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National cholesterol treatment guidelines in Korean population--setting-up the cutpoints for high blood cholesterol
Insights
Establishing national cholesterol guidelines requires population-specific data. This study proposes new Korean cutpoints for borderline-high (200 mg/dL) and high (240 mg/dL) serum cholesterol levels, aiding early intervention for coronary heart disease risk factors.
Area of Science:
- Cardiovascular Epidemiology
- Clinical Biochemistry
- Public Health
Background:
- National cholesterol treatment guidelines vary globally due to genetic, dietary, and lifestyle differences.
- Establishing population-specific guidelines based on epidemiological data is crucial for effective hypercholesterolemia management.
Purpose of the Study:
- To establish hypercholesterolemia cutpoints tailored for the Korean population.
- To determine appropriate serum cholesterol levels for initiating dietary and exercise therapy in Korea.
Main Methods:
- Selected laboratories with <5% cholesterol measurement inaccuracy.
- Conducted an epidemiological survey on cholesterol distribution and coronary heart disease (CHD) risk factors in Korea.
- Analyzed data on hypertension, diabetes, smoking, family history, and serum lipid levels.
Main Results:
- Average Korean cholesterol level: 187 mg/dL (25 mg/dL lower than US).
- 75th percentile: 210 mg/dL; 90th percentile: 235 mg/dL.
- Prevalence of hypertension (28.0%) and smoking (42.6%) was high; diabetes (2.8%) was low.
Conclusions:
- Proposed borderline-high cholesterol cutpoint: 200 mg/dL (instead of 210 mg/dL) for earlier intervention.
- Proposed high cholesterol cutpoint: 240 mg/dL (instead of 235 mg/dL), considering national medical insurance.
- Recommended these cutpoints for effective national cholesterol management strategies in Korea.
Abstract:
National Cholesterol Treatment Guidelines are different according to race and country, and change year by year, because the distribution of lipid and lipoprotein levels are different by genetic background, dietary habit and life style. So it is mandatory to set-up the national cholesterol treatment guidelines based on the epidemiologic results. To establish the cutpoints for hypercholesterolemia specific to the Korean population, we selected the laboratories, whose inaccuracies of cholesterol measurement were less than 5%, in the external laboratory quality assessment survey, and performed epidemiological survey on the distribution of cholesterol levels, and other risk factors of coronary heart disease (CHD). As a result, prevalence of CHD risk factors was very high in hypertension (28.0%) and relatively low in diabetes (2.8%). Smokers were 42.6% of total subjects. Thirteen percent of subjects had a family member(s) who was suffering from or had of hypertension, stroke, and heart diseases. The average cholesterol level of a Korean was 187 mg/dL, which was about 25 mg/dL lower than that of United States. The 75th percentile to total cholesterol was 210 mg/dL and 90th percentile 235 mg/dL. The cutpoint for borderline-high cholesterol levels provide a major guideline for initiation of dietary and exercise therapy. We propose the cutpoint for borderline-high cholesterol levels as 200 instead of 210 mg/dL to initiate more active dietary and exercise therapy, and we also propose the temporary cutpoint for high blood cholesterol levels as 240 mg/dL instead of 235 mg/dL, which is a reasonable cutpoint considering medical insurance policy of the country. In conclusion, we suggest the cutpoints for borderline-high and high serum cholesterol levels as 200 and 240 mg/dL, respectively.