Pass. And how is that credentialism? He asked if I was a doctor and I answered the question. I'm tired of arguing this topic. If you feel like you know better than me then by all means don't do anything to lower your cholesterol levels. No skin off my back.
The consensus is that elevated LDL equates to elevated risk of atherosclerosis. It's really not up for much debate amongst most physicians.
I'm a DO, trained in internal medicine and geriatrics and have been in practice for 10 years.
I've run one for a few years now. Occasionally my Electrum server goes wonky and needs a reset. Otherwise it's pretty reliable.
You can find studies that support whatever theory you want to believe. The vast majority of scientific evidence says LDL is one of the key components to atherosclerosis.
Ok, so as someone who practices medicine, take my word for it: Worry more about your LDL, better yet, your apoB level, than your HDL. HDL numbers are meaningless as the actual functionality of the HDL particle is not measurable.
I don't mean to be rude, but you have no idea what you are talking about.
If there was not a cholesterol atheroma in the artery wall that ruptured then there would be no subsequent thrombus formation and therefore no myocardial infarction. You need a cholesterol plaque rupture to set off the clotting cascade that leads to a heart attack. That is not debatable.
And you're correct, inflammation is another "lever" that we can attempt to modify and lower risk of heart disease. But it's more difficult than lowering cholesterol.
I'm not suggesting that we eliminate cholesterol entirely. Obviously it's a necessary component of a great many things. What I am suggesting is that the circulating level of cholesterol needed to do those things is much lower than what most of us are walking around with. Take kids for example: most kids have LDLs in the 30s and they clearly do just fine. Lowering cholesterol lowers the risk of development of arterial disease. Period. Is high cholesterol the sole reason for heart disease, no. It is necessary but not sufficient. But it is an easily modifiable factor whereas inflammation is not in many cases.