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Cholesterol Link to Heart Not Stroke Mortality Affirmed

Meta-analysis calls ratio of HDL to total cholesterol the strongest predictor of ischemic heart disease mortality

FRIDAY, Nov. 30 (HealthDay News) -- A meta-analysis of mortality related to ischemic heart disease found that lower levels of total cholesterol were associated with a decreased risk of death in middle and old age, however, a similar association was not found in stroke mortality, researchers report in the Dec. 1 issue of The Lancet.

The report was released by the Prospect Studies Collaboration, which is based at the University of Oxford in the United Kingdom. In it, Sarah Lewington and colleagues gathered information from 61 prospective observational studies, mostly from western Europe and North America. The sample population included 892,337 adults (40 to 89 years old) with no previous vascular disease reported and a total of 55,262 vascular deaths. A parallel analysis of the Multiple Risk Factor Intervention Trial included an additional 34,242 vascular deaths.

Across all age groups, a 1 mmol/L lower level of total cholesterol led to about a one-third lower risk of death from ischemic heart disease. The ratio of total to high-density lipoprotein (HDL) cholesterol was more than twice as strong a predictor of ischemic heart disease mortality than total cholesterol. The report was unable to demonstrate an independent positive association between cholesterol and stroke mortality.

An accompanying comment noted, "Whether raising HDL cholesterol, lowering triglyceride, or reducing inflammation and high-sensitivity C-reactive protein will further decrease stroke risk remains to be evaluated in randomized trials."

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