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CONCLUSIONS What we are seeing is that over the years there has been a steady flow of problems and “how come” questions that eat away at the credibility of the cholesterol hypothesis. The resolution of all of these problems is simple— most features of the hypothesis are false. Rephrasing the hypothesis such that it only states that atherosclerosis and CHD are associated with cholesterol levels removes what is considered an incorrect attempt to connect observational studies with causality, but the evidence presented above also argues equally well against there being, for the most part, any such association.

In a second Review related to the Cholesterol Hypothesis, we will look in much more detail at the association between TC and LDL levels and overall and CHD mortality. A third Review will deal with cholesterol lowering studies, the current popular notion that the lower the better for LDL, the so-called Polypill proposal, and the question of cholesterol and stroke risk and stroke mortality.

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International Health News

November 2007

Page 16

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