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National cholesterol treatment guidelines in Korean population--setting-up the cutpoints for high blood cholesterol

Abstract

National Cholesterol Treatment Guidelines are different according to race and country, and change year by year, because the distribution of lipid and lipoprotein levels are different by genetic background, dietary habit and life style. So it is mandatory to set-up the national cholesterol treatment guidelines based on the epidemiologic results. To establish the cutpoints for hypercholesterolemia specific to the Korean population, we selected the laboratories, whose inaccuracies of cholesterol measurement were less than 5%, in the external laboratory quality assessment survey, and performed epidemiological survey on the distribution of cholesterol levels, and other risk factors of coronary heart disease (CHD). As a result, prevalence of CHD risk factors was very high in hypertension (28.0%) and relatively low in diabetes (2.8%). Smokers were 42.6% of total subjects. Thirteen percent of subjects had a family member(s) who was suffering from or had of hypertension, stroke, and heart diseases. The average cholesterol level of a Korean was 187 mg/dL, which was about 25 mg/dL lower than that of United States. The 75th percentile to total cholesterol was 210 mg/dL and 90th percentile 235 mg/dL. The cutpoint for borderline-high cholesterol levels provide a major guideline for initiation of dietary and exercise therapy. We propose the cutpoint for borderline-high cholesterol levels as 200 instead of 210 mg/dL to initiate more active dietary and exercise therapy, and we also propose the temporary cutpoint for high blood cholesterol levels as 240 mg/dL instead of 235 mg/dL, which is a reasonable cutpoint considering medical insurance policy of the country. In conclusion, we suggest the cutpoints for borderline-high and high serum cholesterol levels as 200 and 240 mg/dL, respectively.

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