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Low
good cholesterol predicts death in elderly Reuters Health, July 21, 2003 Low
levels of 'good' cholesterol, rather than high levels of 'bad'
cholesterol, are associated with an increased risk of death from heart
disease and stroke in people who have reached 85 years of age, according
to a report published in the July 14th issue of the Archives of Internal
Medicine. Although
high total cholesterol levels are usually tied to adverse outcomes, there
is evidence that high levels are actually associated with decreased
all-cause mortality in the elderly (see Reuters Health reports October 17,
1997 and August 2, 2001). However, the effect of high-density lipoprotein
(HDL) and low-density lipoprotein (LDL) cholesterol levels on mortality in
this age group is unclear. Dr.
Annelies W. E. Weverling-Rijnsburger, from Leiden University in the
Netherlands, and colleagues measured cholesterol levels in 561 subjects
who had recently reached 85 years of age. The subjects were then followed
for 4 years. During
the study period, 152 subjects died and cardiovascular disease was the
leading cause, the investigators note. Levels
of LDL, the "bad" type of cholesterol, did not influence the
risk of death from cardiovascular disease, the authors found. In contrast,
low levels HDL, the "good" cholesterol increased the risk. Subjects
with HDL cholesterol levels below 40 mg/dL were twice as likely to die
from stroke or heart disease than were subjects with levels above 46 mg/dL.
Low
levels of HDL as well as LDL cholesterol more than doubled the risk of
death from infection, the investigators state. High total cholesterol
levels were associated with a significantly reduced risk of death from
infection. In
addition to indicating that that HDL cholesterol, but not LDL cholesterol,
is a predictor of death in the very old, the results also suggest that the
survival benefits previously seen with high total cholesterol levels may
be due to protection against death from infectious disease. Although
these laboratory findings are implicated in increased risk, rather than
the direct cause of death, "it may be argued that increasing HDL
cholesterol levels is more advantageous than lowering total cholesterol
levels among old people," the authors conclude. Copyright
© 2002 Global Action on Aging
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