Study – Cholesterol-Lowering may Shorten your Life

According to conventional wisdom it is wise to lower your cholesterol if it is too high. The main reason for this advice is the observation that people with a high cholesterol more often get a heart attack than people with a normal or a low cholesterol. The observation is correct, but it does not mean that the high cholesterol is the cause of the heart attack (seesection 1). If it were, lowering of the high cholesterol by any means should prevent it, but it doesn´t (except with the new group of cholesterol-lowering drugs, the statins; see below).

Before the introduction of the new cholesterol lowering drugs, the statins, more than 40 trials have been performed to test if cholesterol-lowering can prevent a heart attack. In some of the trials the number of fatal heart attacks were lowered a little, in other trials the number of fatal heart attacks increased. Overviews of the trials have shown that when all results were taken together, just as many died in the treatment groups (e.g. those whose cholesterol was lowered) as in the untreated control group (78,79). The following table gives the accumulated results. None of the differences were statistically significant. Nor were they by more sophisticated analyses.

	Treatment groups	Control groups
Number of individuals on trial Non-fatal heart attacks; per cent	59,514 2.8	53,251 3.1
Number of individuals on trial Fatal heart attacks; per cent	60,824 2.9	54,403 2.9
Number of individuals on trial Total number of deaths; per cent	60,456 6.1	53,958 5.8

That some overviews have shown a positive result after cholesterol-lowering is because they had ignored or excluded one or more trials with a negative outcome (79).

The mentioned overviews included mostly diet and/or the older cholesterol-lowering drugs. But a new type of drugs, the socalled statins (for instance Zocord®, Mevacor®, Lescol®, Lipitor® and Pravachol®) have been succesful. However, their effect isn´t exerted through cholesterol-lowering, they have other and more useful properties  Unfortunately they also stimulate cancer growth (see section 6)

By Uffe Ravnskov, MD, PhD
Source: http://www.ravnskov.nu/cholesterol.htm#a

Cholesterol Studies:

The questionable role of saturated and polyunsaturated fatty acids in cardiovascular disease. J Clin Epidemiol 1998;51:443-460.   Read also a dissent to the paper: Golomb BA. Dietary fats and heart disease-dogma challenged? and my answer; same journal and same issue. This paper won the Skrabanek award 1999
A hypothesis out-of-date: The diet-heart idea. Published in Journal of Clinical Epidemiology (2002 Nov;55:1057-63. Same issue: Dissent by W.S.Weintraub, and Reply by U. Ravnskov An evaluation of our discussion is available 
Is atherosclerosis caused by high cholesterol? published in Quarterly Journal of Medicine (2002; 95:397–403)
High cholesterol may protect against infections and atherosclerosis published in Quarterly Journal of Medicine (2003;96:927-34).Should medical science ignore the past? BMJ 2008;337:a1681