Repositioning of the global epicentre of non-optimal cholesterol
Authors:   NCD Risk Factor Collaboration (NCD-RisC), Taddei Cristina , Zhou Bin , Bixby Honor , Carrillo-Larco Rodrigo M. , Danaei Goodarz , Jackson Rod T. , Farzadfar Farshad , Sophiea Marisa K. , Di Cesare Mariachiara , Iurilli Maria Laura Caminia , Martinez Andrea Rodriguez , Asghari Golaleh , Dhana Klodian , Gulayin Pablo , Kakarmath Sujay , Santero Marilina , Voortman Trudy , Riley Leanne M. , Cowan Melanie J. , Savin Stefan , Bennett James E. , Stevens Gretchen A. , Paciorek Christopher J. , Aekplakorn Wichai , Cifkova Renata , Giampaoli Simona , Kengne Andre Pascal , Khang Young-Ho , Kuulasmaa Kari , Laxmaiah Avula , Margozzini Paula , Mathur Prashant , Nordestgaard Børge G. , Zhao Dong , Aadahl Mette , Abarca-Gómez Leandra , Rahim Hanan Abdul , Abu-Rmeileh Niveen M. , Acosta-Cazares Benjamin , Adams Robert J. , Agdeppa Imelda A. , Aghazadeh-Attari Javad , Aguilar-Salinas Carlos A. , Agyemang Charles , Ahluwalia Tarunveer S. , Ahmad Noor Ani , Ahmadi Ali , Ahmadi Naser , Ahmed Soheir H. , Ahrens Wolfgang , Ajlouni Kamel , Alarouj Monira , AlBuhairan Fadia , AlDhukair Shahla , Ali Mohamed M. , Alkandari Abdullah , Alkerwi Ala’a , Aly Eman , Amarapurkar Deepak N. , Amouyel Philippe , Andersen Lars Bo , Anderssen Sigmund A. , Anjana Ranjit Mohan , Ansari-Moghaddam Alireza , Aounallah-Skhiri Hajer , Araújo Joana , Ariansen Inger , Aris Tahir , Arku Raphael E. , Arlappa Nimmathota , Aryal Krishna K. , Aspelund Thor , Assunção Maria Cecília F. , Auvinen Juha , Avdicová Mária , Azevedo Ana , Azizi Fereidoun , Azmin Mehrdad , Balakrishna Nagalla , Bamoshmoosh Mohamed , Banach Maciej , Bandosz Piotr , Banegas José R. , Barbagallo Carlo M. , Barceló Alberto , Barkat Amina , Bata Iqbal , Batieha Anwar M. , Batyrbek Assembekov , Baur Louise A. , Beaglehole Robert , Belavendra Antonisamy , Ben Romdhane Habiba , Benet Mikhail , Benn Marianne , Berkinbayev Salim , Bernabe-Ortiz Antonio , Bernotiene Gailute , Bettiol Heloisa , Bhargava Santosh K. , Bi Yufang , Bienek Asako , Bikbov Mukharram , Bista Bihungum , Bjerregaard Peter , Bjertness Espen , Bjertness Marius B. , Björkelund Cecilia , Bloch Katia V. , Blokstra Anneke , Bo Simona , Boehm Bernhard O. , Boggia Jose G. , Boissonnet Carlos P. , Bonaccio Marialaura , Bongard Vanina , Borchini Rossana , Borghs Herman , Bovet Pascal , Brajkovich Imperia , Breckenkamp Juergen , Brenner Hermann , Brewster Lizzy M. , Bruno Graziella , Bugge Anna , Busch Markus A. , de León Antonio Cabrera , Cacciottolo Joseph , Can Günay , Cândido Ana Paula C. , Capanzana Mario V. , Capuano Eduardo , Capuano Vincenzo , Cardoso Viviane C. , Carvalho Joana , Casanueva Felipe F. , Censi Laura , Chadjigeorgiou Charalambos A. , Chamukuttan Snehalatha , Chaturvedi Nish , Chen Chien-Jen , Chen Fangfang , Chen Shuohua , Cheng Ching-Yu , Cheraghian Bahman , Chetrit Angela , Chiou Shu-Ti , Chirlaque María-Dolores , Cho Belong , Cho Yumi , Chudek Jerzy , Claessens Frank , Clarke Janine , Clays Els , Concin Hans , Confortin Susana C. , Cooper Cyrus , Costanzo Simona , Cottel Dominique , Cowell Chris , Crujeiras Ana B. , Csilla Semánová , Cui Liufu , Cureau Felipe V. , D’Arrigo Graziella , d’Orsi Eleonora , Dallongeville Jean , Damasceno Albertino , Dankner Rachel , Dantoft Thomas M. , Dauchet Luc , Davletov Kairat , De Backer Guy , De Bacquer Dirk , de Gaetano Giovanni , De Henauw Stefaan , de Oliveira Paula Duarte , De Ridder David , De Smedt Delphine , Deepa Mohan , Deev Alexander D. , Dehghan Abbas , Delisle Hélène , Dennison Elaine , Deschamps Valérie , Dhimal Meghnath , Di Castelnuovo Augusto F. , Dika Zivka , Djalalinia Shirin , Dobson Annette J. , Donfrancesco Chiara , Donoso Silvana P. , Döring Angela , Dorobantu Maria , Dragano Nico , Drygas Wojciech , Du Yong , Duante Charmaine A. , Duda Rosemary B. , Dzerve Vilnis , Dziankowska-Zaborszczyk Elzbieta , Eddie Ricky , Eftekhar Ebrahim , Eggertsen Robert , Eghtesad Sareh , Eiben Gabriele , Ekelund Ulf , El Ati Jalila , Eldemire-Shearer Denise , Eliasen Marie , Elosua Roberto , Erasmus Rajiv T. , Erbel Raimund , Erem Cihangir , Eriksen Louise , Eriksson Johan G. , Escobedo-de la Peña Jorge , Eslami Saeid , Esmaeili Ali , Evans Alun , Faeh David , Fall Caroline H. , Faramarzi Elnaz , Farjam Mojtaba , Fattahi Mohammad Reza , Felix-Redondo Francisco J. , Ferguson Trevor S. , Fernández-Bergés Daniel , Ferrante Daniel , Ferrari Marika , Ferreccio Catterina , Ferrieres Jean , Föger Bernhard , Foo Leng Huat , Forslund Ann-Sofie , Forsner Maria , Fouad Heba M. , Francis Damian K. , do Carmo Franco Maria , Franco Oscar H. , Frontera Guillermo , Fujita Yuki , Fumihiko Matsuda , Furusawa Takuro , Gaciong Zbigniew , Galvano Fabio , Gao Jingli , Garcia-de-la-Hera Manoli , Garnett Sarah P. , Gaspoz Jean-Michel , Gasull Magda , Gazzinelli Andrea , Geleijnse Johanna M. , Ghanbari Ali , Ghasemi Erfan , Gheorghe-Fronea Oana-Florentina , Ghimire Anup , Gianfagna Francesco , Gill Tiffany K. , Giovannelli Jonathan , Gironella Glen , Giwercman Aleksander , Goltzman David , Gonçalves Helen , Gonzalez-Chica David A. , Gonzalez-Gross Marcela , González-Rivas Juan P. , González-Villalpando Clicerio , González-Villalpando María-Elena , Gonzalez Angel R. , Gottrand Frederic , Graff-Iversen Sidsel , Grafnetter Dušan , Gregor Ronald D. , Grodzicki Tomasz , Grøntved Anders , Grosso Giuseppe , Gruden Gabriella , Gu Dongfeng , Guallar-Castillón Pilar , Guan Ong Peng , Gudmundsson Elias F. , Gudnason Vilmundur , Guerrero Ramiro , Guessous Idris , Gunnlaugsdottir Johanna , Gupta Rajeev , Gutierrez Laura , Gutzwiller Felix , Ha Seongjun , Hadaegh Farzad , Haghshenas Rosa , Hakimi Hamid , Hambleton Ian R. , Hamzeh Behrooz , Hantunen Sari , Kumar Rachakulla Hari , Hashemi-Shahri Seyed Mohammad , Hata Jun , Haugsgjerd Teresa , Hayes Alison J. , He Jiang , He Yuna , Hendriks Marleen Elisabeth , Henriques Ana , Herrala Sauli , Heshmat Ramin , Hill Allan G. , Ho Sai Yin , Ho Suzanne C. , Hobbs Michael , Hofman Albert , Homayounfar Reza , Hopman Wilma M. , Horimoto Andrea R. V. R. , Hormiga Claudia M. , Horta Bernardo L. , Houti Leila , Howitt Christina , Htay Thein Thein , Htet Aung Soe , Htike Maung Maung Than , Huerta José María , Huhtaniemi Ilpo Tapani , Huisman Martijn , Hunsberger Monica L. , Husseini Abdullatif S. , Huybrechts Inge , Hwalla Nahla , Iacoviello Licia , Iannone Anna G. , Ibrahim Mohsen M. , Wong Norazizah Ibrahim , Iglesia Iris , Ikeda Nayu , Ikram M. Arfan , Iotova Violeta , Irazola Vilma E. , Ishida Takafumi , Islam Muhammad , al-Safi Ismail Aziz , Iwasaki Masanori , Jacobs Jeremy M. , Jaddou Hashem Y. , Jafar Tazeen , James Kenneth , Jamrozik Konrad , Janszky Imre , Janus Edward , Jarvelin Marjo-Riitta , Jasienska Grazyna , Jelakovic Ana , Jelakovic Bojan , Jennings Garry , Jensen Gorm B. , Jeong Seung-lyeal , Jha Anjani Kumar , Jiang Chao Qiang , Jimenez Ramon O. , Jöckel Karl-Heinz , Joffres Michel , Jokelainen Jari J. , Jonas Jost B. , Jørgensen Torben , Joshi Pradeep , Joukar Farahnaz , Józwiak Jacek , Juolevi Anne , Kafatos Anthony , Kajantie Eero O. , Kalter-Leibovici Ofra , Kamaruddin Nor Azmi , Kamstrup Pia R. , Karki Khem B. , Katz Joanne , Kauhanen Jussi , Kaur Prabhdeep , Kavousi Maryam , Kazakbaeva Gyulli , Keil Ulrich , Keinänen-Kiukaanniemi Sirkka , Kelishadi Roya , Keramati Maryam , Kerimkulova Alina , Kersting Mathilde , Khader Yousef Saleh , Khalili Davood , Khateeb Mohammad , Kheradmand Motahareh , Khosravi Alireza , Kiechl-Kohlendorfer Ursula , Kiechl Stefan , Killewo Japhet , Kim Hyeon Chang , Kim Jeongseon , Kim Yeon-Yong , Klumbiene Jurate , Knoflach Michael , Ko Stephanie , Kohler Hans-Peter , Kohler Iliana V. , Kolle Elin , Kolsteren Patrick , König Jürgen , Korpelainen Raija , Korrovits Paul , Kos Jelena , Koskinen Seppo , Kouda Katsuyasu , Kowlessur Sudhir , Kratzer Wolfgang , Kriemler Susi , Kristensen Peter Lund , Krokstad Steiner , Kromhout Daan , Kujala Urho M. , Kurjata Pawel , Kyobutungi Catherine , Laamiri Fatima Zahra , Laatikainen Tiina , Lachat Carl , Laid Youcef , Lam Tai Hing , Lambrinou Christina-Paulina , Lanska Vera , Lappas Georg , Larijani Bagher , Latt Tint Swe , Laugsand Lars E. , Lazo-Porras Maria , Lee Jeannette , Lee Jeonghee , Lehmann Nils , Lehtimäki Terho , Levitt Naomi S. , Li Yanping , Lilly Christa L. , Lim Wei-Yen , Lima-Costa M. Fernanda , Lin Hsien-Ho , Lin Xu , Lin Yi-Ting , Lind Lars , Linneberg Allan , Lissner Lauren , Liu Jing , Loit Helle-Mai , Lopez-Garcia Esther , Lopez Tania , Lotufo Paulo A. , Lozano José Eugenio , Luksiene Dalia , Lundqvist Annamari , Lundqvist Robert , Lunet Nuno , Ma Guansheng , Machado-Coelho George L. L. , Machado-Rodrigues Aristides M. , Machi Suka , Madar Ahmed A. , Maggi Stefania , Magliano Dianna J. , Magriplis Emmanuella , Mahasampath Gowri , Maire Bernard , Makdisse Marcia , Malekzadeh Fatemeh , Malekzadeh Reza , Rao Kodavanti Mallikharjuna , Manios Yannis , Mann Jim I. , Mansour-Ghanaei Fariborz , Manzato Enzo , Marques-Vidal Pedro , Martorell Reynaldo , Mascarenhas Luis P. , Mathiesen Ellisiv B. , Matsha Tandi E. , Mavrogianni Christina , McFarlane Shelly R. , McGarvey Stephen T. , McLachlan Stela , McLean Rachael M. , McLean Scott B. , McNulty Breige A. , Mediene-Benchekor Sounnia , Mehdipour Parinaz , Mehlig Kirsten , Mehrparvar Amir Houshang , Meirhaeghe Aline , Meisinger Christa , Menezes Ana Maria B. , Menon Geetha R. , Merat Shahin , Mereke Alibek , Meshram Indrapal I. , Metcalf Patricia , Meyer Haakon E. , Mi Jie , Michels Nathalie , Miller Jody C. , Minderico Cláudia S. , Mini G. K. , Miquel Juan Francisco , Miranda J. Jaime , Mirjalili Mohammad Reza , Mirrakhimov Erkin , Modesti Pietro A. , Moghaddam Sahar Saeedi , Mohajer Bahram , Mohamed Mostafa K. , Mohammad Kazem , Mohammadi Zahra , Mohammadifard Noushin , Mohammadpourhodki Reza , Mohan Viswanathan , Mohanna Salim , Yusoff Muhammad Fadhli Mohd , Mohebbi Iraj , Mohebi Farnam , Moitry Marie , Møllehave Line T. , Møller Niels C. , Molnár Dénes , Momenan Amirabbas , Mondo Charles K. , Monterrubio-Flores Eric , Moosazadeh Mahmood , Morejon Alain , Moreno Luis A. , Morgan Karen , Morin Suzanne N. , Moschonis George , Mossakowska Malgorzata , Mostafa Aya , Mota Jorge , Motlagh Mohammad Esmaeel , Motta Jorge , Msyamboza Kelias P. , Muiesan Maria L. , Müller-Nurasyid Martina , Mursu Jaakko , Mustafa Norlaila , Nabipour Iraj , Naderimagham Shohreh , Nagel Gabriele , Naidu Balkish M. , Najafi Farid , Nakamura Harunobu , Námešná Jana , Nang Ei Ei K. , Nangia Vinay B. , Nauck Matthias , Neal William A. , Nejatizadeh Azim , Nenko Ilona , Nervi Flavio , Nguyen Nguyen D. , Nguyen Quang Ngoc , Nieto-Martínez Ramfis E. , Nihal Thomas , Niiranen Teemu J. , Ning Guang , Ninomiya Toshiharu , Noale Marianna , Noboa Oscar A. , Noto Davide , Nsour Mohannad Al , Nuhoğlu Irfan , O’Neill Terence W. , O’Reilly Dermot , Ochoa-Avilés Angélica M. , Oh Kyungwon , Ohtsuka Ryutaro , Olafsson Örn , Olié Valérie , Oliveira Isabel O. , Omar Mohd Azahadi , Onat Altan , Ong Sok King , Ordunez Pedro , Ornelas Rui , Ortiz Pedro J. , Osmond Clive , Ostojic Sergej M. , Ostovar Afshin , Otero Johanna A. , Owusu-Dabo Ellis , Paccaud Fred Michel , Pahomova Elena , Pajak Andrzej , Palmieri Luigi , Pan Wen-Harn , Panda-Jonas Songhomitra , Panza Francesco , Parnell Winsome R. , Patel Nikhil D. , Peer Nasheeta , Peixoto Sergio Viana , Peltonen Markku , Pereira Alexandre C. , Peters Annette , Petersmann Astrid , Petkeviciene Janina , Peykari Niloofar , Pham Son Thai , Pichardo Rafael N. , Pigeot Iris , Pilav Aida , Pilotto Lorenza , Piwonska Aleksandra , Pizarro Andreia N. , Plans-Rubió Pedro , Plata Silvia , Pohlabeln Hermann , Porta Miquel , Portegies Marileen L. P. , Poudyal Anil , Pourfarzi Farhad , Poustchi Hossein , Pradeepa Rajendra , Price Jacqueline F. , Providencia Rui , Puder Jardena J. , Puhakka Soile E. , Punab Margus , Qorbani Mostafa , Bao Tran Quoc , Radisauskas Ricardas , Rahimikazerooni Salar , Raitakari Olli , Rao Sudha Ramachandra , Ramachandran Ambady , Ramos Elisabete , Ramos Rafel , Rampal Lekhraj , Rampal Sanjay , Redon Josep , Reganit Paul Ferdinand M. , Revilla Luis , Rezaianzadeh Abbas , Ribeiro Robespierre , Richter Adrian , Rigo Fernando , Rinke de Wit Tobias F. , Rodríguez-Artalejo Fernando , del Cristo Rodriguez-Perez María , Rodríguez-Villamizar Laura A. , Roggenbuck Ulla , Rojas-Martinez Rosalba , Romaguera Dora , Romeo Elisabetta L. , Rosengren Annika , Roy Joel G. R. , Rubinstein Adolfo , Ruidavets Jean-Bernard , Ruiz-Betancourt Blanca Sandra , Russo Paola , Rust Petra , Rutkowski Marcin , Sabanayagam Charumathi , Sachdev Harshpal S. , Sadjadi Alireza , Safarpour Ali Reza , Safiri Saeid , Saidi Olfa , Saki Nader , Salanave Benoit , Salmerón Diego , Salomaa Veikko , Salonen Jukka T. , Salvetti Massimo , Sánchez-Abanto Jose , Sans Susana , Santaliestra-Pasías Alba M. , Santos Diana A. , Santos Maria Paula , Santos Rute , Saramies Jouko L. , Sardinha Luis B. , Sarrafzadegan Nizal , Saum Kai-Uwe , Savva Savvas C. , Sawada Norie , Sbaraini Mariana , Scazufca Marcia , Schaan Beatriz D. , Schargrodsky Herman , Scheidt-Nave Christa , Schienkiewitz Anja , Schipf Sabine , Schmidt Carsten O. , Schöttker Ben , Schramm Sara , Sebert Sylvain , Sein Aye Aye , Sen Abhijit , Sepanlou Sadaf G. , Servais Jennifer , Shakeri Ramin , Shalnova Svetlana A. , Shamah-Levy Teresa , Sharafkhah Maryam , Sharma Sanjib K. , Shaw Jonathan E. , Shayanrad Amaneh , Shi Zumin , Shibuya Kenji , Shimizu-Furusawa Hana , Shin Dong Wook , Shin Youchan , Shirani Majid , Shiri Rahman , Shrestha Namuna , Si-Ramlee Khairil , Siani Alfonso , Siantar Rosalynn , Sibai Abla M. , Silva Diego Augusto Santos , Simon Mary , Simons Judith , Simons Leon A. , Sjöström Michael , Skaaby Tea , Slowikowska-Hilczer Jolanta , Slusarczyk Przemyslaw , Smeeth Liam , Snijder Marieke B. , Söderberg Stefan , Soemantri Agustinus , Sofat Reecha , Solfrizzi Vincenzo , Somi Mohammad Hossein , Sonestedt Emily , Sørensen Thorkild I. A. , Jérome Charles Sossa , Soumaré Aïcha , Sozmen Kaan , Sparrenberger Karen , Staessen Jan A. , Stathopoulou Maria G. , Stavreski Bill , Steene-Johannessen Jostein , Stehle Peter , Stein Aryeh D. , Stessman Jochanan , Stevanović Ranko , Stieber Jutta , Stöckl Doris , Stokwiszewski Jakub , Stronks Karien , Strufaldi Maria Wany , Suárez-Medina Ramón , Sun Chien-An , Sundström Johan , Suriyawongpaisal Paibul , Sy Rody G. , Sylva René Charles , Szklo Moyses , Tai E. Shyong , Tamosiunas Abdonas , Tan Eng Joo , Tarawneh Mohammed Rasoul , Tarqui-Mamani Carolina B. , Taylor Anne , Taylor Julie , Tell Grethe S. , Tello Tania , Thankappan K. R. , Thijs Lutgarde , Thuesen Betina H. , Toft Ulla , Tolonen Hanna K. , Tolstrup Janne S. , Topbas Murat , Topór-Madry Roman , Tormo María José , Tornaritis Michael J. , Torrent Maties , Torres-Collado Laura , Traissac Pierre , Trinh Oanh T. H. , Truthmann Julia , Tsugane Shoichiro , Tulloch-Reid Marshall K. , Tuomainen Tomi-Pekka , Tuomilehto Jaakko , Tybjaerg-Hansen Anne , Tzourio Christophe , Ueda Peter , Ugel Eunice , Ulmer Hanno , Unal Belgin , Uusitalo Hannu M. T. , Valdivia Gonzalo , Valvi Damaskini , van Dam Rob M. , van der Schouw Yvonne T. , Van Herck Koen , Van Minh Hoang , van Rossem Lenie , Van Schoor Natasja M. , van Valkengoed Irene G. M. , Vanderschueren Dirk , Vanuzzo Diego , Varbo Anette , Varona-Pérez Patricia , Vasan Senthil K. , Vatten Lars , Vega Tomas , Veidebaum Toomas , Velasquez-Melendez Gustavo , Venero-Fernández Silvia J. , Veronesi Giovanni , Verschuren W. M. Monique , Victora Cesar G. , Vidiawati Dhanasari , Viet Lucie , Villalpando Salvador , Vioque Jesus , Virtanen Jyrki K. , Visvikis-Siest Sophie , Viswanathan Bharathi , Vlasoff Tiina , Vollenweider Peter , Voutilainen Ari , Wade Alisha N. , Wagner Aline , Walton Janette , Bebakar Wan Mohamad Wan , Mohamud Wan Nazaimoon Wan , Wang Ming-Dong , Wang Ningli , Wang Qian , Wang Ya Xing , Wang Ying-Wei , Wannamethee S. Goya , Wedderkopp Niels , Wei Wenbin , Whincup Peter H. , Widhalm Kurt , Widyahening Indah S. , Wiecek Andrzej , Wijga Alet H. , Wilks Rainford J. , Willeit Johann , Willeit Peter , Wilsgaard Tom , Wojtyniak Bogdan , Wong-McClure Roy A. , Wong Andrew , Wong Tien Yin , Woo Jean , Woodward Mark , Wu Frederick C. , Wu Shouling , Xu Haiquan , Xu Liang , Yan Weili , Yang Xiaoguang , Yasuharu Tabara , Ye Xingwang , Yeow Toh Peng , Yiallouros Panayiotis K. , Yoosefi Moein , Yoshihara Akihiro , You San-Lin , Younger-Coleman Novie O. , Yusoff Ahmad Faudzi , Zainuddin Ahmad A. , Zakavi Seyed Rasoul , Zali Mohammad Reza , Zamani Farhad , Zambon Sabina , Zampelas Antonis , Zaw Ko Ko , Zdrojewski Tomasz , Vrkic Tajana Zeljkovic , Zhang Zhen-Yu , Zhao Wenhua , Zhen Shiqi , Zheng Yingfeng , Zholdin Bekbolat , Zhussupov Baurzhan , Zoghlami Nada , Cisneros Julio Zuñiga , Gregg Edward W. , Ezzati Majid 
Published: June 2020

AbstractHigh blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.