Aims Our first aim was to study the trends in lipoprotein levels between 2001 and 2018 in a register-based cohort study in a statin-free population from primary health care, and secondly to compare lipoprotein levels in 2001 and 2018 in relation to sex and age.
Methods and results Measurements of total cholesterol (TC) (n=1,574,339) corresponding to 634,119 individuals, low-density lipoprotein cholesterol (LDL-C) (n=1,302,440), high-density lipoprotein cholesterol (HDL-C) (n=1,417,857) and triglycerides (TG) (n=1,329,477) were identified in a cohort of patients from general practice between 2001 and 2018. Patients with diagnoses and medical treatments that affected lipoprotein levels were excluded.
The mean TC and LDL-C decreased from 5.64 mmol/L (95% CI: 5.63-5.65) in 2001 to 5.17 mmol/L (95% CI: 5.16-5.17) in 2018, and from 3.67 mmol/L (95% CI: 3.66-3.68) to 3.04 mmol/L (95% CI: 3.03-3.04), respectively. The largest decreases in TC and LDL-C levels were seen among the elderly women. The median (geometric mean) TG level decreased 0.4 mmol/L from 2001 to 2008 with, after which it slightly increased. HDL-C levels showed no specific tendency during the observation period.
In general, lipoprotein levels in men are were highest until menopause of the women, after which the women’s levels wereare highest.
Conclusion The levels of TC and LDL-C decreased remarkably in a statin-free population from primary health care from 2001 to 2018. The decrease was most pronounced in the elderly women and does not seem to decelerate. After an initial decrease, TG levels seemed to increase.