The Honolulu study was the
first big study to bring this out:
Quote:
Lancet. 2001 Aug 4;358(9279):351-5.Click here to read Links
Comment in:
Lancet. 2001 Dec 1;358(9296):1903-4; author reply 1906.
Lancet. 2001 Dec 1;358(9296):1904-5; author reply 1906.
Lancet. 2001 Dec 1;358(9296):1904; author reply 1906.
Lancet. 2001 Dec 1;358(9296):1905-6.
Lancet. 2001 Dec 1;358(9296):1905; author reply 1906.
Lancet. 2001 Dec 1;358(9296):1906-7.
Lancet. 2001 Dec 1;358(9296):1907.
Cholesterol and all-cause mortality in elderly people from the Honolulu Heart Program: a cohort study.
* Schatz IJ,
* Masaki K,
* Yano K,
* Chen R,
* Rodriguez BL,
* Curb JD.
Clinical Epidemiology and Geriatrics Division, Department of Medicine, John A Bums School of Medicine, University of Hawaii at Manoa, 1356 Lusitana Street, 7th Floor, Honolulu, HI 96813-2427, USA. schatzi@hawaii.edu
BACKGROUND: A generally held belief is that cholesterol concentrations should be kept low to lessen the risk of cardiovascular disease. However, studies of the relation between serum cholesterol and all-cause mortality in elderly people have shown contrasting results. To investigate these discrepancies, we did a longitudinal assessment of changes in both lipid and serum cholesterol concentrations over 20 years, and compared them with mortality. METHODS: Lipid and serum cholesterol concentrations were measured in 3572 Japanese/American men (aged 71-93 years) as part of the Honolulu Heart Program. We compared changes in these concentrations over 20 years with all-cause mortality using three different Cox proportional hazards models. FINDINGS: Mean cholesterol fell significantly with increasing age. Age-adjusted mortality rates were 68.3, 48.9, 41.1, and 43.3 for the first to fourth quartiles of cholesterol concentrations, respectively. Relative risks for mortality were 0.72 (95% CI 0.60-0.87), 0.60 (0.49-0.74), and 0.65 (0.53-0.80), in the second, third, and fourth quartiles, respectively, with quartile 1 as reference. A Cox proportional hazard model assessed changes in cholesterol concentrations between examinations three and four. Only the group with low cholesterol concentration at both examinations had a significant association with mortality (risk ratio 1.64, 95% CI 1.13-2.36). INTERPRETATION: We have been unable to explain our results. These data cast doubt on the scientific justification for lowering cholesterol to very low concentrations (<4.65 mmol/L) in elderly people.
PMID: 11502313 [PubMed - indexed for MEDLINE]
|
Since then there has been a "war" of sorts to refute it...esp by the drug companies.
Quote:
J Am Geriatr Soc. 2003 Jul;51(7):991-6.Click here to read Links
Low total cholesterol and increased risk of dying: are low levels clinical warning signs in the elderly? Results from the Italian Longitudinal Study on Aging.
* Brescianini S,
* Maggi S,
* Farchi G,
* Mariotti S,
* Di Carlo A,
* Baldereschi M,
* Inzitari D;
* ILSA Group.
Laboratory of Epidemiology and Biostatistics, Istituto Superiore di Sanita, Rome, Italy. sonia.brescianini@iss.it
OBJECTIVES: To analyze the relationship between serum total cholesterol (TC) and all-cause mortality, taking into account various potential confounders. DESIGN: Population-based prospective cohort study. SETTING: Older Italians residing in the general community. PARTICIPANTS: Four thousand five hundred twenty-one men and women aged 65-84. MEASUREMENTS: Vital status data were available for 1992-95. The hazard ratios of dying for subjects in the second, third, and fourth quartiles compared with the first quartile of TC were computed using Cox proportional hazards, adjusting for lifestyle factors, anthropomorphic and biochemical measures, preexisting medical conditions, and frailty indicators. RESULTS: Blood samples were obtained from 3,295 (73%) of the participants, of whom 399 died during almost 3 years of follow-up. Low TC was associated with a higher risk of death. Those with TC in the second, third, and fourth quartiles (TC>189 mg/dL or 4.90 mmol/L) had lower hazard ratios (HRs) of death than subjects in the first quartile (0.57, 95% confidence interval (CI) = 0.38-0.87; 0.56, 95% CI = 0.36-0.88; and 0.53, 95% CI = 0.33-0.84, respectively). Few subjects taking lipid-lowering drugs (LLDs) were in the lowest quartile of cholesterol, suggesting that these individuals have low TC values for reasons other than LLD use. CONCLUSION: Subjects with low TC levels (<189 mg/dL) are at higher risk of dying even when many related factors have been taken into account. Although more data are needed to clarify the association between TC and all-cause mortality in older individuals, physicians may want to regard very low levels of cholesterol as potential warning signs of occult disease or as signals of rapidly declining health.
PMID: 12834520 [PubMed - indexed for MEDLINE]
|
You can find many drug sponsored studies which massage the data to show
positive results, but I have read that those math interventions are really not accurate. There are as many pro-drug studies as against..so it remains
controversial.
This magazine article is very interesting too:
http://www.geriatrictimes.com/g040618.html
Here too:
http://www.ravnskov.nu/cholesterol.htm
With the concern about memory loss and statins, now, this topic is heating up. In general as drugs go off patent, the negative data withheld becomes more available. This certainly happened with Prozac and Paxil. |
