THIRTY-YEAR CHANGES IN AVERAGE BLOOD LIPIDS LEVELS IN POPULATIONS OF THE RUSSIAN FEDERATION AND THE USA

 Aim. To conduct a comparative study of the changes in blood lipids profiles in populations of the Russian Federation (RF) and the United States of America (USA) in different age and gender groups over the period from 1975 to 2014.

Material and methods. Using a secondary analysis of data obtained from the RF population studies carried out in 1975-1982, the multicenter epidemiological study of cardiovascular diseases in different regions of the RF (ESSE-RF), conducted in 2012-2014, as well as the NHANES series of crosssectional surveys in the civilian non-institutionalized population of the USA (NHANES II in 1976-1980 and Continuous NHANES in 2007-2012), we evaluated average lipids in blood tests in men and women of different age groups, with a total number of 48,974 observations.

Results. At present, in the RF population, as compared to the USA one, most age groups demonstrate a higher concentration of total cholesterol, i.e. p<0.05 in all groups except for men aged 25-34 years (distinctions are absent) and women aged 25-34 (the concentrations are lower in Russia, p=0.05); a higher concentration of high-density lipoprotein cholesterol, i.e. p<0.005 in all men and p≤0.05 in women younger than 45 years, while in women aged 45-54 years the differences are non-significant; in 55-64-year-old women high-density lipoprotein cholesterol is higher in the USA; the concentration of triglycerides in Russia is lower in comparison with the USA in all age groups of men and women (p<0.01). Over the three decades, the total cholesterol concentration has declined in both countries; the patterns in theUnited States in comparison withRussia are characterized by an increase in the concentration of high-density lipoprotein cholesterol in all age groups and by the absence of a negative trend in triglyceride concentrations.

Conclusion. Currently, inRussia, the total cholesterol and low-density lipoprotein cholesterol levels are worse, while triglycerides and partly high-density lipoprotein cholesterol concentrations are better than in theUSA. In general, the thirty-year trends for the aggregate of lipid metabolism parameters are better in theUSA population as compared toRussia. 

1. Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143-421. doi: 01.CIR.0000052861.81153.18.

2. Nelson RH. Hyperlipidemia as a Risk Factor for Cardiovascular Disease. Primary Care. 2013;40(1):195211. doi: 10.1016/j.pop.2012.11.003.

3. Jain S, Vaishnavi V, Chakraborty BS. The effect of dyslipidemic drugs on mortality: A meta-analysis. Indian Journal of Pharmacology. 2009;41(1):4-8. doi: 10.4103/0253-7613.48878.

4. Cholesterol Treatment Trialists' (CTT) Collaborators. The effects of lowering LDL cholesterol with statin therapy in people at low risk of vascular disease: meta-analysis of individual data from 27 randomised trials. Lancet. 2012;380(9841):581-90. doi: 10.1016/S0140-6736(12)60367-5.

5. Grundy SM. Primary prevention of cardiovascular disease with statins: assessing the evidence base behind clinical guidance. Clinical Pharmacist. 2016;8(2). Available at: https://www.pharmaceuticaljournal.com/research/review-article/primary-prevention-of-cardiovascular-disease-with-statins-assessing-the-evidence-base-behind-clinical-guidance/20200568.article. Checked 08.01.2018. doi: 10.1211/CP.2016.20200568.

6. Konstantinov VV, Zhukovsky GS, Timofeeva TN, et al. Ischemic heart disease, risk factors and mortality of male population: relationship to education. Kardiologiia. 1996;1:37-41. (In Russ.) [Константинов В.В., Жуковский Г.С., Тимофеева Т.Н., и др. Ишемическая болезнь сердца, факторы риска и смертность среди мужского населения в связи с уровнем образования. Кардиология. 1996;1:37-41].

7. Shalnova SA, Deev AD, Shestov DB, et al. Prognostic assessment of epidemiological characteristics of ischemic heart disease. Kardiologiia. 1997;9:49-54. (In Russ.) [Шальнова С.А., Деев А.Д., Шестов Д.Б. Прогностическая оценка эпидемиологических характеристик ишемической болезни сердца. Кардиология. 1997;9:49-54].

8. Epidemiology of cardiovascular diseases in different regions of Russia (ESSE-RF). The rationale for and design of the study. Profilakticheskaya Meditsina. 2013;6:25-34. (In Russ.) [Эпидемиология сердечно-сосудистых заболеваний в различных регионах России (ЭССЕ-РФ). Обоснование и дизайн исследования. Профилактическая Медицина. 2013; 6: 25-34].

9. National Health and Nutrition Examination Survey: Questionnaires, Datasets, and Related Documentation. Available at: https://wwwn.cdc.gov/nchs/nhanes/Default.aspx. Checked 08.01.2018.

10. Kuklina EV, Yoon PW, Keenan NL. Trends in high levels of low-density lipoprotein cholesterol in the United States, 1999-2006. JAMA. 2009;302(19):2104-10. doi: 10.1001/jama.2009.1672.

11. Carroll MD, Lacher DA, Sorlie PD. 30-year trends in serum lipids among United States adults: results from the national health and nutrition examination surveys II, III, and 1999-2006. Am J Cardiol. 2011;107(12):1868-70. doi: 10.1016/j.amjcard.2011.03.047.

12. Carroll MD, Kit BK, Lacher DA, et al. Trends in Lipids and Lipoproteins in US Adults, 1988-2010. JAMA. 2012;308(15):1545-54. doi: 10.1001/jama.2012.13260.

13. Hyre AD, Munter P, Menke A, et al. Trends in ATP-III-defined high blood cholesterol prevalence, awareness, treatment and control among U.S. adults. Ann Epidemiol. 2007;17(7):548-55. doi: 10.1016/j.annepidem.2007.01.03.

14. Benjamin EJ, Blaha MJ, Chiuve SE, et al. Heart Disease and Stroke Statistics-2017 Update. A Report From the American Heart Association. Circulation. 2017;135(10):e146-e603. doi: 10.1161/CIR.0000000000000485.

15. Kaufman HW, Blatt AJ, Huang X, et al. Blood Cholesterol Trends 2001-2011 in the United States: Analysis of 105 Million Patient Records. PLoS One. 2013;8(5):e63416. doi: 10.1371/journal.pone.0063416.