High cholesterol levels often go untreated in developing countries – SWR Knowledge

In many low-income countries, people’s cholesterol levels have been rising for years, and so has the number of deaths associated with higher levels. One study has now examined whether and how people in poor countries are diagnosed and treated.















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Scientists from the University of Göttingen evaluated data from nearly 135,000 participants from 41 countries. They also analyzed country studies on the topic, development economist Maja-Emilia Marcos explains in an interview.

It states that the studies must have been conducted after 2008 and come from a low- or middle-income country. It is also important that it is represented at the national level and that blood values ​​are available.

Good and bad cholesterol

Not all countries differentiate between the good HDL cholesterol and the bad LDL cholesterol, which is responsible for heart attacks and strokes. In some countries only total cholesterol values ​​have been determined.

It is not cheap to collect blood lipid values ​​in detail, because blood must be taken from many people and examined. As a result, some low-income countries are more likely to have blood pressure values ​​and hardly any values ​​for cholesterol or blood sugar. So countries with these blood values ​​were selected.

Costa Rica is a country with a relatively good healthcare system, and thus could also be an interesting case study for other countries.

For example, other regions studied were Algeria, Azerbaijan, Bangladesh, Burkina Faso, Eswatini, Iraq, Iran, and Mongolia.



Costa Rica can be a good example for other underdeveloped countries.


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IMAGO / Agencia EFE


Differences in health care

Scientists directly identified serious differences. Healthcare is a far cry from where it needs to be. More and more people suffer from high cholesterol, while only a small percentage of people take care of it.

Less than half of people with high cholesterol in these countries ever get their cholesterol checked.

When it comes to its diagnosis and treatment, Marcus says less than 10 percent of people have high cholesterol. Nine out of ten people are not treated. This greatly increases the risk of heart attack or stroke.



Half-naked man with an electrocardiogram (Photo: IMAGO, IMAGO / YAY Images)

Many people with high cholesterol do not receive the treatment they need.


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Images by IMAGO / YAY


Health systems in many countries are still mostly preoccupied with combating infectious diseases such as tropical diseases. Cholesterol is often not a problem. This also has to do with the idea of ​​disease in some countries.

Many people think that you can tell if you have high blood pressure or high cholesterol, but this is not the case. Therefore, many residents go to the doctor only when they are already feeling ill, but not prophylactically, to be examined for diseases.

High cholesterol treatment

In her study, Marcus also looked at how to treat people with high cholesterol. More exercise and better nutrition can reduce values. But people need to know that. When it comes to medications, there are seven different types of statins. They are the drug of choice for lowering elevated levels and thus reducing the risk of stroke and heart attack by up to 30 percent.



Statins (Photo: IMAGO, IMAGO / Pacific Press Agency)

Important medications against high cholesterol are the so-called statins.


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IMAGO / Pacific Press


There are some middle and low income countries that are already treating large numbers of people. For example Costa Rica, Iran, Iraq and Sri Lanka. However, in many other countries, there are few resources and no system for systematically testing people with risk factors. These countries are still far from the goals of the World Health Organization.

“The WHO target is that 50 percent of people with high cholesterol should take stats, and should take statins accordingly. Not a single country in our study is able to do this, it is between 8 and 20 percent People who received statins.”

Even in people who already have cardiovascular disease, only 20 percent get statins. In this study of 41 countries, hardly anyone tests their citizens as part of their health care and treats them properly until they are back to good values ​​again. On the contrary, according to Marcus, many countries hardly achieve this.



The concept of the low carb ketogenic diet (Photo: IMAGO, IMAGO / YAY Images)

Eating a healthy diet containing healthy fats helps fight high cholesterol.


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Images by IMAGO / YAY


It is very important that something be done. There are now cheaper test methods, inexpensive medicines without patents. And deliberating about what to eat and how much to exercise costs almost nothing. But there is still a lot of catching up to do in Germany, explains Stephanie Stock, professor of health economics at the Institute for Health Economics in Cologne.

In general, you can see that the values ​​in Germany and Europe are dropping a little, but I think there is still a relatively large need, and above all, this is awareness, or the importance of high cholesterol. Levels, especially in educationally disadvantaged groups, did not reach this way.

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