Older people with high LDL levels live as long or longer as those with low LDL in 16 of 19 studies

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Older people with high LDL levels live as long or longer as those with low LDL in 16 of 19 studies

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Monday, June 13, 2016 10:10 am Email this article

In people over 60, those with the highest LDL cholesterol levels were at a lower risk of dying over some number of years than those with the lowest LDL levels in 16 of 19 studies according to a new review paper by Uffe Ravnskov, MD, PhD, author of The Cholesterol Myths, Dr. Malcolm Kendrick, author of The Great Cholesterol Con, and others.

One-fourth with highest LDL levels 29-59% less likely to die over next 3-9 years

In 12 of those studies, the one-fourth of people with the highest LDL levels were 29% to 59% less likely to have died over the next 3-9 years than the one-fourth of people with the lowest LDL levels.

A reanalysis of an old study found that a 30 mg/dL decrease in total cholesterol levels in people 65 and older was associated with a 35% GREATER risk of death.

Conclusion: Elderly people with High LDL live as long or longer than those with low LDL

“High [LDL cholesterol] is inversely associated with mortality in most people over 60 years,” the authors of the paper concluded.

“This finding is inconsistent with the cholesterol hypothesis (ie, that cholesterol, particularly [LDL cholesterol] is inherently atherogenic).

“Since elderly people with high [LDL cholesterol] live as long or longer than those with low [LDL cholesterol], our analysis provides reason to question the validity of the cholesterol hypothesis.

“Moreover, our study provides the rationale for a re-evaluation of guidelines recommending pharmacological reduction of [LDL cholesterol] in the elderly as a component of cardiovascular disease prevention strategies.”

Older people with high LDL lived as long or longer than those with low LDL

“[E]lderly people with high LDL-[cholesterol] live as long or longer than those with low LDL-[cholesterol].”
— Abstract

People with the highest LDL were 36% less like to die over the next 4 years

“It is worth considering that some of the participants with high LDL-[cholesterol] may have started statin treatment during the observation period.
“Such treatment may have increased the lifespan for the group with high LDL-[cholesterol] .
“However, any beneficial effects of statins on mortality would have been minimal because most statin trials have had little effect on CVD and all-cause mortality, with a maximum reduction of mortality of two percentage points.
“It is therefore relevant that the 4-year mortality among those with the highest LDL-[cholesterol] in the included cohorts was up to 36% lower than among those with the lowest LDL-[cholesterol].”
— page 3, col. 2

Recent study found a 30 mg/dL drop in total cholesterol was associated with a 35% greater risk of death

“In a recent study, the authors reported that among participants who were older than 65 at baseline, a 30 mg/dL decrease in serum cholesterol was associated with a [35%] higher risk of death.”
— Page 5, col. 1

In almost 80% of people in these studies, higher LDL levels were associated with a lower risk of death

“Our literature review has revealed either a lack of an association or an inverse association between LDL-[cholesterol] and mortality among people older than 60 years.
“In almost 80% of the total number of individuals, LDL-[cholesterol] was inversely associated with all-cause mortality and with statistical significance.”
— Page 6, col. 1

9 studies found higher total cholesterol was associated with a lower risk of cancer over 10-30 years

“Nine cohort studies including more than 140 000 individuals followed for 10–30 years have found an inverse association between cancer and [total cholesterol] measured at the start of the study, even after excluding deaths that occurred during the first 4 years.”
— Page 6, col. 2

Several studies have found that people with cancer were more likely to be on a cholesterol-lowering treatment than people who did not have cancer

“Furthermore, cholesterol-lowering experiments on rodents have resulted in cancer, and in several case-control studies of patients with cancer and controls matched for age and sex, significantly more patients with cancer have been on cholesterol-lowering treatment.”
— Page 6, col. 2

People who have a heart attack have LOWER LDL levels than normal, not higher

“That high LDL-[cholesterol] may be protective is in accordance with the finding that LDL-[cholesterol] is lower than normal in patients with acute myocardial infarction.
“This has been documented repeatedly without a reasonable explanation.
“In one of the studies, the authors concluded that LDL-[cholesterol] evidently should be lowered even more, but at a follow-up 3 years later mortality was twice as high among those whose LDL-[cholesterol] had been lowered the most compared with those whose cholesterol was unchanged or lowered only a little.
“If high LDL-C were the cause, the effect should have been the opposite.”
— Page 6, col. 2

LDL helps to protect us from infections by inactivating bacteria and viruses

“LDL binds to and inactivates a broad range of microorganisms and their toxic products.”
— Page 6, col. 1

Higher total cholesterol was associated with a lower risk of dying from respiratory and gastrointestinal diseases in 19 studies

“In a meta-analysis of 19 cohort studies, for instance, performed by the National Heart, Lung and Blood Institute and including 68 406 deaths, [total cholesterol] was inversely associated with mortality from respiratory and gastrointestinal diseases, most of which are of an infectious origin.
“It is unlikely that these diseases caused the low [total cholesterol] because the associations remained after the exclusion of deaths occurring during the first 5 years.”
— Page 6, col. 1

High LDL levels were NOT associated with an increase in death from heart attack, stroke or all-cause mortality

“Our review has shown either a lack of an association or an inverse association between LDL-[cholesterol] and both all-cause and [cardiovascular] mortality.’
— Page 6, col. 2

This analysis suggests that the cholesterol hypothesis of cardiovascular disease is wrong

“Our review has shown either a lack of an association or an inverse association between LDL-[cholesterol] and both all-cause and [cardiovascular] mortality.
“The cholesterol hypothesis seems to be in conflict with most of Bradford Hill’s criteria for causation, because of its lack of consistency, biological gradient and coherence.”

The guidelines for heart disease must be re-evaluated

“Our review provides the basis for more research about the cause of atherosclerosis and [cardiovascular disease] and also for a re-evaluation of the guidelines for cardiovascular prevention, in particular because the benefits from statin treatment have been exaggerated.”
— Page 6, col. 2

Reference

Ravnskov U, Diamond DM, Hama R, Hamazaki T, Hammarskjöld B, Hynes N, Kendrick M, Langsjoen PH, Malhotra A, Mascitelli L, McCully KS, Ogushi Y, Okuyama H, Rosch PJ, Schersten T, Sultan S, and Sundberg R. 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.

Author’s Contact Info

Uffe Ravnskov, MD, PhD
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