UMMS Affiliation

Department of Medicine, Division of Cardiovascular Medicine

Publication Date


Document Type



Cardiology | Cardiovascular Diseases | Lipids


The so-called LDL hypothesis is the concept that excess low-density lipoprotein (LDL) cholesterol is a causal factor in the development of atherosclerotic vascular disease. By extension, this hypothesis also assumes that reducing LDL cholesterol levels, regardless of the means, should produce a corresponding reduction in cardiovascular events. Considerable evidence supports the LDL hypothesis, including animal studies and epidemiologic studies involving humans, as well as clinical trials of both statins and nonstatin lipid-modifying agents. In a meta-analysis that included more than 90,000 participants in 14 randomized trials of statins, the Cholesterol Treatment Trialists’ (CTT) collaborators found that, on average, a reduction of 1 mmol per liter (38.7 mg per deciliter) in LDL cholesterol levels yields a consistent 23% reduction in the risk of major coronary events over 5 years.


Acute Coronary Syndromes, Coronary Disease, Myocardial Infarction, Lipids, Prevention

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Copyright © 2015 Massachusetts Medical Society. Publisher PDF posted after 6 months as allowed by the publisher's author rights policy at

DOI of Published Version



N Engl J Med. 2015 Jun 18;372(25):2448-50. doi: 10.1056/NEJMe1507041. Epub 2015 Jun 3. Link to article on publisher's site

Journal/Book/Conference Title

The New England journal of medicine

Related Resources

Link to Article in PubMed

PubMed ID