Cholesterol and Coronary Heart Disease in Older Adults

More than a decade ago, randomized placebo-controlled trials proved that reducing elevated cholesterol levels in middle-aged men reduced their risk of coronary heart disease (CHD). 1,2 Whether a similar relationship exists between elevated cholesterol and increased risk of CHD events (defined as hospitalization or death due to CHD) in elderly individuals has remained unclear. 3,4 Data from a cohort of subjects reported by Krumholz and colleagues 5 and an accompanying Editorial 6 published in JAMA last year concluded that by at least the age of 80 years, elevated cholesterol no longer confers an increased risk for CHD events. See also p 539. In this issue ofThe Journal, Corti and colleagues 7 report an association between elevated cholesterol levels and CHD mortality in elderly women but not in elderly men. To JAMA readers, the methods and results of the study by Corti et al will appear similar to those of Krumholz et