Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid?

[Ted_Hutchinson]

Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid?

Abstract
Rationale, aims and objectives Many clinical guidelines for cardiovascular disease (CVD) prevention contain risk estimation charts/calculators.
These have shown a tendency to overestimate risk, which indicates that there might be theoretical flaws in the algorithms.
Total cholesterol is a frequently used variable in the risk estimates. Some studies indicate that the predictive properties of cholesterol might not be as straightforward as widely assumed.
Our aim was to document the strength and validity of total cholesterol as a risk factor for mortality in a well-defined, general Norwegian population without known CVD at baseline.
Methods
We assessed the association of total serum cholesterol with total mortality, as well as mortality from CVD and ischaemic heart disease (IHD), using Cox proportional hazard models.
The study population comprises 52 087 Norwegians, aged 20–74, who
participated in the Nord-Trøndelag Health Study (HUNT 2, 1995–1997) and were followed-up on cause-specific mortality for 10 years (510 297 person-years in total).
Results
Among women, cholesterol had an inverse association with all-cause Mortality [hazard ratio (HR): 0.94; 95% confidence interval (CI): 0.89–0.99 per 1.0 mmol L -1increase] as well as CVD mortality (HR: 0.97; 95% CI: 0.88–1.07).
The association with IHD mortality (HR: 1.07; 95% CI: 0.92–1.24) was not linear but seemed to follow a ‘U-shaped’ curve, with the highest mortality <5.0 and 7.0 mmol L-1
. Among men, the association of cholesterol with mortality from CVD (HR: 1.06; 95% CI: 0.98–1.15) and in total (HR: 0.98; 95% CI: 0.93–1.03) followed a ‘U-shaped’ pattern.
Conclusion
Our study provides an updated epidemiological indication of possible errors
in the CVD risk algorithms of many clinical guidelines. If our findings are generalizable,
clinical and public health recommendations regarding the ‘dangers’ of cholesterol should be revised.
This is especially true for women, for whom moderately elevated cholesterol (by current standards) may prove to be not only harmless but even beneficial.

 

[dogwoman]

I definitely agree that the current models regarding cholesterol are off the mark.

 

[Ted_Hutchinson]

Association between serum cholesterol and noncardiovascular mortality in older age.

Association between serum cholesterol and noncardiovascular mortality in older age.Higher total cholesterol was associated with a lower risk of noncardiovascular mortality in older adults. This association varied across the late-life span and was stronger in older age groups.
Bear in mind this is for Adults aged 55 to 99
Age- and sex-adjusted analyses showed that each 1-mmol/L increase in total cholesterol was associated with an approximately 12% lower risk of noncardiovascular mortality
Age group-specific analyses demonstrated that this association reached significance after the age of 65 and increased in magnitude across each subsequent decade.
This was driven largely by non-high-density lipoprotein cholesterol (non-HDL-C) and was partly attributable to cancer mortality.
Conversely, HDL-C was not significantly associated with noncardiovascular mortality

So as I'm over 65 it applies to me.

For each increase in total cholesterol I lower my risk of noncardiovascular mortality so live longer.

Or I could choose to lower my TC and increase my risk of death and enjoy a wide variety of quite nasty side effects?

Sad isn't it how many people enjoy making themselves ill and just love shortening their lives taking statins. It's amazing how many people are so gullible when it comes to believing adverts.

 

[saved1986]

In some countries in europe, they say cholesterol in the 250 range is fine, in the states they want it lower no matter what.

 

[Ted_Hutchinson]

In some countries in europe, they say cholesterol in the 250 range is fine, in the states they want it lower no matter what.

Well that's one way to drum up business for the undertaker, I'm surprised you aren't able to sue them for negligence.

 

[saved1986]

Well that's one way to drum up business for the undertaker, I'm surprised you aren't able to sue them for negligence.

HUH! If I was a med doctor and someone had a cholesterol number of 240 and I did not prescribe statins and he/she died a month later from a heart attack, I could be sued. Does not matter if the drugs work or not. Sad thing, fish oil flax oil apple peels etc will help clean out the arteries.

 

[Arrowwind09]

My cholesterol is 160 and has been so for many years and the ratios are good.. but I wonder if this low level makes me at risk for some kind of cardiac or vascular issue. I do know that I have a propensity for varicose veins over the last few years and I treat that with supplements. What can I do to raise my cholesterol? or should I not bother?

 

[saved1986]

My cholesterol is 160 and has been so for many years and the ratios are good.. but I wonder if this low level makes me at risk for some kind of cardiac or vascular issue. I do know that I have a propensity for varicose veins over the last few years and I treat that with supplements. What can I do to raise my cholesterol? or should I not bother?

Soluble fibers (especially fruit pectin in apples and oranges) bind bile acids and make them unavailable for the liver to produce cholesterol. Cut down your fruit intake for a couple weeks and see if your cholesterol goes up.

 

[Ted_Hutchinson]

Comparison of Mechanism and Functional Effects of Magnesium and Statin

Comparison of mechanism and functional effects of magnesium and statin pharmaceuticals.

Conclusion
Statin medications inhibit the same rate-controlling enzyme of the cholesterol biosynthesis pathway that requires adequate Mg for normal deactivation, regulation and control.Both the highly beneficial pleiotropic and adverse effects of statins appear to be caused by the decrease in mevalonate (and perhaps other intermediaries in the cholesterol biosynthesis pathway) rather than a lower LDL-C.
Statin drugs lower LDL-C levels more sharply than do Mg supplements, but Mg more reliably acts to improve all aspects of dyslipidemia including raising HDL-C and lowering triglycerides, and has the same pleiotropic effects as statins without their adverse effects.

recent study analyzing the diet of 564 adult Americans, both male and female, the average intake of magnesium was less than two-thirds of the RDA for men and less than 50% of the RDA for women.
If you search my previous posts for MAGNESIUM you should come across several threads where the most effective forms of magnesium are discussed in detail.

 

[Ted_Hutchinson]

Disease Creep: How we're fooled into using more medicine than we need.


This is a guest post from independent medical investigative journalist Jeanne Lenzer.
She is a former Knight Science Journalism Fellow and a frequent contributor to BMJ, and has published works in The Atlantic, The New York Times Magazine, Discover, The New Republic, and other outlets. The full text of article is at the link above and well worth reading.

 

[Ted_Hutchinson]

The Truth About Ancel Keys: We’ve All Got It Wrong

DENISE MINGER does it again.
The Truth About Ancel Keys: We’ve All Got It Wrong
Not only does she make you laugh out loud she also manages to explain some complicated statistics in a way that keeps you interested and smiling.