Interesting study questioning the relationship of LDL cholesterol and cardiovascular disease.
- A recent study in BMJ medical journal found that high LDL-Cholesteral may be consistent with living longer in most people over 60 years. This finding is opposite of the cholesterol hypothesis (ie, that cholesterol, particularly LDL-C, causes clogged arteries and early death). It seems that elderly people with high LDL-C live as long or longer than those with low LDL-C. This analysis provides reason to question the validity of the cholesterol hypothesis. This study provides the rationale for a re-evaluation of guidelines recommending drugs to reduce LDL-C in the elderly as a component of heart disease prevention strategies.
Strengths and limitations of this study ▪ This is the first systematic review of cohort studies where low-density lipoprotein cholesterol (LDL-C) has been analysed as a risk factor for all-cause and/or cardiovascular mortality in elderly people. ▪ Lack of an association or an inverse association between LDL-C and mortality was present in all studies. ▪ We may not have included studies where an evaluation of LDL-C as a risk factor for mortality was performed but where it was not mentioned in the title or in the abstract. ▪ We may have overlooked relevant studies because we have only searched PubMed. ▪ Minor errors may be present because some of the authors may not have adjusted LDL-C by appropriate risk factors. ▪ Some of the participants with high LDL-C may have started statin treatment during the observation period and, in this way, may have added a longer life to the group with high LDL-C and some of them may have started with a diet able to influence the risk of mortality. ▪ We may have overlooked a small number of relevant studies because we only searched papers in English.