- 脂質栄養学 (ISSN:13434594)
- vol.23, no.1, pp.79-88, 2014 (Released:2014-05-01)
Previous cholesterol guidelines for the prevention of CHD were based on "the lower, the better" hypothesis, setting upper LDL-C limits and treating patients to maintain their cholesterol levels below the targets, as seen in the ATP 3 issued from the National Heart, Lung, and Blood Institute (NHLBI) and that issued from the Japan Atherosclerosis Society (JAS GL). We published a new cholesterol guideline for longevity (JSLN GL 2010), in which evidence was presented that a high cholesterol level is not a causative factor of CHD but is a predictor of longevity among general populations over 40-50 years of age. Recently, a long-waited revision of the ATP 3 was published from the NHLBI in conjunction with the American College of Cardiology and the American Heart Association (ACC/AHA GL 2013), in which "setting targets to treating patients with statins" and "the lower, the better hypothesis" were abandoned because of the lack of clinical evidence. However, both the JAS GL 2012 and ACC/AHA GL 2013 brought about estimated 10-year CHD (ASCVD) risk mainly based on NIPPON DATA 80 and NHLBI-supported studies, respectively, resulting in increased estimated number of subjects to be treated with statins. Here, we point out that the estimated 10-year risks are not usable because they are not evidence-based. Moreover, we summarize biochemical mechanisms underlying the statin actions to increase heart failure, diabetes mellitus and other diseases after long-term treatments. The cases for which statins, all mitochondrion-toxic, are applicable should be extremely restricted.