Low Cholesterol May Raise Risk of Death in Elderly

Fri, Aug 03, 2001

By Suzanne Rostler

NEW YORK (Reuters Health) - Elderly people with very low cholesterol levels may be at increased risk of death, according to results of a new study.

The findings seem to contradict recommendations to maintain low blood levels of cholesterol to decrease the risk of heart disease. However, those recommendations are based on studies in people under 65 and may have less relevance to older people, write the authors of the study in the August 4th issue of The Lancet.

Dr. Irwin Schatz, of the University of Hawaii at Manoa, and colleagues measured blood cholesterol levels of more than 3,500 Japanese-American men aged 71-93 years and compared readings taken from the same group of men 20 years earlier. The study volunteers were divided in to four groups according to their cholesterol levels.

Compared with men with the lowest cholesterol levels (2.09-4.32 mmol/L, or approximately 81-167 mg/dl), those with the highest levels (5.44-9.88 mmol/L, or approximately 210-382 mg/dl) were 35% less likely to die of all causes. Those men in the group with the lowest cholesterol at both points were significantly more likely to die than others, report researchers.

In an interview with Reuters Health, Schatz said it is not clear why very low cholesterol levels would be associated with an increased risk of death, and that a properly designed study of the causes would be needed.

"In the meantime, prudence dictates that we be less aggressive in lowering cholesterol in the elderly," he said.

Further, it is not clear whether low cholesterol achieved and maintained naturally has a different effect than low cholesterol achieved through medication.SOURCE: The Lancet 2001;358:351-355.
http://news.excite.com/news/r/010803/17/health-low

My take on this is that, while low cholesterol may ASSOCIATED with increased risk of death in the elderly, it doesn't necessarily CAUSE increased risk of death. There may be other factors, perhaps certain illnesses, causing both factors. Association does not imply causation (a helpful little mantra I learned in my undergrad Psych classes).

That, of course, is also true of risk factors for high cholesterol. As we are starting to understand, it is probably not high cholesterol per se that's a risk factor, but a third factor that affects both: for example, insulin resistance.

It's always more complicated than we think it is!

Rachel

I was actually going to post this article on the weekend, and got sidetracked .....

My thought at first was, being elderly is a risk factor for death, and I'm not trying to be funny, it's true ... the subjects were aged 71 to 93 years, and once past the median age of 75, the risk of death increases exponentially with each passing year just from the age factor alone.

What is most important in this article, in my opinion, is that doctors need to be less hasty with the prescription pad when an elderly patient presents with high cholesterol. The drugs used to lower cholesterol carry serious side-effects with their own risks to health .... and are monumentally expensive. If the whole purpose of prescribing these drugs is to prevent death/prolong life .... and that isn't the outcome that's happening .... then they should not be prescribed in the first place.

Perhaps some enlightened physicians will begin prescribing lowcarb diets for their elderly high-cholesterol patients, given that there is plenty of research to support doing so.

my 2¢

Doreen

I only found about it from OldSalty's post in the Cholestrol/Heart forum. I decided to post the article instead of just the link, since many news websites remove the text after a month or two passes.

Wa'il