Blood cholesterol level and prevalence of hypercholesterolaemia in developing countries: a review of population-based studies carried out from 1979 to 2002.

BACKGROUND: While the age-specific rates of cardiovascular diseases (CVD) are declining in many developed countries, the epidemic is accelerating in most developing countries. Elevated serum total cholesterol (TC) is one of the major risk factors for atherosclerotic CVD. This review was carried out to describe the current situation in mean TC and in the prevalence of hypercholesterolaemia in developing countries. DESIGN AND METHODS: A search for papers published in medical journals from 1990 to 2002 was performed using the MEDLINE database. A total of 37 articles were selected according to previously defined criteria containing information on mean blood total cholesterol and/or hypercholesterolaemia from 38 developing countries.
RESULTS: Hypercholesterolaemia is a public health problem in most of the developing countries reviewed. A positive association between the population mean TC and the GNP per capita was evidenced.
CONCLUSIONS: Differences in methodology between national surveys make international comparisons difficult. Nevertheless, low-cost dietary interventions and the development of primary prevention strategies are needed to reduce the already existing public health problem of elevated TC in developing countries.