This is part 3 of a multi-part series of short "illuminations" on cholesterol.
Cholesterol is the most well-known, misunderstood, and demonized of all substances found in humans and animals. If the subject of health comes up in medicine or culture, you can be sure the lead topic will be cholesterol.
Let's explore randomized control trials (RCTs) and cholesterol
The most common trials involved statin drugs to lower "cholesterol." You now know it lowers LDL, not the cholesterol molecule.
Here is a typical RCT.
Here are some questions and answers regarding RCTs - in general - with specifics for this particular RCT.
You thought these trials were designed to measure and thus improve health - WRONG.
These "gold standard" trials seldom represent the general population. Further, the test intervention (drug in this case) is not compared to a safe alternative treatment. Finally, most of the outcomes are measured in meaningless "relative statistics."
What was the REAL agenda of this published RCT?
"We conclude that primary care clinicians can be trained to give a cholesterol-lowering intervention to low-income patients that results in modest, short-term reductions in total cholesterol and LDL-C."
They enrolled 42 physicians to oversee the trial. THIS IS UP TO 42 NEW STATIN CUSTOMERS.
Hmmm. You see, this trial was NEVER about health. It WAS about getting vulnerable doctors to prescribe more statin drugs!
Now, let's look at a population study. This study evaluated 12.8 MILLION PEOPLE (not 184) for many different outcomes.
Here is the conclusion in tabular form.
Note the Hazard Ratio is the increase in the risk of dying young. An HR of 1.0 means no impact on mortality. An HR of 2.5 means a 250% increase in dying young.
What do you want your TC to be? Looks like 230 provides you the best chance for a healthy longevity.
What does your doctor want your value to be?
Do you want to have a value of 182?
Hmm, 182 and 270 have the same excess mortality.
A "uniformed doctor optimal level" of 155 has the same impact on mortality as a TC of 300
But what is worse is that if your TC is 100, your doctor is happy. Are you?
I have been trying to convince people not to lower their cholesterol for 20 years artificially.
Is a high or low TC a problem? Clearly.
Does lowering it artificially improve your outcome(s)? No
Are there ways to optimize TC? Absolutely yes, and optimal is around 230.
Index & Upcoming (short) blogs
Number 1: Cholesterol fun (true) facts
Number 2: Is the actual cholesterol molecule important?
Number 3: What is an optimal TC value? Remember, no one knows their actual cholesterol molecule value.
Number 4: Surprising fact about cholesterol (ab) Jupiter study
Number 5: TC simple math - dumb doctors
Number 6: What is LDL really?
Number 7: Statins - do they lower the cholesterol molecule?
Number 8: What did we learn from the new "biologics" to lower "cholesterol"
Number 9: Niacin and other "cholesterol" management treatments
Number 10: What did Natasha Campbell-McBride say about cholesterol/lipids?
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