Lowering cholesterol concentrations and mortality: a quantitative review of primary prevention trials
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OBJECTIVE: To determine the effects of lowering cholesterol concentrations on total and cause specific mortality in randomised primary prevention trials. DESIGN: Qualitative (meta-analytic) evaluation of total mortality from coronary heart disease, cancer, and causes not related to illness in six primary prevention trials of cholesterol reduction (mean duration of treatment 4.8 years). PATIENTS: 24,847 Male participants; mean age 47.5 years. MAIN OUTCOME MEASURES: Total and cause specific mortalities. RESULTS: Follow up periods totalled 119,000 person years, during which 1147 deaths occurred. Mortality from coronary heart disease tended to be lower in men receiving interventions to reduce cholesterol concentrations compared with mortality in control subjects (p = 0.06), although total mortality was not affected by treatment. No consistent relation was found between reduction of cholesterol concentrations and mortality from cancer, but there was a significant increase in deaths not related to illness (deaths from accidents, suicide, or violence) in groups receiving treatment to lower cholesterol concentrations relative to controls (p = 0.004). When drug trials were analysed separately the treatment was found to reduce mortality from coronary heart disease significantly (p = 0.04). CONCLUSIONS: The association between reduction of cholesterol concentrations and deaths not related to illness warrants further investigation. Additionally, the failure of cholesterol lowering to affect overall survival justifies a more cautious appraisal of the probable benefits of reducing cholesterol concentrations in the general population.
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Meta-analysis studies have suggested that serum cholesterol is negatively associated with suicidality.
“Supporting the present results, meta-analysis studies have suggested that serum cholesterol is negatively associated with suicidality (Muldoon et al., 1990;Wu et al., 2016).”
From Tryptophan-kynurenine and lipid related metabolites as blood biomarkers for first-episode drug-naïve patients with major depressive disorder: An exploratory pilot case-control study (2018) · cites this paper as Muldoon et al., 1990
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- Authors
- Muldoon, M. F., Manuck, S. B., & Matthews, K. A.
- Affiliations
- University of Pittsburgh (US)
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1990-08-11
- Volume
- 301
- Issue
- 6747
- Pages
- 309-314
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- OpenAlex
- W1984058728
- Cited by
- 960
- References
- 47
- Citations by year
- 2026: 3 · 2025: 5 · 2024: 5 · 2023: 4 · 2022: 10 · 2021: 15 · 2020: 11 · 2019: 9 · 2018: 16 · 2017: 14 · 2016: 9 · 2015: 12 · 2014: 14 · 2013: 14 · 2012: 14
- FWCI
- 20.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Heart, Lung, and Blood Institute (#HL07560, HL 40962, P01HL040962)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
- Health Sciences › Medicine › Surgery › Cholesterol and Lipid Metabolism
- Keywords
- cholesterol lowering, hypercholesterolemia, mortality, coronary heart disease mortality, cancer mortality, primary prevention, statins, drug trials
- MeSH terms
- Aged, Anticholesteremic Agents, Cause of Death, Cholesterol, Coronary Disease, Diet, Humans, Male, Middle Aged, Mortality, Neoplasms, Primary Prevention, Meta-Analysis as Topic
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