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Colesterolo, mortalità e qualità di vita

Colesterolo alto uguale rischio cardiovascolare alto. Questo sempre, anche se qualche dubbio c'è per l'età avanzata quando il binomio colesterolo-rischio è meno evidente o secondo alcuni addirittura invertito. Nell'anziano, dicono alcuni, avere un basso livello di colesterolo si associa anche ad un peggioramento delle funzioni intellettive e, in generale, della qualità di vita. Lo studio della Hyttinen è un prolungamento di uno precedente che si era fermato al 2002 dimostrando che un basso livello di colesterolo, inferiore cioè a 193 mg/dL si associava ad effetti favorevoli sullo stato fisico e mentale. In questo studio si dimostra che un basso livello di colesterolo nell'età media della vita è predittivo di una più lunga sopravvivenza e di una migliore qualità di vita nella vecchiaia.

Effect of cholesterol on mortality and quality of life up to a 46-year follow-up

Hyttinen L, Strandberg TE, Strandberg AY, Salomaa VV, Pitkälä KH, Tilvis RS, Miettinen TA.

Am J Cardiol 2011;108:677-81

The effect of cholesterol level on the health of older people is a matter of debate, probably because of the bidirectional association. We investigated this paradox in a long-term study. The baseline assessments of the Helsinki Businessmen Study (a cohort of mainly business executives, born 1919 to 1934) included the total cholesterol value and other cardiovascular risk factors from 1964 to 1973. These men were followed up for ≤46 years (through January 2010). During the follow-up period, the cholesterol value was assessed by self-report in 2000 (n = 1,292). Mortality was ascertained from the national registers, symptoms, and health-related quality of life with RAND-36 from questionnaires in 2000. A total of 3,277 healthy men without chronic diseases at baseline were included in the analyses. The median total cholesterol concentration at baseline was 6.5 mmol/L (251 mg/dl) (interquartile range 5.8 to 7.3 mmol/L, 224 to 282 mg/dl) and, in 2000, was 5.2 mmol/L (201 mg/dl) (interquartile range 4.6 to 5.9 mmol/L, 178 to 228 mg/dl). During the follow-up period, 1,773 men (54%) died. A strong and graded relation was found between the cholesterol level and total mortality, with the men with a cholesterol level =4 mmol/L (154 mg/dl) having the lowest mortality. In all, the men with the lowest cholesterol gained the most life years. However, no association was found with the cholesterol level in 2000 (when 16% were using statins) and subsequent mortality. The lowest (=4 mmol/L) cholesterol value in midlife also predicted a higher score in the physical functioning scale of RAND-36 in old age. In conclusion, a low total cholesterol value in midlife predicts both better survival and better physical functioning in old age.

Am J Cardiol 2011;108:677-81