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Blood lipid concentrations and other cardiovascular risk factors: distribution, prevalence, and detection in Britain
J I Mann1, B Lewis, J Shepherd
1Department of Community Medicine, University of Oxford.
Insights
This study analyzed blood lipid levels and cardiovascular disease risk factors in 12,092 British adults. Findings reveal regional variations in cholesterol and triglyceride levels, with higher concentrations in Glasgow and London, potentially linked to lifestyle factors.
Area of Science:
- Cardiovascular epidemiology
- Clinical biochemistry
Background:
- Cardiovascular disease (CVD) remains a leading cause of mortality globally.
- Understanding the distribution of blood lipid concentrations and associated risk factors is crucial for public health interventions.
Purpose of the Study:
- To determine the prevalence of blood lipid concentrations (cholesterol, triglyceride, HDL cholesterol, glucose) and other CVD risk factors in a British population.
- To investigate geographical and age-related variations in these risk factors across four UK centers.
Main Methods:
- A cross-sectional study involving 12,092 men and women aged 25-59 from Glasgow, Leicester, London, and Oxford.
- Participants were recruited via opportunistic case finding or random selection, with a 73% overall response rate.
- Data collected included lifestyle questionnaires, anthropometric measurements (height, weight), blood pressure, and plasma lipid/glucose levels.
Main Results:
- Mean cholesterol concentrations were 5.9 mmol/l in men and 5.8 mmol/l in women, with significantly lower levels in London compared to other centers.
- Triglyceride concentrations were higher in men than women and showed age-related increases, with higher overall values in Glasgow and London.
- Higher body mass index and smoking rates were observed in Glasgow, correlating with blood pressure and triglyceride levels.
Conclusions:
- Significant geographical variations in blood lipid concentrations and CVD risk factors exist within Britain.
- Lifestyle factors such as diet, smoking, and obesity appear to contribute to these regional differences and potentially influence coronary heart disease rates.
- Despite public health efforts, cholesterol levels in Britain have remained largely unchanged over the past decade.
Abstract:
To establish the distribution of blood lipid concentrations and the prevalences of other risk factors for cardiovascular disease in Britain 12,092 men and women aged 25-59 in Glasgow, Leicester, London, and Oxford were studied. Subjects were selected by opportunistic case finding, in which patients consulting their general practitioner for any reason were offered a health check by appointment, or random selection from age-sex registers, in which an invitation for a health check was posted. The overall rate of response was 73%, being 91-94% by opportunistic case finding and 36-63% by random selection. At the health check subjects answered a brief questionnaire about risk factors for cardiovascular disease, and their height, weight, and blood pressure were recorded; a blood sample was taken for measuring plasma concentrations of cholesterol, triglyceride, high density lipoprotein cholesterol, and glucose. The mean cholesterol concentrations were 5.9 (SD 1.2) and 5.8 (1.2) mmol/l in men and women, respectively. In London the mean value was 5.5 (1.2) mmol/l for both men and women and was significantly lower than mean values in the three other centres, among which there were no significant differences. In men and women aged 25-29 concentrations were similar but they increased in men until the age of 45-49, after which they showed no further increase; in women concentrations did not increase until the age of 40-44 and by the age of 50-59 values were higher than in men. Mean triglyceride concentrations were significantly higher in men than in women (1.8 (1.4) v 1.3 (0.9) mmol/l, respectively), and trends with age were similar to those for cholesterol concentrations, except that at no age were values higher in women than in men. Mean triglyceride values overall were higher in Glasgow and London than in Oxford and Leicester. Body mass index was higher in Glasgow and London than in the other two centres and correlated with systolic and diastolic blood pressures and triglyceride concentration. In addition, subjects in Glasgow smoked significantly more than those in the other centres. These observations could contribute to the higher rate of coronary heart disease in Glasgow. Plasma lipid concentrations and the prevalences of other risk factors for cardiovascular disease were similar in subjects selected by opportunistic case finding and by random selection. In Britain cholesterol values have changed little during the past 12 years despite dietary recommendations and health education.(ABSTRACT TRUNCATED AT 400 WORDS)