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Cholesterol limbo: how low can you go?

Last summer, the journal Circulation published an analysis of 19 international studies on low cholesterol, involving some 300,000 men and women. In 1971, a Japanese study showed a relationship between cholesterol levels less than 160 and high rates of cerebral hemorrhage.

Subsequent studies have shown similar results. The Circulation report showed that very low cholesterol levels were associated with four times the risk of dying from a number of conditions other than heart disease. These included: suicide, alcoholism, chronic obstructive lung disease, cerebral hemorrhage, and some cancers.

About the same time, an article in the Archives of Internal Medicine showed that, in a 12-year study of 350,000 healthy men, 6 percent of them who had very low cholesterol levels were twice as likely to die of cerebral hemorrhage. Three times as many were likely to die of liver cancer; five times as many were likely to die from alcoholism; and twice as many were likely to commit suicide.

The consensus is that it was not the low cholesterol itself that led to these findings, but some yet-to-be-identified factors in these diseases that produced the low cholesterol-- poor nutrition, for example. It is also thought that a minimal cholesterol level is essential to normal cellular function in the body that guards against these diseases.

Whatever the case, few would suggest that this is sufficient reason to declare a moratorium on cholesterol screening and treatment of those with high cholesterol levels. "There is a definitive and strong relationship between high cholesterol and heart disease, and it is still desirable to get your cholesterol in the 200 range," says Johns Hopkins cardiologist Dr. James Weiss. He points out that cholesterol levels below 160 are rarely reached with diet or mediation. Therefore, there is little cause to worry that all the good things one has been doing to keep cholesterol levels under control-exercise, diet, etc.--are likely to lead to these other diseases.
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Publication:Medical Update
Date:Feb 1, 1993
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