About this episode

David Newman discusses a recent cholesterol trial and its implications for heart disease treatment.

I hope you will forgive the mini-barrage. I don’t usually clutter inboxes, but the timely publication of a trial that fits, hand-in-glove, with the current series was too much temptation. To understand what’s gone wrong in cholesterol research, and what my 4-part series is about, you don’t need a theory. You just need a trial. The one published last night in the New England Journal of Medicine, and delivered straight to my inbox, is as clean an example as you’ll find—and it’s right on time. Patients with heart disease were randomized to more intensive lipid lowering (as recommended by the AHA) or usual care. The result, we’re told, was a resounding success: More lipid lowering led to fewer coronary events, YAY!! Another win for cholesterol reduction? Let’s look inside the numbers. Mortality—what patients care about—was 2% in the treatment group and 1.9% in the control group . No difference. Not just insignificant, untouched. (In fact, numerically higher in the lowest lipids group). So why is the trial a ‘success’, with a fawning editorial that calls the results “firm support” for current AHA guidelines? Because the primary endpoint wasn’t death, or anything else people taking…

People in this episode

Host: David Newman

Topics covered

• cholesterol research
• heart disease
• lipid lowering
• clinical trials
• AHA guidelines

Keywords

• cholesterol
• heart disease
• lipid lowering
• clinical trial
• AHA guidelines
• mortality
• coronary events

Mentioned in this episode

Organizations: New England Journal of Medicine, AHA

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• Cholesterol 4: What Went Wrong · April 16, 2026 · 22 min
• Cholesterol 3: The Big Mistake · April 8, 2026 · 38 min
• Cholesterol 2: Cardiology's Nonfatal Mistake · April 1, 2026 · 19 min
• Cholesterol 1: The First Mistake · March 28, 2026 · 21 min

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