Hypercholesterolemia and coronary heart disease in the elderly: a meta-analysis

Purpose To determine whether hypercholesterolemia is an independent risk factor for CHD morbidity and mortality in persons aged 65 years and above, and to quantify the magnitude of the association, if any, using data from follow-up studies. Methods A MEDLINE search of all published studies that evaluated the association between high cholesterol levels and CHD in persons aged 65 years and above, and the relevant articles referenced in these studies, were used as sources of selected articles. Results In men aged 65 years and above who were followed from middle age, the RR for CHD incidence associated with 1.0 mmol/L increase in total cholesterol was 1.28 (CI: 1.17–1.39). The RR for CHD mortality associated with a similar increase in total cholesterol was 1.22 (CI: 1.18–1.27). In elderly men followed from age 65 and above, the RR was 1.24 (CI: 1.1–1.37) for CHD incidence, and 1.22(CI: 1.15–1.28) for CHD mortality. In elderly women followed after age 65, the association between total cholesterol and CHD mortality was not significant. For men aged 80 years and above at entry, total cholesterol showed an inverse relationship with all-cause mortality. Conclusion Serum total cholesterol shows a positive association with CHD morbidity and mortality in men aged 65 years and above. This may, however, not hold true for persons aged 80 years and above.