It is the general belief today that low blood cholesterol is key in reducing cardiovascular disease. This opinion has now been challenged by data from the Honolulu Heart Program, a large epidemiological study of cardiovascular disease, medical journal The Lancet reports this week. Dr Irwin Schatz and colleagues at the University of Hawaii say that low cholesterol could be associated with higher death-rates among elderly people. They measured fat and cholesterol concentrations in 3572 Japanese American men aged 71-93 years and compared the data with measurements done 20 years earlier. "High concentration of total serum cholesterol is known to be directly related to mortality in individuals aged younger than 65 years. Previous clinical trials have not had large numbers of patients aged older than 70 years, and researchers have been unable to conclusively show this relation in elderly people",they stated. But in the new study a lower cholesterol concentration was associated with increased death-rates. The researchers question whether there is scientific justification for trying to lower cholesterol in elderly people to concentrations below the advised limit of 4·65 mmol/L. Full findings can be found on the Lancet web site.