Scientific evidence certainly shows a positive association between serum cholesterol and the risk of dying from cardiovascular disease (
2,
3,
4).
It is also evident that LDL particles play a causal role in developing of atherosclerotic cardiovascular disease (ASCVD) (
5).
Furthermore, a consensus panel of respected scientists recently concluded that any mechanism of lowering plasma LDL particle concentration should reduce the risk of ASCVD events proportional to the absolute reduction in LDL cholesterol (
6).
But the same panel also concluded that this is true “
provided that the achieved reduction in LDL cholesterol is concordant with the reduction in LDL particle number and that there are no competing deleterious off-target effects.”
I want to emphasize these two key issues:
- provided that the achieved reduction in LDL cholesterol is concordant with the reduction in LDL particle number
- and that there are no competing deleterious off-target effects