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Lack of an association or an inverse association between low-density-lipoprotein cholesterol and mortality in the elderly: a systematic review

Författare och institution:
U. Ravnskov (-); D. M. Diamond (-); R. Hama (-); T. Hamazaki (-); B. Hammarskjold (-); N. Hynes (-); M. Kendrick (-); P. H. Langsjoen (-); A. Malhotra (-); L. Mascitelli (-); K. S. McCully (-); Y. Ogushi (-); H. Okuyama (-); P. J. Rosch (-); Tore Scherstén (Institutionen för kliniska vetenskaper); S. Sultan (-); R. Sundberg (-)
Publicerad i:
Bmj Open, 6 ( 6 )
ISSN:
2044-6055
Publikationstyp:
Artikel, refereegranskad vetenskaplig
Publiceringsår:
2016
Språk:
engelska
Fulltextlänk:
Sammanfattning (abstract):
Objective It is well known that total cholesterol becomes less of a risk factor or not at all for all-cause and cardiovascular (CV) mortality with increasing age, but as little is known as to whether low-density lipoprotein cholesterol (LDL-C), one component of total cholesterol, is associated with mortality in the elderly, we decided to investigate this issue. Setting, participants and outcome measures We sought PubMed for cohort studies, where LDL-C had been investigated as a risk factor for all-cause and/or CV mortality in individuals 60years from the general population. Results We identified 19 cohort studies including 30 cohorts with a total of 68094 elderly people, where all-cause mortality was recorded in 28 cohorts and CV mortality in 9 cohorts. Inverse association between all-cause mortality and LDL-C was seen in 16 cohorts (in 14 with statistical significance) representing 92% of the number of participants, where this association was recorded. In the rest, no association was found. In two cohorts, CV mortality was highest in the lowest LDL-C quartile and with statistical significance; in seven cohorts, no association was found. Conclusions High LDL-C is inversely associated with mortality in most people over 60years. This finding is inconsistent with the cholesterol hypothesis (ie, that cholesterol, particularly LDL-C, is inherently atherogenic). 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.
Ämne (baseras på Högskoleverkets indelning av forskningsämnen):
MEDICIN OCH HÄLSOVETENSKAP ->
Klinisk medicin
Nyckelord:
Risk factor, LDL-cholesterol, cardiovascular mortality, total mortality, elderly, GERIATRIC MEDICINE, eventive medicine, epidemiology, all-cause mortality, coronary-artery-disease, cardiovascular-disease, myocardial-infarction, plasma-lipids, prospective cohort, blood, cholesterol, older-people, serum-lipids, risk-factors, General & Internal Medicine
Postens nummer:
242073
Posten skapad:
2016-09-20 15:39

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