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Cholesterol Reduction and Death by Suicide, Accidents, and Violence
As momentum grows for lowering cholesterol in more people, the need to determine the safety of this practice becomes more compelling. Data from the pre-statin era suggested that cholesterol reduction was associated with a rise in non-illness mortality (death by suicide, accidents, and violence), leading investigators to conduct this updated meta-analysis of randomized trials of cholesterol reduction.
A total of 19 primary and secondary prevention trials were analyzed. Altogether, 215 people died of non-illness causes. The odds ratio for non-illness mortality among intervention patients in all trials, compared with controls, was 1.18. In subanalyses, the ORs were as follows: primary prevention trials, 1.28; secondary prevention trials, 1.00; statin trials, 0.84; diet and non-statin drug trials, 1.32. None of these ORs were significantly different from 1, although the OR in diet and non-statin drug trials approached significance (P=0.06). Furthermore, the ORs for non-illness mortality in the treatment groups were not related to mean cholesterol reduction.
Comment: The authors note that the mortality rate from non-illness causes among participants in 2 of the larger and more recent studies was about one third of that among the general population, indicating that these results might not be broadly generalizable. Nonetheless, the findings suggest that lowering cholesterol with statins does not increase non-illness mortality. The effects of other drugs and diet are less clear, but are likely only minimal.
— KI Marton
Published in Journal Watch General Medicine February 6, 2001
Citation(s):
Muldoon MF et al. Cholesterol reduction and non-illness mortality: Meta-analysis of randomised clinical trials. BMJ 2001 Jan 6 322 11-15.
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