While a specific "dietary portfolio" lowered LDL by 29% in a controlled trial, its effect in real-world conditions dropped to about 13-14%.

Contrary to popular fears, a massive 2023 analysis of over 7 million participants found that statin use was associated with a 14% lower risk of dementia.

Even Akira Endo, the man who discovered statins, was initially reluctant to take one and tried to manage his cholesterol with exercise alone before eventually starting the medication.

In a blinded trial, 90% of the symptom burden patients experienced on statins was also triggered by taking a placebo pill.

Based on recent studies, the new aggressive target is to get LDL cholesterol below 55 mg/dL, as plaque can build up even at levels of 60 mg/dL.

Consider a low-dose statin, as you get most of the cholesterol-lowering effect at low doses while the risk of side effects scales disproportionately with higher doses.

Instead of increasing a statin dose and its side effects, a smarter approach is to add a second drug like ezetimibe, which works through a different mechanism.

The modest 9% increased risk of developing type 2 diabetes from statins is substantially outweighed by the large reduction in the risk of dying from a heart attack.