Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review (Ravnskov U et al.)
A new review paper published in the British Medical Journal Open examines whether low-density lipoprotein cholesterol (LDL-C), one component of total cholesterol, is associated with mortality in the elderly.
The researchers identified 19 cohort studies including 30 cohorts with a total of 68,094 elderly people, where all-cause mortality was recorded in 28 cohorts and cardiovascular (CV) mortality in 9 cohorts. Inverse association between all-cause mortality and LDL-C was seen in 16 cohorts (in 14 with statistical significance) representing 92% of the number of participants, where this association was recorded. In the rest, no association was found. In two cohorts, CV mortality was highest in the lowest LDL-C quartile and with statistical significance; in 7 cohorts, no association was found.
The authors concluded: “This review provides the first comprehensive analysis of the literature about the association between LDLC and mortality in the elderly. Since the main goal of prevention of disease is prolongation of life, all-cause mortality is the most important outcome, and is also the most easily defined outcome and least subject to bias. The cholesterol hypothesis predicts that LDLC will be associated with increased all-cause and CV mortality. Our review has shown either a lack of an association or an inverse association between LDLC and both all-cause and CV mortality.
“Our review provides the basis for more research about the cause of atherosclerosis and CVD and also for a reevaluation of the guidelines for cardiovascular prevention, in particular because the benefits from statin treatment have been exaggerated,” they added.
Ravnskov U. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review. BMJ Open. 2016; 6(6): e010401.