Report of the New South Wales Chief Health Officer, 1997

Behaviours - Blood cholesterol/hypertension

Residence Category Sex 1989 1995
NSW High cholesterol (%) Males 2.3 5.9
    Females 2.9 5.7
    Persons 2.6 5.8
  Hypertension (%) Males 6.1 10.5
    Females 8 11.6
    Persons 7.1 11.1
AUSTRALIA High cholesterol (%) Males . 5.1
    Females . 4.7
    Persons . 4.9
  Hypertension (%) Males . 9.5
    Females . 10.9
    Persons . 10.2

Source:1989 National Health Survey and 1995 National Health Survey, ABS, unpublished data.
There is a strong association between serum cholesterol (especially low-density lipoprotein or LDL cholesterol) level and death from coronary heart disease (CHD). Hypertension (or high blood pressure) is strongly associated with several disorders, including CHD, stroke, congestive heart failure and renal insufficiency (Law et al. 1994).

Data at state and national level from surveys that measured plasma cholesterol and blood pressure indicate that, during the 1980s, mean cholesterol levels changed little and mean blood pressure levels and the prevalence of hypertension declined significantly (Bennett and Magnus 1994).

Self-report data show a different picture. Between 1989 and 1995, self-reported long-term high cholesterol in NSW males more than doubled, and in females increased by almost 50 per cent.

In the same period, self-reported long-term hypertension increased by 45 per cent in NSW females and 72 per cent in males.

These rises may represent real increases in diagnosed high cholesterol and hypertension (due, for example, to increased community awareness and/or general practitioner surveillance). Changes in self-reporting may also be influenced by recollection and interpretation of doctors’ advice, contact with health services and existence of related conditions, such as diabetes and heart disease.

A diet low in fat and the partial replacement of saturated fat with unsaturated fat and complex carbohydrates is the main focus of population-level strategies for preventing high blood cholesterol.

Key issues in preventing hypertension are increasing physical activity and reducing body weight and the intake of alcohol, salt and possibly potassium (NSW Health Department 1995).

References: Law M R, Wald N J, Wu T, et al. ‘Systematic underestimation of association between serum cholesterol concentration and ischaemic heart disease in observational studies: data from the BUPA study’, BMJ, Vol. 308, 1994, pp. 363-366.
Bennett S A and Magnus P, ‘Trends in cardiovascular risk factors in Australia. Results from the National Heart Foundation's Risk Factor Prevalence Study, 1980-89’, Medical Journal of Australia Vol. 161, 1994, pp. 519-527.
For more information, see: NSW Health Department, Coronary heart disease: NSW goals and targets and strategies for health gain, State health publication no. (PHD) 950110, 1995.
Produced by Epidemiology and Surveillance Branch, Public Health Division, New South Wales Health Department on 20 March 1998.