Cholesterol: Up to what age 'the lower the better'?

In the elderly, and particular in the very elderly, the prognostic role of hypercholesterolemia is uncertain and data from scientific literature there are somewhat conflicting. In some studies, the relation between high levels of cholesterol and cardiovascular events, strongly demonstrated for younger subjects, has been confirmed also in the elderly, whereas in other studies a relation between low cholesterol levels and higher mortality risk has been described, particularly in the very elderly. Furthermore, uncertainties regarding hypercholesterolemia treatment have been raised both in secondary and particularly in primary prevention settings, because elderly subjects have been excluded from most randomized clinical trials. In this article are discussed the prognostic role of hypercholesterolemia and the impact of its reduction are discussed.