"Meanwhile, minimizing the risk of CVD, the leading cause of death worldwide, does seem like a good idea, no?" This is the problem of modern medicine in a beau

"Meanwhile, minimizing the risk of CVD, the leading cause of death worldwide, does seem like a good idea, no?" This is the problem of modern medicine in a beautiful shortcut. Everyone is concentrated on their own domain. Oncologists treat cancer, cardiologists treat CVD. Few pay attention to the survival of the whole body, which is what you actually want. Reducing the risk of CVD only makes sense if you reduce all-cause mortality at the same time. A therapy that would protect your heart at the cost of, say, increasing cancer risk, would be almost criminal to administer. Now I don't want to claim that this is what now happens. But 12 million people in the developed world is an enormous statistical set and there likely won't be any weird outliers dragging the total result into implausible values. Reading quickly through, I also notice that the overall effect of cholesterol on mortality seems to go significantly down with increasing age, which is something that has already been observed. I certainly wouldn't be so favorable towards contemporary medications and at the same time so dismissive towards the observational studies. Quite a lot of CVD mortality reduction since the 1960s comes from surgery (stents etc.), from reduced prevalence of smoking and from early treatment of high blood pressure. Anti-cholesterol drugs are pretty deep in the list of interventions by total efficiency.