Are Higher LDL-C Levels Harmful for Older Adults?

Older adults with high low-density lipoprotein cholesterol (LDL-C) live as long or longer than those with low LDL-C, according to recent research.

For decades, the “cholesterol hypothesis” has suggested that total cholesterol levels are linked to cardiovascular (CV) and all-cause mortality. However, it is well known that total cholesterol becomes less of a risk factor for death with increasing age. Yet, little research exists on whether LDL-C is linked to death in this population.
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To conduct their study, the researchers searched online databases for studies investigating LDL-C as a risk factor for all-cause or CV mortality in patients aged 60 years and older from the general population.

The researchers reviewed 19 cohort studies that included 30 cohorts and 68,094 participants.

Overall, the researchers found that CV death was highest in participants with low LDL-C. This finding was seen in 16 cohorts, representing 92% of participants.

“High LDL-C is inversely associated with mortality in most people over 60 years,” the researchers concluded. “This finding is inconsistent with the cholesterol hypothesis.”

“Since elderly people with high LDL-C live as long or longer than those with low LDL-C, 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-C in the elderly as a component of cardiovascular disease prevention strategies.”

—Amanda Balbi

Reference:

Ravnskov U, Diamond DM, Hama R, et al. Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review [published online June 12, 2016]. BMJ Open. doi:10.1136/bmjopen-2015-010401.