Статья

Global Burden of Elevated LDL-C

GBD 2023 LDL Cholesterol CollaboratorsChristian RazoInstitute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, WashingtonNicole K. DeCleeneInstitute for Health Metrics and EvaluationCatherine O. JohnsonInstitute for Health Metrics and EvaluationBenjamin StarkInstitute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, WashingtonKate LeGrandInstitute for Health Metrics and Evaluation (IHME), University of Washington, Seattle, WashingtonHasan AalruzAl Zaytoonah University of Jordan, Amman, JordanUkachukwu O. AbaraoguUniversity of the West of Scotland, Paisley, United KingdomSamar Abd ElHafeezAlexandria University, Alexandria, EgyptMichael AbdelmassehMarshall University, Huntington, West VirginiaMahmoud AbdelnabiMayo Clinic, Phoenix, ArizonaSherief Abd-ElsalamTanta University, Tanta, EgyptRasha Abdelsalam ElshenawyWest Hertfordshire Hospitals NHS Trust, Hertfordshire, United KingdomSiddig Ibrahim AbdelwahabJazan University, Jazan, Saudi ArabiaAli AbdolizadehSt George’s University, St George’s, GrenadaArash AbdollahiIran University of Medical Sciences, Tehran, IranMeriem AbdounCentre Hospito Universitaire de SétifMostafa M. AbdrabouCairo University, Cairo, EgyptDeldar Morad AbdulahUniversity of Duhok, Duhok, IraqAuwal AbdullahiBayero University Kano, Kano, NigeriaToufik Abdul‐RahmanAbiy AbebeWollo University, Dessie, EthiopiaHabtamu Abebe GetahunUniversity of Gondar, Gondar, EthiopiaOlugbenga Olusola AbiodunBabcock University, Ilishan-Remo, NigeriaOlumide AbiodunFederal Medical Centre, Abuja, NigeriaShady AbohashemMassachusetts General Hospital, Boston, MassachusettsUlric Sena AbonieNorthumbria University, Newcastle, United KingdomNagah M. AbourashedUniversity of Ha’il, Ha’il, Saudi ArabiaDmitry AbramovLoma Linda University Medical Center, Loma Linda, CaliforniaMohammed Mehdi AbrarAddis Ababa University, Addis Ababa, EthiopiaDariush AbtahiShahid Beheshti University of Medical Sciences, Tehran, IranRana Kamal Abu FarhaApplied Science Private University, Amman, JordanBilyaminu AbubakarUsmanu Danfodiyo University, Sokoto, Sokoto, NigeriaAhmad Y. AbuhelwaUniversity of Sharjah, Sharjah, United Arab EmiratesHana J AbukhadijahHamad Bin Khalifa University, Doha, QatarSalahdein AburuzUnited Arab Emirates University, Al Ain, United Arab EmiratesDina AbushanabHamad Medical Corporation, Doha, QatarLisa C. AdamsTechnical University of Munich, Munich, GermanyNuhu Lawan Lawan AdamuModibbo Adama University, Yola, Yola, NigeriaMesafint Molla AdaneBahir Dar University, Bahir Dar, EthiopiaIsaac Yeboah AddoUniversity of Sydney, Sydney, New South Wales, AustraliaKamoru A. AdedokunRoswell Park Comprehensive Cancer Center, Buffalo, New YorkOluwatobi E AdegbileEast Tennessee State University, Johnson City, TennesseeNurudeen A. AdegokeThe University of Sydney, Sydney, New South Wales, AustraliaSaheed Ayodeji AdekolaUniversity of Abuja, Abuja, NigeriaOlumide Thomas AdelekeBowen University, Iwo, NigeriaMiracle Ayomikun AdesinaMolalign Aligaz AdisuWoldia University, Woldia, EthiopiaMohd AdnanUniversity of Hail, Hail, Saudi ArabiaClifford AfoakwahQueensland University of Technology, Kelvin Grove, Queensland, AustraliaAanuoluwapo Adeyimika AfolabiMSI Nigeria Reproductive Choices, Abuja, NigeriaFatemeh AfrashtehIran University of Medical Sciences, Tehran, IranEbenezer Afrifa-YamoahEdith Cowan University, Perth, Western Australia, AustraliaSaira AfzalKing Edward Memorial Hospital, Lahore, PakistanPercival Delali AgordohUniversity of Health and Allied Sciences, Ho, GhanaWilliams Agyemang‐DuahQueen’s University, Kingston, Ontario, CanadaAqeel AhmadShaqra University, Shaqra, Saudi ArabiaKhabir AhmadKing Khaled Eye Specialist Hospital & Research Center, Riyadh, Saudi ArabiaSajjad AhmadSchool of Surgery Wales, Bangor, United KingdomSuhaib AhmadAbasyn University, Peshawar, PakistanAsma AhmedThe University of Lahore, Lahore, PakistanGasha Salih AhmedUniversity of Human Development, Sulaymaniyah, IraqLuai A. AhmedUnited Arab Emirates University, Al Ain, United Arab EmiratesMehrunnisha Sharif AhmedRawalpindi Medical University, Rawalpindi, PakistanMeqdad Saleh AhmedMansoura University Hospital, Mansoura, EgyptM. AhmedMajmaah University, Al Majmaah, Saudi ArabiaMushood AhmedRawalpindi Medical University, Rawalpindi, PakistanNesredin AhmedHaramaya University, Harar, EthiopiaSyed Anees AhmedEast Carolina University, Greenville, North CarolinaZohra AhmedShaheed Zulfiqar Ali Bhutto University Islamabad Pakistan, Islamabad, PakistanAishwarya AiyerMaharashtra University of Health Sciences, Pune, IndiaMarjan AjamiShahid Beheshti University of Medical Sciences, Tehran, IranKasuni H.M. AkalankaCharles Sturt University, Orange, New South Wales, AustraliaMuhammad Nadeem AkhtarThe University of Lahore, Lahore, PakistanMukadas O. AkindeleBayero University Kano, Kano, NigeriaMohammed Ahmed AkkaifFudan University, Shanghai, ChinaAshley E AkramiMidwestern University, Downers Grove, IllinoisRalph Kwame AkyeaUniversity of Nottingham, Nottingham, United KingdomSyed Mahfuz Al HasanWashington University in St Louis, St Louis, MissouriMohammad Ahmmad Mahmoud Al ZoubiFares AlahdabUniversity of Missouri, Columbia, MissouriMohammad M. Al-AhmadAl Ain University, Abu Dhabi, United Arab EmiratesStephen AlajajianWuqu’ Kawoq, Maya Health Alliance, Tecpán, GuatemalaMuaaz AlajlaniArab International University, Damascus, SyriaTariq A. AlalwanUniversity of Bahrain, Zallaq, BahrainZiyad Al‐AlyWashington University in St Louis, St Louis, MissouriIssa Sulaiman Al-AmriUniversity of Nizwa, Nizwa, OmanTurki M. AlanziImam Abdulrahman Bin Faisal University, Dammam, Saudi ArabiaAbdullah AlarifiMinistry of Health, Riyadh, Saudi ArabiaFahmi Y. Al-AshwalAl-Ayen Iraqi University, Thi-Qar, IraqAhmad Al‐AzayzihJordan University of Science and Technology, Irbid, JordanSayer Al-AzzamJordan University of Science and Technology, Irbid, JordanAhmad M. Al-BashairehPhiladelphia University, Amman, JordanMohammed AlbashtawyAl al-Bayt University, Mafraq, JordanNader Al-DewikHamad Medical Corporation, Doha, QatarShereen M. AleidiUniversity of Sharjah, Sharjah, United Arab EmiratesFahad D. AlgahtaniUniversity of Hail, Hail, Saudi ArabiaAbdelazeem M AlgammalSuez Canal University, Ismailia, EgyptKhalid F. AlHabibKing Saud University, Riyadh, Saudi ArabiaFadwa Naji AlhalaiqaQatar University, Doha, Qatar

2026en

ABI

Аннотация

Importance: Elevated low-density lipoprotein cholesterol (LDL-C) is a modifiable risk factor for cardiovascular disease, the leading cause of premature death worldwide. Assessing the LDL-C-related burden is critical for guiding prevention and treatment strategies. Objectives: To estimate the global, regional, and national burden of ischemic heart disease and ischemic stroke attributable to elevated LDL-C (relative to 35-54 mg/dL) from 1990 to 2023 and to quantify the contributions of population growth, aging, risk-deleted burden, and exposure changes to burden trends. Design, Setting, and Population: This comparative risk assessment, part of the Global Burden of Disease Study 2023, estimated population-level LDL-C exposure and associated health loss in 204 countries and territories. Mean LDL-C levels were estimated using spatiotemporal gaussian process regression based on 806 studies across 161 countries. Relative risks were derived from meta-analyses of 38 randomized clinical trials. Population-attributable fractions for deaths and disability-adjusted life-years (DALYs) were estimated by age and sex for adults aged 25 years or older from 1990 to 2023, with 95% uncertainty intervals. Exposure: Population-level LDL-C concentrations. Main Outcomes and Measures: Population-attributable fractions, counts, and rates (all ages and age standardized per 100 000) of LDL-C-attributable deaths and DALYs from ischemic heart disease and ischemic stroke, with uncertainty intervals. Results: In 2023, elevated LDL-C accounted for 3.6 million deaths (95% uncertainty interval, 2.2-5.4 million; 6.0% of global mortality) and 90.7 million DALYs (95% uncertainty interval, 58.9-123.3 million; 3.2% of DALYs). Although global all-ages rates remained stable, age-standardized death and DALY rates decreased by 45.6% and 39.5%, respectively, since 1990. In 2023, age-standardized LDL-C-attributable DALY rates were highest in Eastern Europe and lowest in high-income Asia-Pacific. One-third of the global LDL-C burden occurred in India and China. Population growth and aging drove the increasing burden, with notable regional disparities in LDL-C exposure and risk-deleted DALY rates shifting toward middle-sociodemographic settings. Conclusions and Relevance: Despite declining age-standardized rates, the absolute LDL-C burden has increased since 1990 due to demographic changes and has shifted toward middle-sociodemographic countries. Measurement and surveillance gaps persist. Strengthened prevention, diagnosis, and treatment access strategies are essential to mitigate the health burden of LDL-C.

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Идентификаторы

DOI: 10.1001/jama.2026.8628

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