Abstract 1184: Changes In Total Cholesterol Levels In The Icelandic Population Is Not Attributable To Lipid Lowering Medication Use
Background: Total cholesterol (TC) levels have decreased in Western populations over the last decades. This has largely been attributed to changes in dietary intake, mainly reduced intake of saturated fat. The drop in population TC has been very great from the early 1990s in Iceland and many other countries, coinciding with the introduction of lipid lowering medication. A number of studies have examined the changes in TC and frequently attribute the drop to statin use. However, few studies have been able to address this directly due to lack of information on statin use in the same individuals as TC has been measured in at the population level.
Methods & results: We address this in the population based studies of the Icelandic Heart Association, the Reykjavik study and related studies carried out over the last 40 years. TC was measured in fasting blood in 8 different cross sectional samples between 1967 and 2007 of close to 30.000 men and women of age 45– 65 with information on lipid medication. Statin use has been increasing mainly after 1990 and today statin use is about 12% among men and about 5% in women. The changes in population TC in men with and without the use of lipid lowering medication is shown in the Figure⇓. The decline in population level of TC has the same characteristic for the 88% not taking lipid lowering drugs as for those 12% on medication. The same picture is seen for women.
Conclusion: It can be stated that the rapid decline in TC of the Icelandic population over the last 15 years or so is not explained by the introduction of lipid lowering medication. It is likely that the same applies to other populations where similar picture is seen and lipid lowering medication is at a similar or even less level.