AUTHOR=Du Heyue , Shi Qingyang , Song Peige , Pan Xiong-Fei , Yang Xueli , Chen Lingmin , He Yazhou , Zong Geng , Zhu Ye , Su Baihai , Li Sheyu 

TITLE=Global Burden Attributable to High Low-Density Lipoprotein-Cholesterol From 1990 to 2019

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.903126

DOI=10.3389/fcvm.2022.903126

ISSN=2297-055X

ABSTRACT=Background
High low-density lipoprotein-cholesterol (LDL-C) is a public health issue contributing to ischemic heart disease and stroke. 
Method
In this ecological study, we collected summary exposure values (SEVs), deaths, disability-adjusted life of years (DALYs), and SDI of high LDL-C from 1990 to 2019 using the query tool from the Global Burden of Disease Collaborative Network. Outcomes include SEVs, deaths, DALYs attributable to high LDL-C stratified by sex, age, region, SDI, countries and territories. Estimated annual percentage changes (EAPCs) were applied to estimate annual trends of changes in these outcomes. We applied the weighted segmented regression with break-point estimation to detect the linear piecewise relationship between SDI and high LDL-C disease burden.
Results
Globally, 3.00 million (95% uncertainty interval [UI], 2.35 to 3.76 million) people in 1990 and 4.40 million (95% UI, 3.30 to 5.65 million) people died from high LDL-C in 2019. The absolute annual burden from deaths and DALYs attributed to high LDL-C increased 46% (95% UI, 35% to 56%) and 41% (95% UI, 31% to 50%) from 1990 to 2019. The age-standardized SEV, death and DALY decreased 9% (95% UI, -11% to -8%), 37% (95% UI, -41% to -33%), and 32% (95% UI, -37% to -28%) during the study period. There was a negative association between SDI and high LDL-C-related age-standardized death and DALY rates when SDI surpassed 0.71 and 0.71, respectively.
Conclusion
Although the overall age-standardized burden of high LDL-C are controlled in the past thirty years, it remains increasing in moderate SDI countries and decreasing trends is disappearing in high SDI countries. New challenges require new actions stratified by countries with different SDI levels.