by Stephen Luther, M.D.
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![Rethinking LDL Cholesterol: Insights from Recent Research](https://mysymbios.com/wp-content/uploads/2024/07/Rethinking-LDL-Cholesterol-Insights-from-Recent-Research.jpg)
In the ever-evolving guidelines of medical treatments, lowering cholesterol levels by prescribing statins with hopes of preventing cardiovascular disease has become routine care. However, despite statins’ widespread use, valid questions such as, “Why haven’t mortality rates improved with lower cholesterol levels?” have prompted additional independent studies. One recent study of adults ages 50-89 from an extensive healthcare system closely examined the relationship between low-density lipoprotein cholesterol (LDL-C) and long-term mortality with potentially life-extending results.
Symbios invites you to determine cholesterol myths from facts by:
- exploring evidence-based research,
- discovering the significant results of the real-life study, and
- learning the cholesterol ranges of those with the longest lifespans.
Cholesterol is an essential molecule with many positive roles in the body, from maintaining cell structure to hormone production and brain health. The key to benefiting from cholesterol is making lifestyle choices that support a healthy balance between LDL and HDL levels. Read “Befriending Cholesterol” to learn more.
The pharmaceutical industry’s promise that lowering cholesterol by using statins would increase life expectancy is proving to be a myth, as facts speak louder than words, such as:
- Acute coronary syndromes occur regularly in patients within the recommended low-density lipoprotein cholesterol (LDL-C) levels. In a study on lipid levels in patients hospitalized with coronary artery disease, 136,905 patients with coronary artery disease found that less than 25% had LDL-C levels above 130 mg/dL, and many were already on lipid-lowering therapy.
- Women, who are generally at lower risk for coronary heart disease, had slightly higher mean total cholesterol levels than men, according to research on the distribution of lipid parameters, challenging the idea that high LDL-C is directly linked to heart disease and early death.
- Lowering LDL-C has an extremely minimal impact on reducing deaths. A study of 60 clinical trials in 2023 reported that the present meta-analysis confirms that LDL-C–lowering therapy statistically reduces life expectancy.
- The mortality-predicting life insurance industry guidelines prefer a ratio of 5:1 (or more) total cholesterol to HDL-C. For example, a 70-year-old can qualify for a preferred insurance policy with a total cholesterol of up to 300 mg/dL if their HDL-C is 60 mg/dL or higher. This ratio demonstrates an association between higher HDL-C and a lower risk of cardiovascular disease and all-cause mortality.
These evidence-based facts set the foundation for understanding LDL-C’s role in health and mortality.
A Study on LDL-C’s Association to Living Longer
Is LDL-C associated with long-term mortality among primary prevention adults? No. According to this recent study, a higher number of LDL-C did not increase the risk or rate of death. The retrospective cohort study compared the relationship between LDL-C and the death rate over an extended period in adults. Researchers created a group from the University of Pittsburgh Medical Center’s electronic medical records from January 4, 2000, to December 31, 2022. They included all adults aged 50-89 who did not have diabetes and were not on statins. For more accurate results, it excluded patients who died within a year or had significantly low cholesterol levels.
The focus group had 177,860 men and women with a mean age of 61.1 years who were evaluated over a mean of 6.1 years of follow-up. Their primary measure was the baseline LDL-C, with levels categorized into ranges from 30 mg/dL to over 190 mg/dL and a mean of 119 mg/dL. The research tracked the mortality of this group that did not use lipid-lowering therapy. The conclusion was, “among primary prevention-type patients aged 50-89 years without diabetes and not on statin therapy, 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.” (Today’s recommended LDL-C is less than 100 mg/dL). This study found that patients with LDL-C in the 100-189 mg/dL range lived the longest, meaning lower cholesterol is not associated with a longer life expectancy.
Find Your Perfect Balance
Symbios believes a healthy lifestyle promotes an optimal ratio between LDL and HDL cholesterol levels that can positively influence longevity. Our recommendations include:
- Health Check-Up: Regular physical examinations at Symbios Health are vital to evaluate your wellness and diagnose health concerns. Bloodwork at our on-site laboratory can quickly check cholesterol, and our team of experts can monitor your metabolic health by checking your blood pressure, weight, pulse, and more.
- Nutrition: A balanced diet rich in green vegetables, meats, and organic fats (like those found in most nuts, avocados, olives, and fish) can help manage cholesterol levels. Avoid processed foods, artificial fats, and synthetic seed oils. Talk to our nutrition specialists at Symbios Nutrition and download our nutritional guidebook for more information.
- Physical Activity: Regular physical activity boosts HDL-C levels, increases blood flow, strengthens your body, reduces inflammation, and improves cardiovascular health. The friendly coaches at SymbiosFIT have daily exercise classes for every fitness level.