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Updated: Apr 12, 2026

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[LDL-Cholesterol--Is there an "LDL hypothesis"?]

Florian Custodis1, Ulrich Laufs1

  • 1Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes Homburg / Saar.

Deutsche Medizinische Wochenschrift (1946)
|May 14, 2015
PubMed

Insights

The LDL-Hypothesis, linking LDL cholesterol to heart disease, is outdated. Evidence strongly supports LDL-causality, not just a hypothesis, for atherosclerosis development and cardiovascular risk.

Area of Science:

  • Cardiology
  • Biochemistry
  • Genetics

Context:

  • The association between LDL cholesterol and cardiovascular outcomes is often termed the "LDL-Hypothesis."
  • Recent randomized trials prompt re-evaluation of this terminology.

Purpose:

  • To assess the adequacy of the term "LDL-Hypothesis" in light of current scientific evidence.
  • To propose a more accurate term reflecting the established role of LDL cholesterol.

Summary:

  • Extensive evidence, including genetic associations, epidemiological data, and results from major statin trials and the IMPROVE-IT study, supports a causal role for LDL cholesterol in atherosclerosis.
  • The term "hypothesis" is deemed insufficient to describe the established link between LDL cholesterol and cardiovascular events.

Impact:

  • Recommends replacing "LDL-Hypothesis" with "LDL-causality" to accurately reflect scientific consensus.
  • This shift in terminology emphasizes the definitive causal role of LDL cholesterol in cardiovascular disease pathogenesis.

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