Studies show that low cholesterol and low blood pressure increase death rates

Two studies just published both remonstrate the futility of trying to lower both blood cholesterol and blood pressure in the older generation, as both show that low cholesterol, low LDL and low blood pressure actually increase death rates. These studies are part of a long line of such research which shows that lowering cholesterol levels in people does more harm than good.

The first study

Horwich TB et al., Cholesterol levels and in-hospital mortality in patients with acute decompensated heart failure, Am Heart J 2008;156(6):1170-6

This study on 18,000 patients in 240 hospitals was said to be the first that found the relationship between total cholesterol (TC) levels and in-hospital mortality. Mean age 70.

Total Cholesterol, mg/dL (mmol/l) <118 (3.10) 119-145 (3.10 — 3.77) 146-179 (3.78 — 4.65) 180 + (4.65 +)
Numbers 4504 4431 4449 4407
Mean Total Cholesterol 98 (2.55) 131 (3.41) 158 (4.11) 213 (5.54)
Mean LDL-C 54 74 94 135
Statins % 58 50 43 34
Systolic Blood Pressure/Diastolic Blood Pressure 134/75 141/78 145/80 150/83
Died in hospital, % 3.3 2.5 2.0 1.3

This is the most dramatic data we have seen on the failure of statins to prolong life in patients with Congestive Heart Failure (or HF). Does this support a guideline for total cholesterol to be no higher than 200 (5.2) Or LDL less than 125 (3.25)? No it doesn't.

Also, note how those with the highest blood pressure were least likely to die. Use of blood pressure lowering drugs in all groups was similar.

The Second study

Akerblom JL et al., Relation of plasma lipids to all-cause mortality in Caucasian, African-American and Hispanic elders, Age and Ageing 2008;37:207-213

In this study those studied had a mean age 76 years at baseline and were free-living and healthy. About 20% were taking statins, but this was not distinguished by quartile. The table is for Caucasians.

Total Cholesterol, mg/dL 176 177-200 200-228 >228
LDL-Cholesterol, mg/dL <101 101-121 122-145 >145
Died, %, based on LDL-C 18.6 16.9 14.4 13.1

This study also does not support a guideline of having a total cholesterol level of 200 or lower. Neither does it support lowering LDL Cholesterol to less than 125.

One has to ask, in the face of this ever-growing body of evidence that higher cholesterol levels are protective, why on earth are doctors so adamant about getting blood cholesterol levels down? Do they, perhaps, have a hidden agenda?

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Last updated: December 9, 2011