Push To Drive Cholesterol To Ever Lower Levels Could Be Fatal

| October 11, 2012

We’re warned repeatedly about the supposed hazards of ‘raised’ cholesterol levels, particularly when it comes to increasing the risk of heart disease. However, lower levels are also linked to serious health problems, specifically an increased risk of cancer, as well as ‘haemorrhagic stroke’ (strokes caused by bleeding in the brain). For this reason, best practice dictates that we can get the best overall picture of the relationship cholesterol has with health by examining its relationship with overall risk of death – also known as overall mortality.

Previous evidence has revealed that while higher levels may be associated with increased overall mortality in younger individuals, this trend reverses as people age. The relevance of this is that most individuals die when they are advanced in years, and therefore the relationship cholesterol has with overall mortality in the elderly is, generally, much more relevant and important than this relationship in the young.

A recent study illustrates this [1]. In it, researchers examined the relationship between overall mortality and individuals aged 60-85 (average age 71) over a period stretching 12 years. Their initial results revealed that higher total lipid (blood fats) levels (> 200 mg/dl/5.2 mmol/l) were associated with a 24 per cent reduced risk of mortality over the study period. Lower levels (< 170 mg/dl/4.4 mmol/l) were associated with a 60 per cent increased risk of death.

Some claim that the association between lower lipid levels and increased risk of death is due to the fact that when individuals are ill and/or frail their levels tend to be low. In other words, the heightened risk of death is due to the illness and/or frailty associated with low cholesterol, not the low cholesterol itself.

In order to factor this into the equation, the researchers reanalysed the data after removing individuals who were low in weight (BMI < 20) and/or who died within 2 years of the analysis starting. Once these adjustments had been made, the relationship between raised cholesterol and lower risk of mortality was no longer statistically significant. However, a statistically significant relationship between lower levels and raised risk of death remained (36 per cent increased risk).

So-called ‘epidemiological’ studies of this nature do not tell us if low level actually causes death. However, this sort of evidence should at least cause us to pause before we recommend that individuals, especially elderly ones, drive their lipid levels to ever-lower levels.

While cholesterol is generally regarded in medicine as a scourge, I think it should not be forgotten that it is an essential constituent of many important substances and tissues in the body including vitamin D, several hormones and the brain. It simply does not make sense to push cholesterol down to a level where it may rob the body and brain of potentially life-giving constituents.

Here’s to a healthy heart

Dr John Briffa
Editor
for The Cholesterol Truth



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Bear in mind we are not addressing anyone’s personal situation and you should rely on this for informational purposes only. Please consult with your own physician before acting on any recommendations contained herein.


References:

1. Sarria Cabrera MA, et al. Lipids and all-cause mortality among older adults: a 12-year follow-up study. Scientific World Journal Epub 1 May 2012

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