Abstract
To the Editor. —The Whitehall Study, a large cohort study of middle-aged male civil servants in London, England, revealed intriguing associations between cholesterol levels and mortality from various causes. 1 The inverse association between cholesterol levels and noncardiovascular mortality was attributed to sociodemographic factors; however, this may be a premature assumption. Mortality from lung cancer and nonneoplastic pulmonary disease (bronchitis and pneumonia) was inversely related to the cholesterol concentration at all levels in this study. Likewise, an inverse relationship between lung cancer and cholesterol levels was seen in men in another study of a large European population. 2 A small study of elderly women nursing home residents revealed a J-shaped relationship between overall mortality and cholesterol levels over several years of observation. 3 Most of the mortality was associated with lower cholesterol levels, and it was in large part due to bronchopneumonia and septicemia. Primary prevention trials of cholesterol lowering
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