How many Australian deaths from heart disease and stroke could be avoided by a small reduction in population cholesterol levels

Aim:  To quantify the number of premature deaths from coronary heart disease and ischaemic stroke that potentially could be avoided annually among the Australian population if a sustained 10% reduction in the mean population level of low-density lipoprotein cholesterol were to be achieved. Methods:  Data were obtained on the number of deaths from coronary heart disease and stroke in the Australian population, subdivided into age and sex strata, and on the mean population level of low-density lipoprotein cholesterol. Published relative risks (95% CI) from a meta-analysis of lipid-lowering therapy were used to calculate the reduction in the relative risk for coronary heart disease and stroke associated with a 5%, 10% and 15% reduction in low-density lipoprotein cholesterol. The expected number of deaths from coronary heart disease and ischaemic stroke avoidable with a 10% reduction in low-density lipoprotein cholesterol was modelled. Secondary analyses were performed assuming reductions in low-density lipoprotein cholesterol of 5% and 15%. Results:  A 10% reduction in low-density lipoprotein cholesterol would prevent 2279 deaths from coronary heart disease (95% CI: 2025–2531 deaths) and 641 deaths from ischaemic stroke (95% CI: 440–881 deaths). The projected benefits are greatest among the elderly, although some benefit would be expected in all age and sex groups and among individuals with a broad range of baseline levels of low-density lipoprotein cholesterol. Conclusions:  A small leftward shift in the low-density lipoprotein cholesterol distribution of the adult Australian population has the potential to save about 3000 lives from coronary heart disease and stroke annually. Achieving this goal will require the active participation of key public health, food industry and government stakeholders.

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