MONDAY, April 9 (HealthDay News) -- People's average cholesterol levels seem to rise and fall along with their countries' economies and ease of access to quality health care, according to a new study.

Researchers examined data from thousands of patients with a history of high cholesterol (more than 200 milligrams per deciliter) in 36 countries, including the United States.

The analysis revealed that countries with higher overall income levels, lower out-of-pocket health care costs, and high-performing and efficient health systems tend to have lower rates of high cholesterol among people who'd had a history of high cholesterol.

For patients with no history of high cholesterol, there was no association between a country's economy and health care system and the risk of high cholesterol.

Among the specific findings:

  • Rates of total high cholesterol varied widely, ranging from 73 percent in Bulgaria to 24 percent in Finland.
  • Rates of elevated cholesterol levels in patients were particularly high in the following Eastern European countries: Bulgaria, Lithuania, Romania, Ukraine, Hungary and Russia. These countries also scored relatively low in terms of their economies and health systems.
  • The United States' rate of people with elevated cholesterol levels was similar to that of other developed countries -- such as Australia, Canada, Finland, Israel and the United Kingdom -- but U.S. spending on health care was considerably higher than other developed countries.

The study appears April 9 in the journal Circulation.

The optimum management of heart disease is difficult, and differences in rates of high cholesterol between nations "may be due to differences in clinical guidelines, as well as whether and the extent to which guidelines are followed and specific initiatives are effectively implemented," lead author Elizabeth Magnuson, director of the Health Economics and Technology Assessment at Saint Luke's Mid America Heart Institute in Kansas City, Mo., said in a journal news release.

She added that the association between high out-of-pocket health care costs for patients and their higher cholesterol levels "may reflect an inability or unwillingness" among these patients to take the medicines they've been prescribed. However, "the recent availability of generic cholesterol-lowering therapy should make out-of-pocket expense less of a barrier," Magnuson noted.

More information

The American Academy of Family Physicians has more about high cholesterol.