ReviewJournal of atherosclerosis and thrombosis2020
Low-Density Lipoprotein Cholesterol Level cannot be too Low: Considerations from Clinical Trials, Human Genetics, and Biology.
Review in Journal of atherosclerosis and thrombosis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 22 citations in OpenAlex.
- Association Between HDL Cholesterol Changes and Cardiovascular Event Risk: A Nationwide Health Screening Cohort in Japan.Healthcare (Basel, Switzerland) · 2026Article
- Lipid lowering in coronary artery disease - not just statins.Clinical medicine (London, England) · 2026Review
- Oral Semaglutide Further Reduced LDL Cholesterol in a Patient with Familial Hypercholesterolemia Treated with Statins, Ezetimibe, and Evolocumab.Internal medicine (Tokyo, Japan) · 2026Article
- Dose-response relationships of normal blood lipid levels in metabolic and endocrine diseases: mechanistic similarities, differences, and functional insights.Frontiers in endocrinology · 2026Review
- Partitioned polygenic risk scores identify distinct types of metabolic dysfunction-associated steatotic liver disease.Nature medicine · 2024Article
- Partitioned polygenic risk scores identify distinct types of metabolic dysfunction-associated steatotic liver disease.Research square · 2024Article
- Case report: Unusual coexistence between familial hypercholesterolemia and familial hypobetalipoproteinemia.Frontiers in cardiovascular medicine · 2022Article
- Individualized Treatment for Patients With Familial Hypercholesterolemia.Journal of lipid and atherosclerosis · 2022Review
- Triglycerides on the Rise!Journal of atherosclerosis and thrombosis · 2021Article
- Current Diagnosis and Management of Abetalipoproteinemia.Journal of atherosclerosis and thrombosis · 2021Review
- Challenges of Precision Medicine for Atherosclerotic Cardiovascular Disease Based on Human Genome Information.Journal of atherosclerosis and thrombosis · 2021Review
- Familial Hypercholesterolemia: A Narrative Review on Diagnosis and Management Strategies for Children and Adolescents.Vascular health and risk management · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
LDL cholesterol is by far the best established "causal" cardiovascular risk. It is distributed normally, and the mean value ranges around 100~120 mg/dl. In terms of preventive cardiology, we now know very well that the lower the LDL cholesterol, the better. Clinical usefulness of aggressive LDL-lowering therapies using statin, ezetimibe, and proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors have been shown in primary and in secondary prevention settings. Additionally, the idea, based on recent randomized controlled trials (RCT), that the lower LDL cholesterol the better appears to be true for LDL as low as ~ 30 mg/dl. According to those data, recent guidelines in Europe and in Japan suggest the lowering of LDL cholesterol level ＜70 mg/dl for high-risk patients. However, the attainment rates of such "strict" goals seem to be quite low, probably because most cardiologists still have a sense of anxiety of "low" LDL cholesterol level. But "low" indicates no more than "lower" than the "average" range, which is not always implying the optimal range. Additionally, Mendelian randomization studies focusing on individuals exhibiting "low" LDL cholesterol suggest that "normal" LDL cholesterol levels might be too much for us. Moreover, LDL cholesterol levels of other primates are substantially lower than those in humans. In this review article, based on a series of evidence from clinical trials, human genetics, and biology, we provide the idea that we need to rethink what is the optimal range of LDL cholesterol level, instead of "normal" or "average" range.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.