Diet, serum cholesterol and the prevention of coronary heart disease in New Zealand.

A combination of the population strategy and the high risk strategy has been recommended for the prevention and control of coronary heart disease in New Zealand. In this paper, using data from a variety of sources, we estimate the potential relative benefits of these two strategies to reduce the contribution of diet and high blood cholesterol to coronary heart disease mortality in New Zealand. It is estimated that diet is responsible, at a minimum for between 22% (1600 deaths) and 39% (2800 deaths) of the coronary heart disease mortality in New Zealand each year. Achievement of the suggested short term dietary goals for the New Zealand population would have at least the same benefit as the identification and successful treatment of all people in the top 10% of the serum cholesterol distribution. This indicates that the population strategy should have higher priority in efforts to prevent and control coronary heart disease. Decisions concerning the level at which elevated blood cholesterol levels are treated pharmacologically will have important logistic and cost implications; national guidelines are required for the management of people with high blood cholesterol levels.