Heart health and cholesterol levels of Canadians, 2007 to 2009

Over 40% of Canadians aged 20 to 79 have an unhealthy level of total cholesterol and about 25% have an unhealthy level of triglycerides.

Lipids are a class of fats, or fat-like substances, which includes cholesterol and triglycerides. Cholesterol is vital for our body but there are two types, good and bad. "Good" cholesterol, called high density lipoprotein-cholesterol (or HDL cholesterol), helps to prevent the narrowing of artery walls by removing and transporting any excess to the liver for excretion. "Bad" cholesterol, called low density lipoprotein-cholesterol (or LDL cholesterol), carries cholesterol for cell-building needs but leaves behind any excess on the walls of the arteries. "Bad" cholesterol can lead to cardiovascular diseases. Lowering this type of cholesterol reduces the risk of heart attack, stroke, and the necessity for heart bypass surgery. High triglyceride levels increase the tendency of the blood to clot.

The Canadian Health Measures Survey (CHMS) tested the blood samples of participants for a number of lipids: total cholesterol, triglycerides, "bad" cholesterol, "good" cholesterol and the ratio of total cholesterol to high density lipoprotein-cholesterol (TC/HDL-C). The healthy levels for lipids, suggested by current evidence, are outlined in Table 1.

Monitoring lipids for the management of abnormal levels and the prevention of cardiovascular diseases is particularly important for men over 40 years of age and women who are menopausal or over 50 years of age. Lipid monitoring is also important for people with diabetes and atherosclerosis, or for those who have risk factors such as smoking, abdominal obesity, hypertension, and a strong family history of premature cardiovascular diseases.

High "bad" cholesterol can be prevented through physical activity, healthy diet and not smoking. A lipid-lowering therapy might be recommended to normalize the cholesterol level of people with specific conditions (including atherosclerosis, coronary artery disease, hypertension, diabetes and obesity) or for anyone with high, moderate or even low risk of cardiovascular diseases.

Table 1 - Healthy levels of lipids in blood
Total cholesterol < 4.5 mmol/L (6 to 19 years)1
< 5.2 mmol/L (20 to 79 years)1
Triglycerides < 1.7 mmol/L1
Low density lipoprotein-cholesterol LDL,
"bad" cholesterol
< 3.4 mmol/L2
High density lipoprotein-cholesterol HDL,
"good" cholesterol
> 1.0 mmol/L men1
> 1.3 mmol/L women1
Ratio of total cholesterol to HDL cholesterol
(TC/HDL-C )
< 4.112

1 Based on recommendations from the CHMS Physician Advisory Committee
2 Based on recommendations from the U.S. National Cholesterol Education Program

Results

Among Canadians aged 20 to 79, over 40% have a high total cholesterol level (Chart 1), with no substantial gender differences. High total cholesterol and triglycerides levels increase with age.

Unhealthy levels of "bad" cholesterol generally increase with age, but peaked in the 40 to 59 year age group, where about 43% of Canadians registered unhealthy levels. About 30% of Canadians aged 20 to 79 have low levels of "good" cholesterol, with no substantial difference between age groups (Chart 2).

Chart 1
Percentage of Canadian adults with unhealthy levels of total cholesterol and triglycerides, by age group

Description

Chart 1 – Percentage of Canadian adults with unhealthy levels of total cholesterol and triglycerides, by age group

Note: All data presented are from fasting respondents and do not account for the impact of lipid adjusting therapy.
Source: Canadian Health Measures Survey, 2007 to 2009

Chart 2
Percentage of Canadian adults with unhealthy levels of "good" and "bad" cholesterol, by age group

Description

Chart 2 – Percentage of Canadian adults with unhealthy levels of "good" and "bad" cholesterol, by age group

Note:  All data presented are from fasting respondents and do not account for the impact of lipid adjusting therapy.
Source: Canadian Health Measures Survey, 2007 to 2009

Lipid levels among Canadian children and youth

Most Canadian children and youth aged 6 to 19 have normal triglycerides and "bad" cholesterol levels, with no substantial gender differences (Table 2). However, a relatively lower percentage of children and youth have levels of total cholesterol within normal ranges.

Table 2 - Percentage of Canadian children and youth with lipids within normal ranges, by sex

Lipid

Age Group
6 to 11 12 to 19
 Males   Females   Males   Females 
Total cholesterol 70 68 78 78
Triglycerides 99 98 91 91
Low density lipoprotein-cholesterol
LDL, "bad" cholesterol
95 93 94 94
Ratio of total cholesterol to HDL
cholesterol (TC/HDL-C )
95 89 88 89

Note:  All data presented are from fasting respondents and do not account for the impact of lipid adjusting therapy.
Source: Canadian Health Measures Survey, 2007 to 2009

High lipids and health

About 36% of Canadian adults aged 20 to 79 who don't have a healthy level of "good" cholesterol are obese; by comparison, only about 16% of those with a healthy level of good cholesterol are obese (Table 3). Generally, unhealthy levels of total cholesterol, triglycerides and "bad" cholesterol are associated with higher measured hypertension. CHMS results also show that Canadian adults who do not meet healthy levels of triglycerides and "good" cholesterol seem to have a higher incidence of self-reported heart disease.

Table 3 - Lipid levels and obesity, measured hypertension and heart disease of Canadian adults
Lipid Have healthy levels
Yes/ No
% who are obese % with measured hypertension*
(≥ 140 systolic or
 ≥ 90 diastolic)
% with self-reported heart disease
Total cholesterol yes 19 3.8 5.3E
no 27 8.8 2.7E
Triglycerides yes 17 5.1E 3.6
no 40 8.1E 6.2E
Low density lipoprotein-cholesterol LDL,"bad" cholesterol yes 17 5.1 5.1E
no 31 7.1E 2.7E
High density lipoprotein-cholesterol HDL,"good" cholesterol yes 16 6.2 3.1E
no 36 4.9E 7.0E
Ratio of total cholesterol to HDL cholesterol (TC/HDL-C ) yes 16 5.9 4.5E
no 32 5.8 E 3.8E

E Use with caution (data with a coefficient of variation from 16.6% to 33.3%)
* The data presented are based on measured hypertension and do not account for the impact of medication.
Note:  All data presented are from fasting respondents and do not account for the impact of lipid adjusting therapy.
Source: Canadian Health Measures Survey, 2007 to 2009

Additional physical health measures information from the Canadian Health Measures Survey 2007 to 2009 is available from the Statistics Canada health module.
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