High cholesterol among older people is associated with longer life. In Japan, high cholesterol is associated with longer life at all ages. More recent evidence indicates that the relation of high cholesterol to longevity is as robust as ever, and that older people with high cholesterol live longer.
Consider the following an “out of sample” study in which results are verified, associations confirmed, and the risk of data mining undercut.
Cholesterol and mortality
A newly published study looked at 3090 adults aged 60 and up in the Swedish National study on Aging and Care. Baseline date was 2001-04. The study followed the subjects until the end of 2011.
The results:
Compared to normal total cholesterol (<5.18 mmol/l), borderline-high (5.18–6.21 mmol/l) and high (≥6.22 mmol/l) total cholesterol were associated with a decreased risk of all-cause mortality, with the multiple-adjusted hazard ratio (95% confidence interval, CI) of 0.71 (0.61–0.83) and 0.68 (0.57–0.80), respectively (P for trend <0.001)… reduced all-cause mortality associated with high total cholesterol (≥6.22 mmol/l)) was mainly due to the reduced risk of non-cardiovascular mortality (hazard ratio = 0.67, 95% CI = 0.51–0.88). These associations were statistically evident only among individuals without use of cholesterol-lowering medications.
Conclusions
The inverse association between high total cholesterol and reduced all-cause mortality in older adults is primarily due to non-cardiovascular mortality, especially among those who are not treated with cholesterol-lowering medications.
Graphs showing survival curves shown below. Those with the highest cholesterol, >240 mg/dl, lived the longest, those at 200-240 mg/dl were in the middle, and those with cholesterol <200 had the highest death rate. (To convert cholesterol from mmol/L to mg/dl, multiply by 38.67.)
Noteworthy, those who had high cholesterol but took cholesterol-lowering drugs such as statins had no survival advantage.
The reduced risk of death seen in those with high cholesterol was mainly due to lower risk of non-cardiovascular death. High cholesterol was associated with a ~30% lower mortality rate.
The authors speculate that higher cholesterol may modulate inflammation, or that low cholesterol is a sign of frailty and poor health. Proponents of the harmfulness of cholesterol argue the latter case, but even if true, why would you want your cholesterol in the range of unhealthy, frail people?
In men aged 85 or more, who are described as “very elderly”,
… total mortality in the low-TC [total cholesterol] group was 1.7-fold higher than that in the high-TC group. Mortality, adjusted for the same factors, decreased 0.9% with each 1 mg/dL increase in the serum TC concentration and decreased 0.8% with each 1 mg/dL increase in the serum (low-density lipoprotein) LDL-cholesterol (LDL-C) concentration. Our results indicate an association between lower serum TC concentrations and increased all-cause mortality in a community-dwelling, very elderly population. Mortality decreased with the increases in both TC and LDL-C concentrations, after adjustment for various confounding factors. These findings suggest that low TC and low LDL-C may be independent predictors of high mortality in the very elderly.
When I’m 85 years old or more, I don’t plan on being described as “very elderly”. I’ll still be doing deadlifts and won’t be trying to lower my cholesterol.
Should the elderly take statins?
In a review of studies on cholesterol and statins in the elderly – greater than 80 years old – found two basic conclusions:
- total mortality was highest at the lowest cholesterol levels: “Low TC (<5.5 mmol/l) [total cholesterol <212 mg/dL] is associated with the highest mortality rate in 80+-year olds.”
- no benefit of lipid-lowering in this age group: “There is not sufficient data to recommend anything regarding initiation or continuation of lipid-lowering treatment for the population aged 80+, with known CVD, and it is even possible that statins may increase all-cause mortality in this group of elderly individuals without CVD.” [Emphasis added.]
Hemodialysis patients
In hemodialysis patients, who are quite ill indeed, higher levels of LDL were associated with reduced risk of infections, and no increase in cardiovascular risk.
Cholesterol-lowering insanity
When will the cholesterol-lowering, statin-prescribing insanity end? Probably not any time soon, since Big Pharma has a large influence on medical practices. There’s huge money in prescription drugs including statins.
Cholesterol is a natural molecule synthesized by the human body, and is critical for the function of cell membranes and hormones.
If higher cholesterol is associated with longer life in the elderly, and in all ages in Japan, then that casts considerable doubt on cholesterol as a cause of cardiovascular disease. Since age is a risk factor for CVD, if high cholesterol caused it, we would expect to see higher death rates in the elderly with high cholesterol. But we do not.
PS: For how iron can cause cardiovascular disease, see my book, Dumping Iron.
9 Comments
As you and others have said, the reason that statins are so widely prescribed, despite the evidence that cholesterol is not the cause of heart disease, is that there is too much money involved to do anything different. This is exactly why I always tell people to not blindly follow your doctor’s advice (especially when it comes to taking prescription meds), because the advice is often tainted by the influence of Big Pharma (and could do you more harm than good). There are a few doctors out there who are willing to go against the tide and actually practice real patient-based integrative medicine, but not all that many (yet), at least in my experience.
Perhaps a change of approach is needed. I am reminded of France in the 1760’s when the government was trying to encourage peasants to grow potatoes to make up for a deficiency in the wheat crop. Resistance among peasant growers was near universal !
Then someone had a bright idea : plant a potato crop in a big walled garden with guards to ‘prevent’ theft of the crop. But have the guards were sent off for a mug of wine, a meal & to sleep at night. Result ? Wholesale theft of the secret potato crop which were then planted and grown. And spuds became part of the french national cuisine.
So ….. Let’s form an international secret ‘”No CVD Society” ! And only allow ‘No CVD’ information to be granted to people who are members. Gosh PD maybe you could even charge a modest fee for membership and maybe retire to a more leisured life.
🙂
Sorry..I am not catching the metaphor..
ok…sorry.
I got it now!! hahahaha but I am afraid naysayers can say what they want and they have made up their mind… when they get the information they will still go with Vegan Gainzz
Interesting. I just read your post this morning, then saw this:
https://www.dailymail.co.uk/health/article-5464247/Could-high-cholesterol-PREVENT-cognitive-decline.html
Thanks Mike for the link ! A very interesting article.
It’s clear that the Low Cholesterol ideology is bloody plot to kill the elderly. So old timers the solution is obvious : ignore the stupid death causing advice of your doctors and live long without dementia !
PS Why is it that obvious is so hard to ‘see’ for the researchers in this research ? Could it be that they only want an opportunity to get position, money, prestige & status ?
Mas para pessoas mais novas, tipo 50 anos, quais os niveis aceitos, TC e HDL? TC/HDL < 4 e Triglicerides/HDL < 2?
Nesse caso, o LDL não teria influencia