When I was a kid, I figured out that drinking really hot chocolate right before my mom took my temperature could fake a fever.
The thermometer said "sick." But I was perfectly healthy.
In medicine, we call this a surrogate marker. And a new massive meta-analysis suggests we might be falling for the "hot chocolate" trick when it comes to LDL Cholesterol and Statins.
The New Science:
A review published in the European Heart Journal analyzed 20 Randomized Controlled Trials (RCTs) including 194,686 participants.
🤔 The researchers asked a simple question: Does the magnitude of LDL reduction predict the reduction in cardiovascular risk?
🫨 The answer: Not really.
Here is the data breakdown:
The Statistic: They looked at r2 (which tells you how well one number predicts another).
The Result: The r2 for LDL-C on major adverse cardiovascular events ranged from 0 to 0.1.
The Translation: Reducing LDL-C more didn't necessarily mean reducing heart attacks more.
But wait—This is where the nuance lives (and why headlines often fail us). In these trials, statins did reduce cardiovascular events. But if the LDL drop wasn't the predictor, what was?
The likely answer is a complex set of effects on the background of metabolically unwell patients.
Statins don't just lower cholesterol. They are also anti-inflammatory and improve vasodilation (blood flow). In a metabolically unhealthy population (which is most of us), these effects might be the real heroes, while LDL gets all the credit.
We have built a massive industry on a surrogate that, in isolation, might just be hot chocolate.
Read more by clicking the link above. And remember... sharing is caring :).
Nick Norwitz
The LDL Illusion... We might be measuring the wrong marker...
Link: staycuriousmetabolism.substack.com/p/the-ldl-illus…
When I was a kid, I figured out that drinking really hot chocolate right before my mom took my temperature could fake a fever.
The thermometer said "sick." But I was perfectly healthy.
In medicine, we call this a surrogate marker. And a new massive meta-analysis suggests we might be falling for the "hot chocolate" trick when it comes to LDL Cholesterol and Statins.
The New Science:
A review published in the European Heart Journal analyzed 20 Randomized Controlled Trials (RCTs) including 194,686 participants.
🤔 The researchers asked a simple question: Does the magnitude of LDL reduction predict the reduction in cardiovascular risk?
🫨 The answer: Not really.
Here is the data breakdown:
The Statistic: They looked at r2 (which tells you how well one number predicts another).
The Result: The r2 for LDL-C on major adverse cardiovascular events ranged from 0 to 0.1.
The Translation: Reducing LDL-C more didn't necessarily mean reducing heart attacks more.
But wait—This is where the nuance lives (and why headlines often fail us).
In these trials, statins did reduce cardiovascular events. But if the LDL drop wasn't the predictor, what was?
The likely answer is a complex set of effects on the background of metabolically unwell patients.
Statins don't just lower cholesterol. They are also anti-inflammatory and improve vasodilation (blood flow). In a metabolically unhealthy population (which is most of us), these effects might be the real heroes, while LDL gets all the credit.
We have built a massive industry on a surrogate that, in isolation, might just be hot chocolate.
Read more by clicking the link above. And remember... sharing is caring :).
#metabolichealth #LDL #cholesterol #medicalresearch #newstudy #statins #cardiology
5 days ago | [YT] | 443