A paper published today in BMJ Open suggesting that patients with high LDL cholesterol had lower or similar mortality rates has been criticised by scientists.
The paper, led by a group of international scientists reviewed 19 studies into the effect of LDL cholesterol on mortality.
They found that in most studies there was an inverse relationship between LDL cholesterol levels and mortality for those over 60, and the authors concluded that ‘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.’
However, others have cautioned that patients should not be taken off statins yet, as the total body of evidence for statins is strong and the current paper examined cohort studies, not randomised controlled trials. Also, some patients in the group with high LDL cholesterol levels could have received statins during the study which could have had a protective effect, which the authors acknowledge as a limitation of their study.
A statement from the British Heart Foundation said: ‘There is nothing in the current paper to support the author’s suggestions that the studies they reviewed cast doubt on the idea that LDL Cholesterol is a major cause of he’rt disease or that guidelines on LDL reduction in the elderly need re-valuating.’
The authors have defended their results. Dr Malcolm Kendrick, a GP and author of the study said that the results were ‘robust’, according to the Telegraph: ‘What we found in our detailed systematic review was that older people with high LDL (low-density lipoprotein) levels, the so-called “bad” cholesterol, lived longer and had less heart disease.’
Also in the Telegraph, another author of the study, Professor Sherif Sultan from the National University of Ireland, said: ‘Lowering cholesterol with medications for primary cardiovascular prevention in those aged over 60 is a total waste of time and resources, whereas altering your lifestyle is the single most important way to achieve a good quality of life.’