Monday March 16 6:19 PM EST Low Cholesterol Linked To Violence By E.J. Mundell NEW YORK (Reuters) -- Lowering cholesterol could trigger changes in brain chemistry that encourage violent behavior, according to a report. But leading cardiovascular experts believe that evidence of such a link remains inconclusive, and they say the medical benefits of cholesterol-lowering medications still outweigh any theoretical risks. Dr. Beatrice Golomb, of the Department of Medicine at the University of California San Diego, says her review of dozens of studies supports a connection between low or lowered cholesterol levels and adverse violent outcomes in certain populations. Golomb's analysis appears in the current issue of the Annals of Internal Medicine. She explains that cholesterol levels directly affect the activity of serotonin, a brain neurotransmitter implicated in the control of violent behaviors. She believes it is possible that lowered cholesterol levels may lead to lowered brain serotonin activity; this may, in turn, lead to increased violence. Golomb says many studies seem to support the existence of a cholesterol-violence relationship. One 1992 analysis, published in the journal Circulation, looked at 18 different study groups and found 50% more violent deaths in men with cholesterol levels less than 160 milligrams per deciliter (mg/dL) than in the group with the highest cholesterol levels, Golomb said. She says a 1996 French study of nearly 6,400 men, published in the British Medical Journal, also found that a low average cholesterol was linked to subsequent death by suicide. Studies in monkeys may support such a relationship. Two separate studies conducted in the early 1990s revealed that monkeys assigned to diets low in fat or cholesterol showed significantly lower brain serotonin activity. Finally, the California researcher says three separate neurological studies (in 1989, 1990, and 1994) agreed that in humans, low brain serotonin is linked to increased impulsive violence, including homicide, arson, and suicide. In her opinion, the evidence favor(s) a conservative approach to cholesterol management among patients who are otherwise at relatively low risk for heart disease. But the American Heart Association (AHA) does not agree. "In no way should physicians abandon cholesterol-lowering strategies for patients with high cholesterol levels", said Dr. Sidney Smith, a past AHA president. "There is far more good than harm accomplished through cholesterol lowering". Cardiovascular expert Dr. James Cleeman, coordinator of the National Cholesterol Education Program at the National Heart, Lung, and Blood Institute in Bethesda, Maryland, agrees. " Clinical trials show us the benefit (of cholesterol-lowering therapies) and no harm", Cleeman told Reuters. He points to a major review (published last year in The Journal of the American Medical Association) of clinical trials involving over 29,000 patients taking cholesterol-lowering medications for periods averaging over three years. That study's authors concluded that these therapies conferred a large and significant decrease in cardiovascular mortality, while having no effect on patient death rates from other causes. Source: Annals of Internal Medicine (1998;128(6):478-487); The Journal of the American Medical Association (1997;278:313-321) S. Zarina firstname.lastname@example.org
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