The American Heart Association is concerned that stroke and heart attack survivors don't think enough about 'risk' of LDL (low-density lipoprotein) cholesterol, now colloquially termed 'bad' cholesterol.

The public are not wrong to be jaded by epidemiology,(1) the EPA is overrun with it and now seems to believe in homeopathy when it comes to weedkillers. Our CDC brazenly invented epidemics using epidemiology before a real pandemic hit and they showed how incompetent they are. The AHA is the same group that, using suspect epidemiology, claimed all cholesterol was bad, and red meat was killing us. Now, the beef industry is one of their largest donors. As is Amgen, which makes the LDL drug Repatha, and sponsored this new initiative.

Awareness is fine, and if companies can educate people and check off a charity box, even better, I wish companies would fund us, except without a deliverable like AHA provides. Yet scaremongering using correlation to increase market share of a $400 million product is not the way to go. Epidemiology is not science, that is why their claims are over in the exploratory pile.(2) The exploratory pile in this case is a May 2023 Harris Poll of 503 U.S. adults aged who experienced a stroke and/or heart attack. It bizarrely claims that respondents didn't know about cholesterol, yet if you ask heart attack survivors they can give you lots of detail about ATP citrate lyase Inhibitors, statins, and Ezetimibe - which lowers LDL. Which is a risk factor for a risk factor for a heart attack.(3) Something does not add up, except in the light of Amgen wanting more people to know about Repatha.

Everyone knows 'correlation is not causation' - except epidemiologists in their press releases and journalists in corporate media. They will tout any claim if the study was in mice or on a spreadsheet provided it scares people, promotes longevity, or will appeal to the anti-corporate fringe that controls who gets Pulitzer prizes. When a press release notes that 75 percent of people who have heart attacks have high cholesterol, they are implying it is causal. Yet 82 percent of heart attacks are in senior citizens, making age the big risk factor. More women than men die from them, making being a woman the big risk factor.

We can't control either of those so it isn't bad to mitigate what you can, but epidemiology often leaves out absolute and relative risk. Someone with multiple actual co-morbidities has almost no meaningful increased risk from salt or red meat. Unless they are eating 4,000 calories a day and generating obesity.

Focusing on cholesterol is, for most, treating the symptom. The medical world stopped symptom-based diagnosis 50-years ago so it is strange that symptom-based therapy us now the norm. It is the norm, but only in the US. Amgen is not wrong to focus on Americans, 66 percent of their revenue is in America. Because America leads the world in taking prescription medication for everything.

Instead of changing lifestyle, which does a lot more to prevent high LDL cholesterol.


(1) Don't believe that a horse dewormer cures COVID-19? Why not? It is the exact same methodology used to make 9,000 other claims about the pandemic, and that was just in the summer of 2021.  If real peer review only happens when a Republican says something, then as I noted in the Wall Street Journal, nearly all peer review is suspect too.

(2) Epidemiologists "linked" cholesterol to heart issues the same way they linked salt and butter - they looked at how many people who had heart attacks also reported eating a lot of meat and things like salt and butter. 

What was better to epidemiologists then? Trans-fats and vegetable oils, the thing they started claiming 20 years ago was bad while butter was okay. France's International Agency for Research on Cancer used that same suspect methodology - food surveys - to "suggest" that chewing gum causes cancer.

Chewing. gum. But only if it is chewing gum without sugar, the gum that has saved hundreds of millions of lives and an untold number of teeth due to the known oral health benefits of sugar-free gum.

The US FDA has flatly stated IARC is off the rails. But the science community has known that since 2009. Unfortunately for California, the state long ago abdicated its science to IARC under Proposition 65 - and it is the reason why tens of thousands of ordinary products have cancer warning labels on them in California. Get ready to read about your risk of cancer on every pack of Trident sold in California real soon.

(3) Epidemiology has long been more politics and opportunism than desire to be trusted guides for the public. After the phenomenal Master settlement against Big Tobacco over cigarettes - a giant win for epidemiology (thank you!) - the entire field rushed to start finding new carcinogens and maladies so they could get "expert witness" contracts.

The absolute nadir for the field should have been 2017, when IARC Working Group members had been caught colluding with attorneys who wanted to sue over products before monograph results had been released. Yet instead of fixing their problems, the Old Guard circled the wagons - the new head of the group is literally married to the most Old Guard of the Old Guard.