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Stephen B. Hulley, MD, MPH; Thomas B. Newman, MD, MPH
University of California, San Francisco

JAMA. 1995;273(17):1331.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.

—Dr Harris and colleagues note that "busy practitioners" may be "left with the impression that lipoprotein lipids are not risk factors for older people." This would be rational, since this is the empirical observation. We do agree with Harris et al that the paradoxical inverse association between blood cholesterol and mortality, which extends to the upper half of the cholesterol distribution in the elderly,¹ may not be causal. Their hypothesis that this association would go the other way were it not for an interaction with prior health status is intriguing, but only one of the possible explanations, only partly supported in their own studies,² and still to be examined elsewhere.

Two other issues raised by Harris et al deserve comment. One is their use of the LaRosa et al reference, from which they concluded that lipid treatment is not hazardous in the elderly. That was a . . . [Full Text PDF of this Article]

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