Setting aside the fact that the majority of people prescribed them tolerate statins with minimal side effects, there are other therapies besides statins available for treating dyslipidemia such as PCSK9 and ANGPTL3 inhibitors, to say nothing of non-pharmaceutical lifestyle interventions one can make.

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breadwinner 5 days ago | parent [-]

Therapy for what, exactly? Cholesterol? A substance the human body naturally produces because it needs it (cholesterol is a key structural component of every cell membrane in the body)? A substance that has not been conclusively proved to be harmful?

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derektank 5 days ago | parent [-]

Excess LDL and VLDL cholesterol have absolutely been shown to be harmful. We know from studies of familial hypercholesterolemia, a disorder caused by single mutation in the LDL receptor gene, that too much LDL cholesterol directly leads to artherosclerosis and early death from heart disease.

There's a pretty direct analogy to type 2 diabetes and metabolic disease generally. The human body naturally produces blood glucose and we would quite quickly die if our blood glucose levels went to zero. That doesn't mean that hyperglycemia is healthy and in fact, we know it directly causes all kinds of bad health outcomes. We absolutely need some LDL cholesterol, and in our evolutionary history when we faced famine there was probably some selection for people whose livers didn't aggressively metabolize LDL particles from the blood (an energetically costly process), but that doesn't mean that high LDL cholesterol today is safe if you're hoping to live a long life.

	▲	breadwinner 5 days ago \| parent [-]
		If LDL cholesterol is the villain it is made out to be then lowering it — by whatever means — should produce a proportionate reduction in heart disease. It does not (see ENHANCE trial [1]). And yet lowering cholesterol using statins has proved beneficial for people who have already suffered heart attacks. How do you explain this? One explanation is that statins work for these people not because they lower cholesterol but because they reduce inflammation and stabilize plaque. The science behind this is not fully understood. Big Pharma has no incentive to research this because they are raking in money, and any further research could only slow down the gravy train at best. [1] https://www.nejm.org/doi/full/10.1056/NEJMoa0800742