Is there an association between blood cholesterol levels and coronary heart disease incidence or death in elderly people?
This editorial highlights a study challenging the association between blood cholesterol levels and CHD incidence or death in the elderly, questioning the extrapolation of cholesterol-lowering benefits to this population.
There is a growing tendency to encourage measurement of and treatment for high blood cholesterol levels in elderly people. The 1993 adult treatment guidelines from the National Cholesterol Education Program (NCEP) note an "enhanced recognition since 1988 that... high-risk elderly patients who are otherwise in good health are candidates for cholesterol-lowering therapy."1This policy shift is based on the belief that the association between blood cholesterol and coronary heart disease (CHD) persists after age 65 years and on a growing willingness to extrapolate to older people the reduced CHD rates observed in clinical trials of hypolipidemic treatment in middle-aged men. See also p 1335. In this issue ofThe Journal, the contention that an association between cholesterol and CHD persists in the elderly is called into question in a report by Krumholz et al.2The report finds no association between blood cholesterol level and CHD incidence or death
Stephen B. Hulley (Wed,) studied this question.
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