akita27 said:
Show me studies that show that very low LDL levels can cause a quicker onset of illness??? I have never heard of this. In fact, I have always heard that the lower the better, in terms of LDL levels.
Well then you need to do more reading on the topic...
http://www.americanheart.org/presenter.jhtml?identifier=1208
Very Low Cholesterol and Cholesterol Lowering
Year Published:
1994
Product Code:
71-0059
A Statement for Healthcare Professionals From the American Heart Association Task Force on Cholesterol Issues
Author(s):
Michael H. Criqui, MD, MPH
Footnotes
Epidemiological studies have consistently reported a U-shaped relationship between total cholesterol and all-cause mortality. A recent meta-analysis confirms that at high levels of cholesterol the increase in total mortality is due to a sharply increased risk of cardiovascular death, particularly death from coronary heart disease (CHD).
At low levels of cholesterol, where the cardiovascular death rate is low, the increase in total mortality is due to a number of causes, including trauma, cancer, hemorrhagic stroke, and respiratory and infectious diseases. It should also be noted that there is no trend for an increase in total mortality unless the total cholesterol level is less than 160 mg/dL. It is estimated that in the United States less than 10% of middle-aged men and women have serum cholesterol levels below this range. Careful analysis has revealed that a substantial portion of this excess mortality at low levels of cholesterol appears to be caused by poor health at baseline in many persons with lower cholesterol. However, after exclusion of ill persons and early deaths, a residual association between very low cholesterol and mortality persists in some studies. Although this issue clearly requires further evaluation, it is of little current relevance to the prevention of cardiovascular disease in patients or populations.
Completed clinical trials of cholesterol lowering have focused on patients with high cholesterol, and investigators have typically reported a modest reduction in cholesterol, so that even after intervention cholesterol remains relatively high. As expected, a decrease in CHD has been observed in these trials. Meta-analyses of trials of cholesterol lowering in patients with established CHD (secondary prevention), in which subjects were at high short-term risk of death from CHD, have demonstrated significant declines in total mortality as well as CHD death. Clinical trials and regression studies have shown that cholesterol lowering can be beneficial, even in patients with advanced coronary disease.
Unexpectedly, in trials of healthy persons (primary prevention), where the short-term risk of CHD death is lower, the reduction in coronary death has frequently been offset by an increase in various non-CHD causes of death, such as some cancers, hemorrhagic stroke, and trauma (accidents, homicides, and suicides). This finding appears stronger for trials of pharmaceutical intervention than for dietary intervention. The findings of primary prevention studies require cautious consideration. First, the number of deaths in primary prevention studies is typically small, so that no single study provides clear-cut evidence. Second, there are different non-CHD end points in excess in different studies, and there is no dose-response relationship between such end points and cholesterol lowering. Third, despite some suggested mechanisms of action (eg, brain serotonin for trauma), no cause-and-effect mechanism has been established. In contrast, the experimental evidence for a causal association between cholesterol and atherogenesis is robust and convincing. Fourth, coronary and other atherosclerotic morbidity, as well as mortality, is reduced with cholesterol lowering. Comparable data on traumatic or other non-cardiovascular disease morbidity has not been routinely collected. Fifth, few primary prevention studies have been extended for prolonged periods, usually because the study ends after a reduction in cardiac events is observed. Longer studies are needed to examine the effect of long-term cholesterol lowering on total mortality. %Further work is clearly required to determine if there are any true hazards of cholesterol lowering. All of these considerations from both primary and secondary prevention studies are reflected in the new revised National Cholesterol Education Program Adult Treatment Panel guidelines, which focus pharmacologic therapy on those at high risk of CHD, and particularly those with CHD.
"Very Low Cholesterol and Cholesterol Lowering" was approved by the Science Advisory Committee of the American Heart Association on June 16, 1994. Requests for reprints should be sent to the Office of Scientific Affairs, 7272 Greenville Ave, Dallas, TX 75231-4596. © 1994 American Heart Association, Inc. November, 1994