High LDL cholesterol in healthy older people wasn't associated with higher mortality.
Another Study of Cholesterol in Older Patients
Allan S. Brett, MD reviewing Maihofer AX et al. J Am Geriatr Soc 2020 Feb
High LDL cholesterol levels, measured after age 68, were not associated with higher mortality.
As our population ages, healthy older patients often ask whether they should be concerned about their cholesterol levels. In this analysis, researchers used data from the Women's Health Initiative studies to examine associations between lipids and longevity in older adults.
A subgroup of 3600 women who were born before 1926 — and thus would be age 90 or older by the year 2016 — were included in this cohort. Lipids were measured when participants were 68 to 81 years old; those with histories of cardiovascular disease or cancer were excluded. After adjustment for numerous potentially confounding medical and lifestyle variables, no association was found between HDL cholesterol levels (at ages 68–81) and survival to age 90. However, women whose LDL cholesterol levels were in the two highest quartiles (149–183 mg/dL and >183 mg/dL) had higher odds of survival to age 90 with intact mobility, compared with those whose LDL cholesterol levels were lower than 126 mg/dL (odds ratios, ≈1.4).
COMMENT
In another recent observational study of older men and women with no history of cardiovascular disease, higher LDL cholesterol levels in those who were 75 or older were not associated with risk for subsequent coronary events (NEJM JW Gen Med Jan 15 2020 and J Am Geriatr Soc 2019; 67:2560). In the current study, higher LDL cholesterol levels in relatively healthy older women actually were associated with longer survival. Until we have compelling evidence that cholesterol-lowering drugs improve clinical outcomes in such patients, we should emphasize healthy lifestyle and resist pharmacologic intervention.
EDITOR DISCLOSURES AT TIME OF PUBLICATION
Disclosures for Allan S. Brett, MD at time of publication
Nothing to disclose
CITATION(S):
Maihofer AX et al. Associations between serum levels of cholesterol and survival to age 90 in postmenopausal women. J Am Geriatr Soc 2020 Feb; 68:288. (Δεν είναι ορατοί οι σύνδεσμοι (links).
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