TY - JOUR T1 - Is interleukin-6 the link between low LDL cholesterol and increased non-cardiovascular mortality in the elderly? JF - Open Heart JO - Open Heart DO - 10.1136/openhrt-2018-000789 VL - 5 IS - 1 SP - e000789 AU - James J DiNicolantonio AU - Mark F McCarty Y1 - 2018/04/01 UR - http://openheart.bmj.com/content/5/1/e000789.abstract N2 - A number of prospective studies, dating back to the 1980s, have found that lower levels of plasma cholesterol correlate with increased risk for cancer; in some of these studies, it was noted that this correlation was strongest for cancers diagnosed within a year of cholesterol measurement, suggesting the possibility of reverse causality.1–11 More recently, Ravnskov and colleagues conducted a systematic review of cohort studies enrolling subjects over 60 in which the association of low-density lipoprotein cholesterol (LDL-C) with all-cause mortality and/or cardiovascular mortality had been evaluated.12 In 14 of the 30 total cohorts involved, LDL-C was inversely and significantly associated with all-cause mortality; in the remaining 16, no association was found. With respect to cardiovascular mortality, which was determined in nine cohorts, the association of LDL-C was inverse and significant in two and null in seven. The failure to find a positive a correlation between LDL-C and cardiovascular mortality is consistent with the previous research reporting that the positive correlation of LDL cholesterol and cardiovascular mortality that is clearly seen among younger subjects is substantially blunted among the elderly.These findings have led some to suspect that low LDL-C plays a pathogenic role in cancer and perhaps other non-cardiovascular pathologies and that LDL-C is of little pathogenic significance for the progression atherogenic disease in the elderly.12 This interpretation evidently casts doubt on the wisdom of medicating the elderly for LDL-C control.The thesis that low LDL-C may play a causative role in higher non-cardiovascular mortality has been challenged cogently by several lines of evidence. Law and colleagues13 compared cohort studies of groups of employees, most of whom could be presumed to be healthy at baseline, with community cohorts, which included many individuals with prevalent disease. They found that low total cholesterol in the employee cohorts was not … ER -