Rethinking LDL and Heart Risk

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Dr. David Diamond is not a cardiologis, he’s a neuroscientist who spent decadesresearching PTSD and Alzheimer’s disease. His path into heart health began whenhis own doctor warned him about “dangerous” cholesterol levels and prescribedstatins. Instead of filling the prescription, he went to the library andstarted reading the original research. What he found led him to a verydifferent conclusion than most doctors share today.

Why High LDL Isn’t the Whole Story

Conventional wisdom says high LDL cholesterol is a directpath to clogged arteries and early death. But Diamond reviewed long-termstudies on people born with very high cholesterol, a condition known asfamilial hypercholesterolemia (FH). The findings shocked him. Many of theseindividuals lived into their seventies and eighties without elevated rates ofstroke or heart disease. In fact, some data showed they lived longer than thegeneral population.

The early deaths seen in a small subset of FH patients, heexplained, were usually linked to clotting disorders—not cholesterol itself.This turns the “LDL equals heart attack” model upside down.

The Real Predictors of Risk

If LDL isn’t the villain, what should we be watching?Diamond pointed to more reliable indicators:

Metabolic health consistently predicts outcomes. High bloodsugar, insulin resistance, and elevated triglycerides—especially when combinedwith low HDL—track strongly with heart disease. The triglyceride-to-HDL ratiois one of the most powerful predictors, often more telling than LDL levels.Coronary artery calcium scoring also provides a far better window into futureheart problems than a standard cholesterol panel.

Statins: Miracle Drugs or Marketing Spin?

Statins are promoted as life-saving. Ads highlight numberslike a “54% reduction in heart attacks” with drugs like Crestor. But Diamondunpacked the raw data: in the JUPITER trial, fewer than 1% of participants hadheart attacks—whether on statins or placebo. The so-called 54% benefit camefrom statistical sleight of hand, inflating tiny differences into bigpercentages.

The true absolute risk reduction? Less than one percent. Toprevent a single heart attack, more than 200 people would need to take thedrug. Meanwhile, the harms are well documented: muscle damage, diabetes risk,sexual dysfunction, kidney disease, and even memory loss. Some patientsdiagnosed with dementia improved once they stopped statins—only to see symptomsreturn when restarted.

Why Cholesterol Matters for More Than the Heart

Cholesterol isn’t just a “bad actor” in the bloodstream.Diamond emphasized that it plays a vital role in the immune system, helping thebody neutralize toxins and fight infection. People with higher cholesteroloften fare better in severe infections like sepsis. This overlooked role mayexplain why low cholesterol can actually be a disadvantage.

A Better Way Forward

Diamond concluded with a call to rethink the entirecholesterol-centric model. The real culprits in heart disease are damagedmetabolism, high blood sugar, high triglycerides, clotting tendencies, and thebreakdown of protective artery linings. Lifestyle changes—especially reducingcarbohydrates—improve nearly every marker that matters.

His bottom line: a person who is metabolically healthyshould not fear high LDL, nor rush into lifelong statin therapy. Cholesterolhas been miscast as the enemy, while the true drivers of heart disease remainlargely ignored.