High cholesterol a benefit in advanced age

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If you are over age 85, you can stop worrying about your cholesterol. In fact, contrary to conventional medical wisdom, high levels in this oldest old age group are associated with increased longevity. Thats the finding from a new study of 724 men and women whose median age was 89 years when the research project began at Leiden University Medical Center, Netherlands (The Lancet, 18 October 1997). Annelies W.E. Weverling-Rijnsburger, M.D., and colleagues measured the cholesterol level of all participants and divided them into three groups according to whether their total cholesterol levels were high, moderate, or low. No one was taking cholesterol-lowering drugs.

Drug Therapy Questioned
When the study ended ten years later, 642 people had died, most of heart disease. But the heart disease death rate was similar for all three groups. (This is also the leading cause of death among middle-aged and younger elderly people.) The study participants with the highest total cholesterol lived the longest. Not surprisingly, Dr. Weverling-Rijnsburger and fellow investigators concluded, On the evidence of our data, cholesterol-lowering therapy in the elderly is questionable.

Researchers have long debated whether high cholesterol has any significance to people over 70. The elderly rarely become the subject of a clinical trial exploring the value of cholesterol reduction. This new Leiden University study is unique not only because of the advanced age of the participants but also the lack of medical intervention.

Dr. Weverling-Rijnsburger and colleagues observed that stroke is the most prevalent and disabling disorder in old people. Though high cholesterol is not a risk factor for stroke, they cite two meta-analyses that have shown that one class of cholesterol-lowering drugs called statins (some brand names: Mevacor, Pravachol, Zocor) will reduce the risk of stroke by 30%.

They wrote: A conclusion about the balance between the benefit and the risk of cholesterol-lowering therapy in the oldest has yet to be reached.

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By Maryann Napoli

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