What do you think is the highest quality paper based on an RCT comparing statins vs no-statins for cardiovascular health?
The poem in appreciation of cholesterol got quite a bit of attention.
I'd like to direct your attention to an article I wrote in August, 2022, entitled
"Cholesterol Good - Statins Bad."
This information is relevant to everyone from the recently retired, to recent graduates embarking on their new career.
https://open.substack.com/pub/remnantmd/p/cholesterol-good-statins-bad?utm_source=share&utm_medium=
Discussion
I don't have an answer for you because I don't think about physiology and medicine this way.
RCTs are informative, but not the most important thing when appraising research.
First we must understand physiology and life, then we can judge experiments on several factors, chief amongst them is biological plausibility.
Don't care how good an RCT looks statistically.
Ok - but biology is complex and evaluating what is plausible can be subjective. A study can cut throw the noise if done properly. I agree a hypothetical mechanisms of action must also be plausible, but that is something that further studies canhelp refine.
For example, what if statins do lower CVD risk in a RCT, but due to some different mechanism than their purported LDL lowering? maybe they act as mild blood thinners.
How would you recommend a properly skeptical patient with a family history of CVD evaluate the various preventative measures they could take?
This is a complicated question that will depend on tailored discussion and assessment of personal risk factors.
There are no blanket solutions, but some guidance:
Mind what you:
-eat
-drink
-do
-value
All of these are linked.
I have written on inflammation extensively, and will continue to do so