Advertisement

Status and management of blood lipids in Greek adults and their relation to socio-demographic, lifestyle and dietary factors: the ATTICA Study

Blood lipids distribution in Greece

      Abstract

      Objective: In this work, we assessed the status and management of blood lipids in a sample of cardiovascular disease free adult men and women from Greece. We also evaluated the effect of several socio-demographic, dietary and lifestyle habits on lipid levels. Methods: The ATTICA Study is a population-based cohort that has randomly enrolled 1128 men and 1154 women (aged >18 years old), stratified by age–gender, from the greater area of Athens, during 2001–2002. Adherence to Mediterranean diet was assessed through a diet score that was based on a validated food-frequency questionnaire. Results: Forty-six percent of men and 40% of women had total serum cholesterol levels >200 mg/dl. Of them, 40% of men and 30% of women were unaware of their condition. Twenty-one percent of men and 7% of women had HDL–cholesterol levels <35 mg/dl. Twenty-eight percent of men and 13% of women had triglyceride levels >150 mg/dl. Fifteen percent of men and 12% of women had LDL–cholesterol levels >160 mg/dl and 52% of men and 48% of women had LDL >130 mg/dl. Of those who had known blood lipid abnormalities, 36% of men and 33% of women followed a dietary medication, 31% of men and 20% of women were receiving a pharmaceutical treatment (mainly statin) and the rest were untreated. Participants who adopted the Mediterranean diet and received statin, had on average 9% lower total cholesterol (P=0.04), 19% lower LDL–cholesterol levels (P=0.02) and 32% lower oxidized LDL–cholesterol levels (P<0.001) compared to those who were untreated and adopted a Westernized diet. Conclusions: We could speculate that about 3 million Greek adults had high total cholesterol levels. Adverse findings were also observed regarding the other investigated blood lipids. Mediterranean diet could be a complimentary mean to pharmaceutical treatment in reducing blood lipids.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Atherosclerosis
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

      1. Gotto Jr AM, Lipid and lipoprotein disorders. In: Pearson TA, Criqui MH, Luepker RV, Oberman A, Wilson M, editors. Primer in preventive cardiology. Dallas, Tex: American Heart Association;1994. p. 107–29.

        • Ginsberg H.N
        Lipoprotein metabolism and its relationship to atherosclerosis.
        Med. Clin. North Am. 1994; 78: 1-20
        • Wilson P.W.F
        • Abbott R.D
        • Castelli W.P
        High density lipoprotein cholesterol and mortality.
        Arteriosclerosis. 1988; 8: 737-741
      2. Executive summary of the third report of the National Cholesterol Educational Program Expert panel on detection, evaluation, and treatment of high blood cholesterol in adults. JAMA 2001;285(19):2486–97.

        • Gran B
        Major differences in cardiovascular risk indicators by educational status. Results from a population based screening program.
        Scand. J. Soc. Med. 1995; 23: 9-16
        • Keys A
        • Menotti A
        • Karvonen M.J
        The diet and 15-year death rate in the Seven Countries Study.
        Am. J. Epidemiol. 1986; 124: 903-915
        • Denke M
        Cholesterol lowering diets. A review of evidence.
        Arch. Int. Med. 1995; 155: 17-26
        • Trichopoulou A
        • Kouris-Blazos A
        • Wahlqvist M
        • et al.
        Diet and overall survival in elderly people.
        Brit. Med. J. 1995; 311: 1457-1460
        • Kafatos A
        • Diacatou A
        • Voukiklaris G
        Heart disease risk-factor status and dietary changes in the Cretan population over the past 30 years: the Seven Countries Study.
        Am. J. Clin. Nutr. 1997; 65: 1882-1886
        • de Lorgeril M
        • Salen P
        • Martin J.-L
        • Monjaud I
        • Delaye J
        • Mamelle N
        Mediterranean diet, traditional risk factors and the rate of cardiovascular complications after myocardial infarction. Final report of the Lyon Diet Heart Study.
        Circulation. 1999; 99: 779-785
        • Panagiotakos D.B
        • Pitsavos H
        • Chrysohoou C
        • et al.
        Status and management of hypertension, in Greece the role of the adoption of Mediterranean diet: the ATTICA Study.
        J. Hypertens. 2003; 21: 1483-1489
        • Trichopoulou A
        • Costacou T
        • Bamia C
        • Trichopoulos D
        Adherence to a Mediterranean diet and survival in a Greek population.
        N. Engl. J. Med. 2003; 348: 2599-2608
        • Trichopoulou A
        From research to education: the Greek experience.
        Nutrition. 2000; 16: 528-531
        • Willett W.C
        • Sacks F
        • Trichopoulou A
        • et al.
        Mediterranean diet pyramid: a cultural model for healthy eating.
        Am. J. Clin. Nutr. 1995; 6: 1402S-1406S
        • Pitsavos C
        • Chrysohoou C
        • Panagiotakos D.B
        • et al.
        Association of leisure-time physical activity on inflammation markers (C-reactive protein, white-blood cell count, serum amyloid A and fibrinogen), in healthy subjects (from the ATTICA Study).
        Am. J. Cardiol. 2003; 91: 368-370
      3. Third report on nutrition monitoring in the United States, vol. I. Washington, DC: Government Printing Office; 1995.

      4. Dontas A. Recent trends in cardiovascular disease and risk factors in the Seven Countries Study: Greece. In: Toshima H, Koga Y, Blackburn H, Keys A, editors. Lessons for science from the Seven Countries Study. Tokyo, Japan: Springer-Verlag; 1994.

        • Moulopoulos S.D
        • Adamopoulos P.N
        • Diamantopoulos E.I
        • Nanas S.N
        • Anthopoulos L.N
        • Iliadi-Alexandrou M
        Coronary heart disease risk factors in a random sample of Athenian adults. The Athens Study.
        Am. J. Epidemiol. 1987; 126: 882-892
        • Franceschini G
        Epidemiologic evidence for high-density lipoprotein cholesterol as a risk factor for coronary artery disease.
        Am. J. Cardiol. 2001; 88: 9N-13N
        • Hokanson J.E
        • Austin M.A
        Plasma triglyceride levels is a risk factor for cardiovascular disease independent of high-density lipoprotein cholesterol level: a meta-analysis of population based prospective studies.
        J. Cardiovasc. Risk. 1996; 3: 213-219
        • Bostom A.G
        • Cupples L.A
        • Jenner J.L
        Lipoprotein(a) levels and risk for coronary heart disease in men aged 55 years old and younger a prospective study.
        JAMA. 1996; 276: 544-548
      5. Davidson M. The mobile lipid clinic. Philadelphia, USA: Lippincot Williams and Wilkins Publications; 2002.

        • Dionyssiou-Asteriou A
        • Rizos I
        Serum lipoprotein-(a) levels in a Greek population sample without a history of premature myocardial infarction.
        J. Cardiovasc. Risk. 1996; 3: 277-280
        • Petridou E
        • Malamou H
        • Doxiadis S
        • et al.
        Blood lipids in Greek adolescents and their relation to diet, obesity, and socioeconomic factors.
        Ann. Epidemiol. 1995; 5: 286-291
        • Shepherd J
        Economics of lipid lowering in primary prevention: lessons from the West of Scotland Coronary Prevention Study.
        Am. J. Cardiol. 2001; 87: 19-22