Cholesterol - can it be too low?

sallylondon said:

My last HDL was 0.97mmol/L, my LDL 0.88 mmol/L, my triglycerides 1.88mmol/L. Serum cholesterol 2.7mmol/L

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Kendrick said:

To date, no large trial of women statin users who already have cardiovascular disease has been shown to increase life expectancy by one day. More importantly, the use of statins in women at lower risk has not increased life expectancy nor prevented heart attacks and stroke.

It raises the question whether women should be prescribed statins at all. I believe that the answer is no. Statins fail to provide any overall health benefit in women. The more recent heart protection study was hailed as a success for men and women, but despite the hype there was no effect on mortality in women.

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Eddie Vos responding to Cochrane review said:

What the editorial does not mention are differences with women, and where there is no doubt that there is no mortality benefit, as per at least three meta-analyses. Two of them found a relative risk [RR] of 1.00 versus placebo, including one including secondary prevention, and one concluding: "Our study showed that statin therapy reduced the risk of CHD events in men without prior cardiovascular disease, but not in women. Statins did not reduce the risk of total mortality both in men and women"

Suggesting that women at any cardiac risk reduce all-cause deaths by taking statins is, at best, a statistics-derived artifact with unclear but massive numbers needed to treat, and at worst, a delusion or a deception. The reality: even in extreme-risk women in the much-cited 4S study,[5] there were three more deaths in women on statin than on placebo.

I suggest that in a next analysis women and men should be treated separately, and this regarding all single individual endpoints. The universally abused reporting item of "major cardiovascular events" should be banished, since it virtually always includes non-fatal angina-related effects, including medical decisions such as non-life-saving planned revascularisations. For example, in JUPITER, revascularisations were by far the major "event" benefit and, in women, the only significant one after 6500 on-statin years … and cardiovascular mortality was not reduced in either men or women.[6]

When any-cause deaths are not reduced by drugs prescribed for a fatal disease, we are treating either lesser value effects, numbers in lab reports or other surrogate endpoints but not real causes.[7] That is the case for statins in women, a mathematical certainty.

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