[medstrom]

> High LDL is correlated with the development of heart disease, but it does not cause heart disease.

You realize this sentence is an oxymoron?

Unless you meant to say "it does not cause the development of heart disease". I agree correlation is not causation.

[rowanG077]

I don't think it is. Something can either be correlated and causal or correlated and non-causal. It makes sense to talk about which.

[smt88]

> You realize this sentence is an oxymoron?

No it isn't.

Think of heart disease as slow, long-term damage to the cardiovascular system, and cholesterol is what the body uses as a bandaid.

If you have a lot of LDL cholesterol available, your body will use a lot of it, and you'll have stiffer arteries. If you don't have much available, it takes longer for the bandaids to build up.

This is one of the reasons statins reduce the number of heart attacks, but don't always seem to reduce all-cause mortality.

[KempyKolibri]

The band aid analogy doesn’t make sense when we consider the MR studies showing the lower your genetically determined LDL-c, the lower your risk of CVD. If everything was randomised except the number of band aids, why would having fewer band aids result in lower CVD risk?

> This is one of the reasons statins reduce the number of heart attacks, but don't always seem to reduce all-cause mortality.

That’s one potential explanation, but I don’t think it’s the most likely one. We tend to see non significant ACM in smaller, less powered trials, or those with lower LDL-c lowering. ACM is simply a less sensitive endpoint - if you have a treatment that reduces CVD incidence, then the “CVD incidence” endpoint will give you significant results with fewer CVD event differences between study arms compared to ACM since your power to detect differences is diluted by other fatal events that aren’t affected by statins (cancer, motor accidents etc).

[elromulous]

You realize correlation does not imply causation?

Edit: this was written before OP edited their comment