Optimising Cholesterol Management Strategies Based on Cholesterol–Mortality Associations

Clinical guidelines emphasize that lowering low-density lipoprotein cholesterol (LDL-C) levels is fundamental to the primary prevention of atherosclerotic cardiovascular disease (CVD) [1]. However, emerging evidence suggests that low LDL-C levels are associated with an elevated risk of incident cancer [2]. A previous study indicated a U-shaped association between LDL-C levels and all-cause mortality [3]. Inconsistent findings from studies may have been confounded by both lipid-lowering medication use and comorbidities. To address these uncertainties, comprehensive analyses are required to clarify the relation between mortality and all cholesterol indicators, including total cholesterol (TC), LDL-C, high-density lipoprotein cholesterol (HDL-C), and non-HDL-C levels. In a recent study published in Engineering, Jiang et al. [4] provided critical insights by analyzing data from three prospective, longitudinal cohorts comprising 163 115 Chinese adults and 317 305 UK adults, with a median follow-up of nearly ten years. Their study examined the associations between untreated baseline cholesterol levels, longitudinal changes, and all-cause and cause-specific mortality. The research yielded several key findings with potential implications for public health policies and clinical practice.