Blood LDL levels and mortality: Is lower always better?

2 Comments

In this episode of The Health Edge Mark and John review some papers that challenge the well accepted clinical meme that lowering LDL should be the focal point of reducing CV risk and all-cause mortality risk. Papers referenced: https://www.nature.com/articles/s4159… https://bmjopen.bmj.com/content/6/6/e… https://www.ncbi.nlm.nih.gov/pmc/arti…

LDL-and-mortality powerpoint slidesDownload
Lack-of-an-association-or-an-inverse-association-between-low-density-lipoprotein-cholesterol-and-mortality-in-the-elderly-a-systematic-reviewDownload

2 thoughts on “Blood LDL levels and mortality: Is lower always better?”

  1. Caroline

    Thank you for this podcast. There’s now a lot of talk about high Lp(a) levels being an independent marker for higher risk of aortic valve stenosis, atherosclerosis and thrombosis I believe. Although not much can be done to lower Lp(a) at the moment, should someone with a high Lp(a) e.g. above 150 nmol/L (the relatively new but better measure of Lp(a)) consider taking a statin to keep other markers like Apo B low?

    Reply
    • Mark Pettus

      Hi Caroline,
      That is a great question! Lp(a) is a very important and under recognized biomarker for CV risk. As you suggest, there is no specific intervention that can lower it. I am unaware of any lipid-lowering strategy that has been studied specifically in this cohort as a basis for target LDL recommendations. That said, I would have a lower threshold to suggest a statin in such an individual in the absence of high cardiometabolic risk. I would also leverage a positive test to underscore the importance of global risk reduction through lifestyle considerations. Thanks so much for listening to the Health Edge!

      Reply

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