Cholesterol & Statins
A critical synthesis — for the conversation, not the prescription.
This site is a careful read of what the science actually says about cholesterol, statins, and the long argument about whether they help, harm, or both. It was commissioned by a non-clinician with twenty-five years in marketing analytics, who wanted to walk into a substantive conversation with a friend who works at Roche without either deferring to authority or pretending the headlines on social media are the same thing as the evidence.
The synthesis runs to roughly 267 pages with footnoted citations. It steelmans both sides of every contested question, lands a calibrated position, and tells you what would change its mind. A separate plain-English summary fits the headline conclusions on a single page. An external review panel of five reviewers — academic lipidologist, cardiology trialist, evidence-based-medicine methodologist, pharmacology lecturer, and clinical pharmacist — scored the document 74 out of 100 and found no invented citations in their samples. Their full critique is included, unedited.
Should I be on a statin? — Decision pathway
Eight questions. Picks your doctor type. Stratifies you into the matching evidence band. Outputs a printable list of questions to take to your appointment. Neutral, no commercial interest in your decision.
Start the pathway →Start here
Plain-English Summary
The headline-page version. If you only read one thing, read this. About ten minutes.
Read the summary →Full Synthesis
The 267-page document with biology, trial history, disputes, harms, adjudication, and a debate playbook.
Read the synthesis →External Review
Five-reviewer panel critique. Honest, not flattering. Find the weaknesses before someone else does.
Read the review →Why this was commissioned
The framing behind the project — why an informed lay reader would want a post-graduate-level synthesis.
Read the framing →Methods & orchestration
How the multi-agent system was set up, what worked, what didn't, what to weight when reading the output.
Read the methods →Sources
Master bibliography, primary trial links, grounding searches that anchored the synthesis.
Browse sources →The one-sentence position
The case for statin therapy is overwhelming in secondary prevention, familial hypercholesterolaemia, and high-risk primary prevention; the case is empirically thinner and ethically more contestable in low-risk primary prevention and the healthy elderly, and is properly resolved by shared decision-making with patient-specific NNT/NNH calculations rather than by population-level mandate.
That sentence will not satisfy a partisan of either camp. That is the point.
A note on what this isn't
This is not medical advice. It is a research synthesis intended to support an informed conversation. Clinical decisions belong with a clinician who knows the patient. The synthesis is designed to give you what you need to have the conversation, not to replace it.