Trends in lipid levels and hypercholesterolemia in hypertensive and normotensive Finnish adults from 1982 to 1997

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Abstract
Kastarinen M, Tuomilehto J, Vartiainen E, Jousilahti P, Sundvall J, Puska P, Nissinen A (University of Kuopio, Kuopio; National Public Health Institute, Helsinki; Kuopio University Hospital, Kuopio, Finland). Trends in lipid levels and hypercholesterolemia in hypertensive and normotensive Finnish adults from 1982 to 1997. J Intern Med 2000; 247: 53–62. Objectives. To assess the trends in lipid levels and awareness of hypercholesterolemia in hypertensive and normotensive population in Finland from 1982 to 97. Design. Four independent cross‐sectional population surveys conducted in 1982, 1987, 1992 and 1997. Setting. The provinces of North Karelia and Kuopio in eastern Finland and the region of Turku‐Loimaa in south‐western Finland. Subjects. Men and women aged 25–64 years, selected randomly from the national population register. The subjects were classified to four groups according to their blood pressure level and treatment status: normotensive, unaware hypertensive, aware but not treated hypertensive and treated hypertensive. The total number of participants was 24 083. Main outcome measures. We assessed the mean serum total cholesterol and HDL cholesterol concentrations, the prevalence of hypercholesterolemia (total cholesterol ≥6.5 mmol L–1 or the use of lipid‐lowering drugs), the prevalence of a high ratio of total cholesterol to HDL cholesterol (ratio ≥5) and the awareness of hypercholesterolemia amongst the four study groups. Results. Mean total cholesterol, the prevalence of hypercholesterolemia and the prevalence of a high ratio of total to HDL cholesterol decreased, whereas the awareness of hypercholesterolemia increased significantly in all study groups. The decline in mean total cholesterol was largest in treated hypertensive subjects of both sexes (13% in men, 14% in women). Mean HDL cholesterol increased significantly in all study groups except in the unaware hypertensive men, but it remained significantly lower in treated hypertensive patients in both sexes compared with the other groups (P < 0.001). Conclusions. The lipid profile of both the hypertensive and normotensive population has significantly improved in both the hypertensive and normotensive population in Finland from 1982–97. The introduction of newer antihypertensive drugs has not had any effect on the HDL cholesterol level amongst treated hypertensive patients at the population level.

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