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

Autor:	Ravnskov U; Magle Stora Kyrkogata 9, 22350 Lund, Sweden., Diamond DM; Department of Psychology, Department of Molecular Pharmacology and Physiology, Center for Preclinical and Clinical Research on PTSD, University of South Florida, Tampa, Florida, USA., Hama R; NPO Japan Institute of Pharmacovigilance, Osaka, Japan., Hamazaki T; Department of Internal Medicine, Toyama Jonan Onsen Daini Hospital, University of Toyama, Toyama City, Japan., Hammarskjöld B; Strömstad Academy, Strömstad, Sweden., Hynes N; Western Vascular Institute, University Hospital Galway & Galway Clinic, National University of Ireland & Royal college of Surgeons of Ireland affiliated Hospital, Galway, Ireland., Kendrick M; East Cheshire Trust, Macclesfield District General Hospital, Macclesfield, Cheshire, England., Langsjoen PH; Solo Practice in Cardiology, Tyler, Texas 75701, USA., Malhotra A; Department of cardiology, Frimley Park Hospital, Portsmouth road, Surrey GU16 7UJ, UK., Mascitelli L; Medical Service, Comando Brigata Alpina 'Julia'/Multinational Land Force, Udine, Italy., McCully KS; Pathology and Laboratory Medicine Service, VA Boston Healthcare System, West Roxbury; Harvard Medical School, Boston, Massachusetts., Ogushi Y; Tokai University, Daikancho, Hiratsuka, Kanagawa, Japan 254-0807., Okuyama H; Nagoya City University and Institute for Consumer Science and Human Life, Kinjo Gakuin University, Nagoya, Japan., Rosch PJ; New York Medical College; The American Institute of Stress., Schersten T; Sahlgren's Academy, University of Gothenburg, Sweden, and Colombia University, NY, USA., Sultan S; Western Vascular Institute, University Hospital Galway & Galway Clinic, National University of Ireland & Royal college of Surgeons of Ireland affiliated Hospital, Galway, Ireland., Sundberg R; Slottsstadens Läkarhus, Malmö, Gothenburg, Sweden.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2016 Jun 12; Vol. 6 (6), pp. e010401. Date of Electronic Publication: 2016 Jun 12.
DOI:	10.1136/bmjopen-2015-010401
Abstrakt:	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 ≥60 years from the general population. Results: We identified 19 cohort studies including 30 cohorts with a total of 68 094 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 60 years. 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. (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)
Databáze:	MEDLINE
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