Global, regional, and national high LDL-cholesterol-related disease burden: an updated analysis of the global burden of disease study 2021.

BACKGROUND AND AIMS: High low-density lipoprotein cholesterol (HLDL-C) levels are independently associated with adverse cardiovascular events. Based on the latest Global Burden of Disease Study 2021 (GBD2021) data, we explored the current global, regional, and national HLDL-C-related disease burden under the updated diagnostic criteria.

METHODS AND

RESULTS

Using data from the GBD2021, we analysed the HLDL-C-related mortality and disability-adjusted life year (DALY) rates between 1990 and 2021, stratified by region, sex, age, and temporal changes. The overall global HLDL-C-related mortality and DALY rates are declining, with a greater burden in men than in women. Nevertheless, the absolute death and DALY numbers have steadily increased by 48·69% and 45·72%, respectively. Only regions with a high sociodemographic index (SDI) achieved a reduction in disease burden. In 2021, middle-SDI regions had the highest death and DALY numbers and the greatest percentage change in these numbers. The highest mortality and DALY rates were found in the middle-high- and low-high-SDI regions, respectively. Globally, China had the heaviest burden and Nauru the highest mortality and DALY rates. Additionally, the proportion of deaths or DALYs from different causes varied with age, with those of ischemic stroke increasing with age. The peak age of HLDL-C-related burden was subtly different between the sexes.

CONCLUSION

In most regions, HLDL-C levels are not effectively controlled, resulting in a significant increase in the overall global burden. Targeted measures to prevent HLDL-C-related diseases and reduce disparities across different populations are urgently needed.