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Cholesterol protective in older people

LEIDEN, THE NETHERLANDS. There is increasing evidence that while high total and high LDL cholesterol levels are associated with an increased risk of cardiovascular disease in middle age they may actually be protective in old age that is, in people older than 85 years.

Researchers at Leiden University recently completed a study aimed at investigating the association between cholesterol levels and mortality in older people. Their survey involved 561 older people who were followed for 4 years subsequent to their 85th birthday. During the follow-up 152 of the participants died. The leading cause of death was cardiovascular disease, but there was no indication that high LDL levels were associated with an increased risk. Low HDL levels, on the other hand, were associated with a 2-fold higher risk of fatal cardiovascular disease and a 2.6 times higher risk of stroke. Low LDL and HDL levels were both associated with a 2- to 3-fold increased risk of dying from an infection.

The researchers conclude that high cholesterol levels are not a risk factor for cardiovascular disease in old people and that it would make more sense to attempt to increase HDL levels than to lower LDL and total cholesterol levels with statins and other medications. It is important to note that old people with high cholesterol levels (LDL, HDL and total) actually had a lower overall mortality than did those with low levels because of the protection afforded by cholesterol against dying from infectious diseases.
Weverling-Rijnsburger, AWE, et al. High-density versus low-density lipoprotein cholesterol as the risk factor for coronary artery disease and stroke in old age. Archives of Internal Medicine, Vol. 163, July 14, 2003, pp. 1549-54

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