This paper was published in the Journal of Clinical Epidemiology 1992 Apr;45(4):333-46
Study title and authors:
Will lowering population levels of serum cholesterol affect total mortality? Expectations from the Honolulu Heart Program.
Frank JW, Reed DM, Grove JS, Benfante R.
Departments of Preventive Medicine, University of Toronto, Canada.
The paper can be accessed at:
http://www.ncbi.nlm.nih.gov/pubmed/1569429?dopt=Abstract
The authors set out to find if the advice to try and lower cholesterol levels is wise. They note that the campaign to reduce the cholesterol levels of entire national populations has not given serious consideration to the high rates of noncardiovascular disease and death associated with low cholesterol levels of less than 190 mg/dl (4.9 mmol/L).
To explore this problem, the relationships between cholesterol levels and subsequent deaths were analysed in 7,478 men who were followed for up to 20 years. From these results the authors then calculated the effects cholesterol lowering would have on the population.
The paper found:
(a) Those with low cholesterol levels had a significantly increased risk of deaths due to hemorrhagic stroke, all cancer, liver disease, chronic obstructive lung disease and "unknown cause".
(b) From this data the investigators calculated that lowering cholesterol in the population might theoretically increase the risk of death for the 60% of the population whose initial cholesterol levels were less than 225 mg/dL (5.8 mmol/L).
