"Long-term persistence of low cholesterol increases risk of death," says new

Many studies have indicated the importance of cholesterol-lowering withthe use of statins, and some have also said that the statins market is underprescribed. However, new research indicates that, at least as far as the elderly are concerned, this may not be the case, and that lowering cholesterol levels in elderly patients to reduce the risk of heart disease can do more harm than good.

Researchers at the University of Hawaii at Manoa, Hawaii, USA, measured lipid and serum cholesterol concentrations in 3,572 Japanese/American men, aged 71 to 93, as part of the Honolulu Heart Program. They compared changes in these concentrations over 20 years with all-cause mortality using three different Cox proportional hazards models.

The study, reported in The Lancet (August 4), found that mean cholesterol fell significantly with increasing age. Age-adjusted mortality rates were 68.3, 48.9, 41.1 and 43.3 for the first to fourth quartiles of cholesterol concentrations, respectively. Relative risks for mortality were 0.72 (95% C1 0.60-0.87), 0.60 (0.49-0.74) and 0.65 (0.53-0.80) in the second, third and fourth quartiles, respectively, with quartile 1 as reference. Only the group with low cholesterol concentrations at both examinations had a significant association with mortality (risk ratio 1.64, 95% C1 1.13-2.36), the researchers, led by Irwin Schatz and Kamal Masaki, note.