Editorials

Lowered serum cholesterol and low mood

BMJ 1996; 313 doi: https://doi.org/10.1136/bmj.313.7058.637 (Published 14 September 1996) Cite this as: BMJ 1996;313:637
  1. S Lori Brown, Senior research scientist officer
  1. Center for Devices and Radiological Health, 1350 Piccard Drive, HFZ-541, Rockville, MD 20850, USA

    The link remains unproved

    Reducing serum cholesterol has long been seen as a desirable goal, particularly for those with high concentrations of serum cholesterol and a history of atherosclerotic disease. Recently, the value of lowering (or low) serum cholesterol concentrations has been called into question. A meta-analysis of six primary prevention trials suggested that coronary heart disease mortality tended to be lower in men who were treated with cholesterol lowering regimens, but that the overall mortality did not decline because of a significant increase in deaths from external causes (accidents, suicide, or homicide).1 This increased risk for violent death was apparent whether cholesterol lowering was by drug or dietary intervention. Subsequent studies on this phenomenon have not resolved the issue but have caused further debate on the design and meaning of each study as well as the central issue of whether low serum cholesterol is a desirable goal.

    Mechanisms

    Because death from external causes has a behavioural component, the search for an explanation of the association between low cholesterol concentrations and these deaths has focused on the possibility that lowering or low cholesterol concentrations influence mood …

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