laura A., Roggenbuck, Ulla, Rojas-Martinez, Rosalba, Romaguera, Dora, Romeo, Elisabetta L., Rosengren, Annika, Roy, Joel G. R., Rubinstein, Adolfo, Ruidavets, Jean-Bernard, Ruiz-Betancourt, Blanca Sandra, Russo, Paola, Rust, Petra, Rutkowski, Marcin, Sabanayagam, Charumathi, Sachdev, Harshpal S., Sadjadi, Alireza, Safarpour, Ali Reza, Safiri, Saeid, Saidi, Olfa, Saki, Nader, Salanave, Benoit, Salmerón, Diego, Salomaa, Veikko, Salonen, Jukka T., Salvetti, Massimo, Sánchez-Abanto, Jose, Sans, Susana, Santaliestra-Pasías, Alba M., Santos, Diana A., Santos, Maria Paula, Santos, Rute, Saramies, Jouko L., Sardinha, Luis B., Sarrafzadegan, Nizal, Saum, Kai-Uwe, Savva, Savvas C., Sawada, Norie, Sbaraini, Mariana, Scazufca, Marcia, Schaan, Beatriz D., Schargrodsky, Herman, Scheidt-Nave, Christa, Schienkiewitz, Anja, Schipf, Sabine, Schmidt, Carsten O., Schöttker, Ben, Schramm, Sara, Sebert, Sylvain, Sein, Aye Aye, Sen, Abhijit, Sepanlou, Sadaf G., Servais, Jennifer, Shakeri, Ramin, Shalnova, Svetlana A., Shamah-Levy, Teresa, Sharafkhah, Maryam, Sharma, Sanjib K., Shaw, Jonathan E., Shayanrad, Amaneh, Shi, Zumin, Shibuya, Kenji, Shimizu-Furusawa, Hana, Shin, Dong Wook, Shin, Youchan, Shirani, Majid, Shiri, Rahman, Shrestha, Namuna, Si-Ramlee, Khairil, Siani, Alfonso, Siantar, Rosalynn, Sibai, Abla M., Silva, Diego Augusto Santos, Simon, Mary, Simons, Judith, Simons, Leon A., Sjöström, Michael, Skaaby, Tea, Slowikowska-Hilczer, Jolanta, Slusarczyk, Przemyslaw, Smeeth, Liam, Snijder, Marieke B., Söderberg, Stefan, Soemantri, Agustinus, Sofat, Reecha, Solfrizzi, Vincenzo, Somi, Mohammad Hossein, Sonestedt, Emily, Sørensen, Thorkild I. A., Jérome, Charles Sossa, Soumaré, Aïcha, Sozmen, Kaan, Sparrenberger, Karen, Staessen, Jan A., Stathopoulou, Maria G., Stavreski, Bill, Steene-Johannessen, Jostein, Stehle, Peter, Stein, Aryeh D., Stessman, Jochanan, Stevanović, Ranko, Stieber, Jutta, Stöckl, Doris, Stokwiszewski, Jakub, Stronks, Karien, Strufaldi, Maria Wany, Suárez-Medina, Ramón, Sun, Chien-An, Sundström, Johan, Suriyawongpaisal, Paibul, Sy, Rody G., Sylva, René Charles, Szklo, Moyses, Tai, E. Shyong, Tamosiunas, Abdonas, Tan, Eng Joo, Tarawneh, Mohammed Rasoul, Tarqui-Mamani, Carolina B., Taylor, Anne, Taylor, Julie, Tell, Grethe S., Tello, Tania, Thankappan, K. R., Thijs, Lutgarde, Thuesen, Betina H., Toft, Ulla, Tolonen, Hanna K., Tolstrup, Janne S., Topbas, Murat, Topór-Madry, Roman, Tormo, María José, Tornaritis, Michael J., Torrent, Maties, Torres-Collado, Laura, Traissac, Pierre, Trinh, Oanh T. H., Truthmann, Julia, Tsugane, Shoichiro, Tulloch-Reid, Marshall K., Tuomainen, Tomi-Pekka, Tuomilehto, Jaakko, Tybjaerg-Hansen, Anne, Tzourio, Christophe, Ueda, Peter, Ugel, Eunice, Ulmer, Hanno, Unal, Belgin, Uusitalo, Hannu M. T., Valdivia, Gonzalo, Valvi, Damaskini, van Dam, Rob M., van der Schouw, Yvonne T., Van Herck, Koen, Van Minh, Hoang, van Rossem, Lenie, Van Schoor, Natasja M., van Valkengoed, Irene G. M., Vanderschueren, Dirk, Vanuzzo, Diego, Varbo, Anette, Varona-Pérez, Patricia, Vasan, Senthil K., Vatten, Lars, Vega, Tomas, Veidebaum, Toomas, Velasquez-Melendez, Gustavo, Venero-Fernández, Silvia J., Veronesi, Giovanni, Verschuren, W. M. 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• Format: Article in Journal/Newspaper
• Language: English
• Published: Nature Publishing Group UK 2020
• Subjects: Greenland; Norway; Pacific; Iceland
• Online Access: https://eprints.mdx.ac.uk/33358/; https://eprints.mdx.ac.uk/33358/1/41586_2020_2338_MOESM2_ESM.pdf; https://doi.org/10.1038/s41586-020-2338-1

High blood cholesterol is typically considered a feature of wealthy western countries1, 2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4, 5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.