World Health Matters: Sweden: Improved lifestyle led to decreased cholesterol and less cardiac death

by Gary Finnegan: Cholesterol levels – the most common risk factor for heart attacks – have decreased in northern Sweden over the last 20 years. Since medication only accounts for a third of the decrease, the reduced risk of cardiovascular disease is largely thanks to changes in lifestyle, according to a study published in the European Heart Journal.

Researchers at Umeå University and Sunderby Hospital in Luleå, both in northern Sweden, have found a general decrease in cholesterol levels, which was more pronounced in older people, women without university education and in people with high risk of cardiovascular disease.

“The most important reason for the decreased cholesterol level in the population of Norrbotten and Västerbotten counties in northern Sweden is most likely a change in lifestyle, such as a reduced intake of fat, together with an increased intake of fibre from fruit, vegetables and grains,” according to Professor Mats Eliasson.

The study shows that the average level of blood cholesterol in the population decreased from 6.2 to 5.5 mmol/L between 1994 and 2014. The decrease was more pronounced in the elderly than in younger participants, but no difference was found between men and women.

The group with the largest decrease was people with high risk of cardiovascular disease, who had been treated for high blood pressure, diabetes and previous heart attack or stroke.

“The fact that women without university education now have the same low cholesterol levels [as the general population] or that obese persons have equally good levels as normal-weight persons confirms that health care is now offered on the same terms,” says Professor Marie Eriksson, a statistician at Umeå University and co-author of the study.

“The efforts on primary and secondary preventions in health care centres and heart clinics have contributed significantly,” she said. “However, there is still room for improvement, both by continuously encouraging an improved lifestyle and through the use of medical drugs. The constantly decreasing cholesterol levels are pointing towards a continuous reduction in cardiovascular disease.”

Even if the risk of cardiovascular disease has been heavily reduced in the last 10-20 years, it is still the most common cause of death in Sweden, especially when it comes to heart attacks. High cholesterol levels are the most important cause of disease followed by smoking and high blood pressure.