Cardiovascular Drugs and Therapy

, Volume 7, Issue 5, pp 789–793

Does low cholesterol cause death?

  • Jacques E. Rossouw
  • Antonio M. GottoJr.
The Cholesterol Controversy Editorial

DOI: 10.1007/BF00878932

Cite this article as:
Rossouw, J.E. & Gotto, A.M. Cardiovasc Drug Ther (1993) 7: 789. doi:10.1007/BF00878932


Data linking low cholesterol with excess mortality have been gathered from both observational and clinical trials. The data are probably unrelated, as the levels of total cholesterol associated with excess mortality in observational studies are well below 160 mg/dl (4.1 mmol/l), whereas the levels achieved in clinical trials average around 230 mg/dl (5.9 mmol/l). Likely explanations of the association are that low cholesterol is a consequence of disease or is a confounder associated with other variables. The authors assess the relevance of the data to public health policy and medical practice. They conclude that evidence suggesting low cholesterol is a cause of excess mortality currently lacks breadth and rigor, and find no basis for changing cholesterol-management guidelines.

Key Words

Cholesterol mortality meta-analysis drug therapy confounding factors epidemiology 

Copyright information

© Kluwer Academic Publishers 1993

Authors and Affiliations

  • Jacques E. Rossouw
    • 1
  • Antonio M. GottoJr.
    • 2
  1. 1.National Heart, Lung, and Blood InstituteNational Institutes of HealthBethesda
  2. 2.Department of MedicineBaylor College of Medicine and The Methodist HospitalHouston
  3. 3.Department of Medicine, SM-1423Baylor College of MedicineHouston