The anti-cholesterol bandwagon has been picking up steam for decades. People have been bludgeoned into believing that margarine is better than butter, eggs are evil and that beef is a bad word. Everyone was encouraged to get total cholesterol below 200. If diet didn't work, drugs were often prescribed.
But now a new study has created confusion. Researchers have discovered that in older people, cholesterol doesn't seem to count. Their subjects were over 70 and had not had a heart attack. Cholesterol levels were not associated with rates of heart attack or risk of death.
Older women actually appeared to do better when their cholesterol levels were higher. This is contrary to conventional wisdom.
Part of the problem is that investigators have largely ignored older people, especially women.
Studies have shown that men with elevated cholesterol are at higher risk of heart attacks. Doctors assumed that this was also true for older people and women, who had not been studied as carefully. As a result, many cardiologists have tried to get cholesterol levels down in the hope that this will reduce risks for ,, everyone.
An editorial in the Journal of the American Association (JAMA) notes that more than 2 million people over 65 are on cholesterol-lowering medications. For those who have had heart attacks, this may be appropriate. But the editorial goes on to note that treatment might turn healthy older people into patients and place them at risk of drug side effects and interactions.
This issue is especially important for women who have high HDL cholesterol. They may not realize that their ratio of total cholesterol to good HDL is now considered more relevant than a simple cholesterol count. Trying to get cholesterol down in such a situation is probably unnecessary and might be counterproductive.
Our Guide to Cholesterol discusses these important concepts and tells how to calculate and interpret such ratios. Anyone who would like a copy, please send $2 with a long (No. 10) stamped, self-addressed envelope to Graedons' People's Pharmacy, No. C-11, P. O. Box 52027, Durham, N.C. 27717-2027.
The new research does not mean that younger people should ignore a cholesterol problem or revert to poor eating habits. Fat is still a problem for most Americans.
But this study does suggest that when it comes to heart disease, men and women may differ and older people must be treated more conservatively than middle-aged men.
Joe Graedon is a pharmacologist. Dr. Teresa Graedon is a medical anthropologist and nutrition expert.