Higher LDL-Cholesterol Tied to Lower Risk of Death
May 15, 2024
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A study challenges low LDL cholesterol benefits; optimal range is higher than expected. U-shaped curve of high LDL and mortality risk. Focus on cholesterol ratios and triglycerides. Importance of advanced health markers for longevity.
Low LDL cholesterol linked to higher cardiovascular mortality risk; optimal range is 100-189 mg/dL.
Total cholesterol to HDL ratio crucial for assessing cardiovascular risk; mid-range LDL levels show lowest risk.
Deep dives
Low LDL Cholesterol Linked with Higher Cardiovascular Mortality
A 22-year follow-up study involving 177,000 individuals revealed that lower levels of LDL cholesterol were associated with an increased risk of dying from cardiovascular-specific mortality. Contrary to common belief that lower LDL levels are better, the study found that individuals with LDL levels between 160-190 milligrams per deciliter had the highest survival probability. This challenges the conventional wisdom of aggressively lowering LDL cholesterol, emphasizing the need to consider other factors like inflammation, blood viscosity, and insulin resistance in assessing cardiovascular health.
Importance of Total Cholesterol to HDL Ratio
Another crucial finding was the importance of total cholesterol to HDL ratio in assessing cardiovascular risk. The study highlighted a U-shaped curve, indicating that mid-range LDL cholesterol levels (100-159 milligrams per deciliter) had the lowest hazard ratio for atherosclerotic cardiovascular disease events. Moreover, higher total cholesterol to HDL ratios were linked to increased odds of cardiovascular events, emphasizing the significance of a balanced lipid profile, including triglycerides and HDL cholesterol.
Reevaluating LDL Cholesterol Guidelines
The study challenges current guidelines by suggesting that the optimal LDL cholesterol range for primary prevention adults without diabetes is wider than traditionally recommended, spanning from 100 to 189 milligrams per deciliter. It emphasizes the limited predictive value of LDL cholesterol alone and advocates for assessing other factors such as total cholesterol to HDL ratio and triglyceride to HDL ratio. This nuanced approach to lipid management could lead to more personalized and effective cardiovascular risk assessment strategies.
A 22-year follow-up study involving 177,000 individuals reveals that low LDL cholesterol is associated with higher cardiovascular-specific mortality.
The authors of this study write, "...the lowest risk for long-term mortality appears to exist in the wide LDL-C range of 100–189 mg/dL, which is much higher than current recommendations."
0:00 Intro 0:04 22 Year Study 0:22 Study Title 0:52 Study Findings 1:52 Probability of survival 2:12 Counterintuitive Findings 3:42 High LDL and odds of death 3:59 U-Shaped Curve 5:50 Metabolic Health 6:34 Study of 177,000 people 8:09 Lowest risk of mortality 9:17 Watch this! 11:01 Lipid paradox
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