Talk:Lipid hypothesis

No longer a hypothesis

In 2019, the European Society of Cardiology (ESC) and European Atherosclerosis Society (EAS) stated that clinical trials and human Mendelian randomization studies have demonstrated the role of LDL-C and LDL-CApoB-containing lipoproteins in atherosclerotic plaque formation and cardiovascular events. LDL-C is causally related to ASCVD. This is no longer a hypothesis but considered as fact:

Furthermore, these clinical trials have clearly indicated that the lower the achieved LDL-C values, the lower the risk of future cardiovascular (CV) events, with no lower limit for LDL-C values, or ‘J’-curve effect... Human Mendelian randomization studies have demonstrated the critical role of LDL-C, and other cholesterol-rich ApoB-containing lipoproteins, in atherosclerotic plaque formation and related subsequent CV events. Thus, there is no longer an ‘LDL-C hypothesis’, but established facts that increased LDL-C values are causally related to ASCVD, and that lowering LDL particles and other ApoB-containing lipoproteins as much as possible reduces CV events. [1]

This is supported by another recent textbook overview

The first and most relevant update presented in the 2019 guidelines concerns the old concept of an “LDL-C hypothesis,” which is now replaced by the established causal role of elevated LDL-C levels in ASCVD. Besides this causal role, genetic studies have introduced the concept of exposure time, revealing that LDL-C also has a cumulative effect on the risk of ASCVD9, a longer-term exposure leads to a greater retention over time of LDL particles (or, more generally, proatherogenic apoB-containing particles) in the arterial wall. Thus, the overall effect of LDL-C level on ASCVD risk is determined by the combination of both plasma levels and time of exposure. [2]

The article should be updated with the recent guidelines position. Psychologist Guy (talk) 15:23, 23 January 2024 (UTC)

The article title should change, too. There is also a category named "Lipid hypothesis" which would also need changes. What name would you suggest for both? CarlFromVienna (talk) 08:56, 29 January 2024 (UTC)

It might be too early days to change the title of the article right now, but lipid theory would probably be more accurate in the future. I know that many papers still refer to it as the "lipid hypothesis" but mainstream health organizations no longer really view it as just a hypothesis. Interestingly in the 1980s, the lipid hypothesis was referred to in books and papers as the "lipid theory of arteriosclerosis". I think lipid theory is correct but we should wait until more medical textbooks update the language. I think this will be happening in the next 2 years. Psychologist Guy (talk) 12:52, 12 February 2024 (UTC)