all cause mortality and cholesterol levels

A forum to discuss cholesterol and the meaning of blood cholesterol levels.

all cause mortality and cholesterol levels

Postby David Staup » Wed Jul 22, 2009 11:39 am

some data on ideal cholesterol levels:


This section includes excerpts from the book Malignant Medical Myths by Joel M. Kauffman

This news does not reflect the best dietary science on a number of issues. Lowering total cholesterol by 4% would mean about 8 mg/dL, a trivial change. The assay is ± 25% and total serum cholesterol varies depending on a recent meal, exercise (up) and stress (up).

Hypercholesterolemia is a made up condition now said to mean that total serum cholesterol is above 200 mg/dL or LDL-C is over 125 mg/dL. This was done to advance the sales of cholesterol-lowering drugs, and Cheerios® incidentally benefited.

A 2004 observational study from the University of Innsbruck, Austria, on 150,000 subjects showed that low cholesterol levels predict premature death in men of all ages, and in women over the age of 50.

In the 1990 Quebec Cardiovascular Study on 4576 men aged 35-64 years to start, serum total cholesterol levels were not associated with either cardiovascular disease or all-cause mortality.

Even in dialysis patients, all-cause mortality was highest at the lowest total cholesterol levels, being 30% lower when total cholesterol was approximately 240 mg/dL compared with TC <160. Also, mortality was 17% lower at low-density-lipoprotein (LDL-C) approximately 190 mg/dL compared with LDL-C <130 in a 2004 study.

Among the elderly the effects of low serum total cholesterol and low LDL-C were found to be deadly. In a study on residents of northern Manhattan, NY, 2,277 subjects were followed for 10 years with results reported in 2005. Two-thirds were female and 1/3 of the total were Hispanic, African American and white. Subjects were 65-98 years old at baseline, mean age 76. The chance of dying was twice as great in the lowest quartile of total cholesterol or LDL-C levels, while HDL-C and triglyceride levels were not related to all-cause mortality in this age group.

Women had higher baseline total cholesterol and LDL-C levels (206 and 124) than men (191 and 117), yet the women lived longer. Men with the same total cholesterol and LDL-C levels as women lived as long. Of the subjects, 1/5 were taking statin drugs to lower total cholesterol and LDL-C, which would have pushed them into the lowest quartile.

This is an excellent confirmation that high total cholesterol and LDL-C ( low density lipoprotein cholesterol ) levels are beneficial, certainly in the elderly who are most likely to be prescribed a statin drug. The emphasis on the value of lowering LDL-C, rather than lowering total cholesterol, taken by Big Pharma in the last few years, is invalidated by this study. LDL-C is not bad cholesterol; it is an essential form!

Dr. Bernard Forette and a team of French researchers from Paris reported in 1989 that women of mean age 82 with high cholesterol and followed for 5 years lived the longest. When the data of Forette are graphed, the age-adjusted data show a minimal risk of dying out to total cholesterol = 320 mg/dL for elderly women. The minimum death rate occurred with a total cholesterol level of 272 mg/dL, far higher than the current National Cholesterol Education Program (NCEP) recommendations of approximately 200 mg/dL for everyone.

The death rate was 5.2 times higher for women who had very low cholesterol, specifically, 155 mg/dL.  The death rate was 1.8 times higher for women who had very high cholesterol, specifically, 348 mg/dL, and also 1.8 times higher at 200 mg/dL.

What possible basis could there be for the NCEP recommendations for <200? In their report, the French doctors warned against lowering cholesterol in elderly women.

Serum total cholesterol rises naturally with age from a mean level of 178 mg/dL in 18-24 year-olds to a maximum mean level of 230 mg/dL in 55-64 year-olds. Men over 55 and women of all ages who have the highest cholesterol levels live the longest, since high total cholesterol protects against cardiovascular disease (CVD) and infections (Ravnskov U. High cholesterol may protect against infections and atherosclerosis. Quarterly Journal of Medicine, 2003;96:927-934).

For people of a narrow age range, even in a 13-year span, say ages 50-62 years, a graph of total cholesterol levels of men who did and did not have CVD has been published in 2001.

There is so much overlap between the men with or without CVD that there is no likelihood that the slightly greater chance for CVD at the higher total cholesterol levels could be used for prediction in any one individual, even in this group spanning 13 years in age.

This is the reason that drug advertising claims that higher total cholesterol means quicker death from CVD are false - in large groups of people of mixed ages, the older ones will have higher total cholesterol and LDL-C, and older people die sooner than younger ones, not necessarily from CVD.

Joel M. Kauffman, Ph.D.
Former Professor of Chemistry of the University of the Sciences in Philadelphia, now Emeritus.
Author of Malignant Medical Myths: Why Medical Treatment Causes 200,000 Deaths per Year
David Staup
 
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Postby lars999 » Tue Dec 28, 2010 10:38 am

Hello David!!

Just reread your excellent post and highly recommend that others do the same.

I have been digging around in other sources in recent months and find the same basic information. Once again, I have come to consider this to be the norman situation rather than the hoaxed-up stuff the drug and processed food companies have been conning folks with.

In 1970s I worked for NASA at Johnson Space Center, Seabrook, TX, USA. ALL NASA employees above a certain grade level were given extensive medical check-ups every year. The reason for this was the astronauts for whom NASA had a huge amount of medical, etc. data but very little such data for general population, that could be used as controls. So, we became the "control" or "background" group.

This program became hugely popular because it found many serious medical conditions in time to sucessfully treat them. However, there was one aspect that resulted in the doctors becoming laughing stock for the local NASA personnel -- it was the early version of the cholesterol con and the effects of dietary cholesterol, fats, exercise, etc. on cardiovascular conditions.

Basically, there was no good, even "decent" correlation between cholesterol levels in blood serium and diet, exercise, cardiovascular condition, etc. Many individuals did what I did, kept records of diet, exercise, cholesterol levels, etc. and found no consistant correlations at all. During that decade, my total cholesterol levels ranged from 180 to almost 300, if any thing, more exercise, lower weight, "better" diet correlated with higher cholesterol. Really, however, there was no correlation.

Please understand that I come from a science and engineering world where data that require statistical analysis to demonstrate "significance" are shoddy data indeed. SO, nearly all medical data get the horse laugh -- they are really just "scatter grams".

And now I have a few self-inflicted bootprints on my rear, a direct result of listening to a doctor's lies about the wonderful and almost totally harmless drug Lipitor. How could I have been so complacent?

Now that I am soon to be 71, I am quite happy that my total cholesterol is back to a normal for me of 278. It has been in 270s for past 25+ years, except when Lipitor reduced it to the deadly levels mentioned in David's post above. And I have no evidence of any adverese cardiovascular condition.

Lars
lars999
 
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Postby David Staup » Tue Dec 28, 2010 8:17 pm

Lars,

here is some "actual data". I spent some time looking for all cause vs. cholesterol studies and came across the following. I believe it'd tables 5 and 6 that are interesting. run the numbers yourself and you get actual "risk" numbers that pretty much fit the numbers quoted in the article posted above...not my writing by the way, copied directly from the pages of space doc.

"http://dspace.lib.kanazawa-u.ac.jp/dspace/bitstream/2297/7526/1/ME-PR-MABUCHI-H-1087.pdf

also you might find the following "interesting" as it explains how this all came about, see paragraphs 6 through 9 in the preface:


"http://dspace.lib.kanazawa-u.ac.jp/dspace/bitstream/2297/7526/1/ME-PR-MABUCHI-H-1087.pdf

and then read the following for further understanding, the first paragraph says it all:

"http://www.bartleby.com/37/3/19.html

David
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Location: granbury, texas

Postby lars999 » Wed Dec 29, 2010 11:54 am

Hello David!

I have read that Univ of Kanazawa paper before. I am not very positively impressed with what it shows. For example, Table 4 shows 95% confidence intervals that are HUGE, with more than a 2-fold range from lowest to highest value of the interval in all cases for total cholesterol and LDL-C and HDL-C. Except for very highest total cholesterol, there is overlap in the 95% confidence intervals for total cholesterol. Almost as bad for LDL-C. Even worse overlap in "risk" for entire range of lipid concentrations in Table 5. Pretty sloppy data!! But it is just for "risk", not for actual deaths (Table 6).

Table 6 gives ranges of 95% confidence limits that extensively, but not completely overlap for ALL ranges of lipid concentrations!!

Figure 2 shows a total overlap for ages from less than 45 to greater than 65.

Only a few things can be stated with confidence from this study. First is that a lot of people were studied and lots and lots of yen were expended. Second is that there is very loose, if any, connection between lipid levels and actual mortality from any causes listed. Brings to mind "mental masturbation", defined as lots of activity, resulting in a gratifying outcome -- at least for the lipid peddlers.

I can say with almost absolute certainty that something will kill me in the coming 30 years, perhaps even in coming 10 years, or maybe 20. Maybe it will be heart attack, stroke, cancer, truck, fire, crime, lightening, etc., ect. For sure, my personal lipid levels are hardly a death sentence, more likely, irrelevant or even protective (another set of data to scrutinize).

Taking Lipitor had me headed for grave, even at 10 mg/day -- that is hard fact for me.

At moment, I am on hunt for some hard evidence in my body, be it vulnerable plaque, cancerous polyp, etc. At least this gets me into the world of analytical techniques, something I can deal with on basis of 50+ years of professional experience and have some personal confidence (or lack thereof) in the measurements, operations, etc. So far all such techniques indicate low to very low risk of deadly medical event in near future. I am getting some insights as to why my blood relatives lived so long.

Lars
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Postby David Staup » Wed Dec 29, 2010 1:24 pm

Lars

I think you missed my point.

if you look at tables 5 and 6, for each cholesterol range there is a population (for that range) and number of deaths. find the ratio and multiply by 1000 to get a look at the Un massaged numbers. clearly the highest death rates occur at cholesterol levels that line up with the
guidelines HMMM the numbers you get are actual rates as opposed to relative rates....


David
David Staup
 
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Postby lars999 » Wed Dec 29, 2010 3:28 pm

David,

OK, I did go in different direction than you. And yes, this study shows that total cholesterol greater than 280 and lower than 160 both give higher rates of cardiac deaths (about 3-4 times higher) that do intermediate concentrations -- no matter how you slice the data. From 160 to 279 one has to doubt the existance of any substantive difference in either actual or relative risk. Removing the 13 deaths from the total of 83, one could only prevent 15% of cardiac deaths by keeping cholesterol above 160 and below 280.

And how many additional deaths will statins cause when they lower total cholesterol below 160????

SO, what do we learn that we -- at least us cholesterol skeptics -- did not already know?

Really, though, I find the much more valuable result is that cardiovascular deaths (188) and maligncies (313) and other deaths (181) each out rank cardio deaths (83) by at least 2 fold, EACH. That is ratio of 682 to 83, or 8,2 times as many deaths, or 9,7 times if we subtract the 13 that had less than 160 or more than 280 mg/dl total cholesterol. SO, why all the fuss about deaths from reasons cardio?

Frankly, I have lost many friends from non-cardiac deaths and not one from a heart attack.

It would be great if all similar studies reported all-cause mortality.

Thanks,
Lars
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Joined: Mon Sep 20, 2010 10:14 am


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