Study: High Cholesterol May Benefit Heart Failure Patients

A new study suggests people with heart failure are better off with high cholesterol, and that low cholesterol may increase their risk of dying.

In the study of 417 patients with chronic heart failure, researchers from England and Germany found that increasing cholesterol was associated with increased survival. The results are published in Wednesday's issue of the Journal of the American College of Cardiology.

The researchers found that the chance of survival increased 25 percent for each millimoles per liter -- equivilent to about 39 milligrams per deciliter -- increment in total cholesterol. For example, patients with a total cholesterol level of 232 mg/dl had a 25 percent higher survival rate than heart failure patients with a total cholesterol level of 193 mg/dl, on average.

Although the results of this study go against the usual "lower cholesterol is better" advice, they agree with the findings of several earlier studies that linked lower cholesterol with poorer prognosis in heart failure patients.

"We have been developing for some time the notion that heart failure is a metabolically stressful illness. In this light, a high cholesterol level can be seen as beneficial as it indicates a greater reserve to deal with metabolic stress," said Dr. Andrew Clark, a study researcher from Castle Hill Hospital and the University of Hull in Hull, England.

"At first this was thought to be, 'This couldn't be right, it has to be counterintuitive. There's got to be something wrong.' But it's been seen over and over again," said Dr. Michael Lauer, of the Cleveland Clinic.

Lauer said he has seen it in his heart failure patients over the years, so he said he's not surprised at the study. He said heart patients shouldn't make anything of it, and that the information should really only help guide the doctor.

"It may be useful to help identify people who may be at higher risk and people who may be a lower risk and that's perfectly OK," said Lauer.

Clark emphasized that there isn't enough evidence to establish that low cholesterol is the cause of increased risk of death. He said a cholesterol level may be a marker of some other factor, and he urged caution in interpreting the study's findings.

And the study does not give heart failure patients the green light to hit the "golden arches."

"No, no, people with heart failure should not start eating cheeseburgers," Lauer said.

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