Report refuting link between cholesterol and elderly heart disease should be taken with pinch of salt

The link between cholesterol and heart disease in elderly people has been questioned in a controversial new study. Credit: PA Wire

Coronary heart disease is the UK's biggest killer. Every year the NHS spends millions of pounds trying to combat it by helping patients reduce their cholesterol levels using drugs like statins.

So when an international group of experts claims cholesterol doesn't cause heart disease in the elderly, and questions whether statins are worth the money, you can see why it makes the headlines.

But where does that leave patients who have spent years trying to avoid "bad" cholesterol (known rather less snappily by the scientists as low-density lipoprotein cholesterol or LDL-CC)?

If you've been religiously cutting down on the kinds of saturated fat found in bacon butties and cream cakes, can you now afford to ignore the NHS guidelines and indulge with impunity?

Not, say many scientists, without first adding a big pinch of salt into the mix - metaphorically speaking at least.

Why? Well, the review looked at the experiences of 70,000 people before concluding there was no link between cholesterol and the premature deaths of the over 60s from cardiovascular disease.

Published in the BMJ Open journal, it found that 92% of people with a high cholesterol level lived longer.

A procedure to check for cholesterol levels. Credit: PA Wire

But it's been heavily criticised for relying on second-hand data and for failing to mention extensive clinical research which demonstrates the opposite.

As Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, puts it, "The evidence from large clinical trials demonstrates very clearly that lowering LDL cholesterol reduces our risk of death overall and from heart attacks and strokes, regardless of age.

"There is nothing in the current paper to support the authors’ suggestions that the studies they reviewed cast doubt on the idea that LDL cholesterol is a major cause of heart disease".

Dr Tim Chico, a consultant cardiologist from the University of Sheffield agrees there is nothing in the report that would justify re-evaluating the NHS guidelines.

He believes observational studies like this are often wrong because of confounding influences - especially when it comes to the elderly, because the older you get, the more various factors have an impact on your overall health.

"The literature is full of examples of this," he said. "Which is why to properly examine whether cholesterol influences risk of heart disease, the "gold standard" is a randomised study where some patients have their cholesterol lowered using a drug and others receive a placebo."

So while no one could blame you for reaching for the cake tin as you peruse the headlines, the best advice may be to wait for new evidence, rather than relying on today's interesting, but ultimately unproven, review.