Elderly people with elevated blood cholesterol levels have a significantly increased risk of heart disease, and many of them would benefit from preventative medicine. Cardiologist Martin Bødtker Mortensen from Aarhus University Hospital is lead author of a study published in The Lancet today.

2020.11.10 | Ib Salomon

Many heart attacks could be prevented, if we begin to take increased levels of cholesterol in the blood among the elderly over the age of seventy more seriously. This is shown by a comprehensive Danish population study published in The Lancet, which has been carried out by Professor Børge Nordestgaard from the Department of Clinical Medicine, University of Copenhagen and Medical Doctor, PhD Martin Bødtker Mortensen, Department of Cardiology, Aarhus University Hospital.

"The normal perception is that elevated cholesterol in the elderly doesn’t play any role, and in fact that cholesterol almost loses its significance with age. But this thinking is based on studies that are decades old and which are based on a time when our life expectancy was shorter. Our study is contemporary and thus completely up-to-date," says Martin Bødtker Mortensen.

In the study, he and Børge Nordestgaard have analysed data on 91,131 residents of Copenhagen between the ages of 20-100 – of these, 10,592 were between the ages of 70-79, and 3,188 were older than 80. On average, the residents were followed oven 7.7 years, and none of them had clinical signs of heart disease when they were included in the study, although doctors had information about the level of LDL cholesterol in their blood. 

Proponent of preventive treatment

High levels of LDL cholesterol can cause the arteries to harden and narrow – due to atherosclerosis – which increases the risk of a number of cardiovascular diseases such as e.g. angina, heart attack and stroke.

During the study, 1,515 participants suffered heart attacks for the first time, while 3,389 experienced diseases in the circulatory system. The level of LDL cholesterol in the blood is measured in mmol/litre, and the analysis shows that the risk of a heart attack increased by 34 per cent each time the cholesterol level increased by 1 mmol/litre. This effect was virtually the same in all age groups, including those between the ages of 70-80 and 80-100.

Elevated levels of cholesterol can be treated with medication, and as a rule, this is done using drugs known as statins. Approximately half a million Danes take statins.

"I’m a proponent of preventive statin treatment for people who have a high risk of developing cardiovascular disease," says Martin Bødtker Mortensen.

One of the findings of the study is that among the age group 80-100 years, treatment with statins could prevent a heart attack or stroke for approx. every 40 people who are treated over five years – by comparison, 769 people aged 20-49 would need to be treated to achieve the same effect. Martin Bødtker Mortensen therefore expects that the study will come to alter attitudes to the role of cholesterol in the development of cardiovascular diseases in elderly people. The results are particularly important for elderly people and medical doctors – who simply must take the new knowledge into account. 

Reinforces another study

Today's edition of The Lancet also includes an international meta-analysis based on data from 21,000 people over the age of 75. The main conclusion is that it makes just as much sense to lower cholesterol levels in elderly people as it does in younger people. In both groups, the number of heart attacks and strokes are reduced.

"We weren’t aware of this study beforehand, but the two studies reinforce one another and really support each other," says Martin Bødtker Mortensen. 

The research results – more information:

The study is a population study. 

The study was carried out by Professor Børge Nordestgaard and Medical Doctor, PhD Martin Bødtker Mortensen, Department of Cardiology, Aarhus University Hospital.

Link to the press release in The Lancet:

Link to the study:

 

Contact

Martin Bødtker Mortensen

Telefonnr.: (+45) 5135 5929