HoldsUp

Aseem Malhotra

Aseem Malhotra is a medical researcher working in the fields of cardiovascular health and clinical nutrition. His published research examines coronary artery disease interventions, including the clinical roles of coronary stents, statin therapy, and target cholesterol levels. He has also published work evaluating dietary strategies for type 2 diabetes remission and the relationship between lifestyle factors, inflammation, and cardiovascular disease.

13 claims checked on air: 1 context 3 contradicted 1 overstated 8 supported

What they said on air - citing their own research

3 citing their own research

0:48:30supportedmoderatetheir own paperIt's Not Cholesterol. Inflammation Is What's Actually Causin

A systematic review of over 30 randomized controlled trials found no clear relationship between the degree of LDL reduction from cholesterol-lowering drugs and prevention of cardiovascular events.

"So myself and two cardiologists did a systematic review of the totality of drug industry-sponsored trials, by the way, and some diet trials, but many drug industry-sponsored trials, all of the randomized controlled trials on cholesterol-lowering drugs: statins, PCSK9, blah, blah. Was there a clear relationship as you lowered LDL in low-risk and high-risk patients, Mark, okay, over 30 studies, was there a relationship with lowering LDL and preventing cardiovascular events? No." (said at 0:48:30)

The speaker accurately describes the findings of a published systematic review of 35 randomized controlled trials (PMID 32747335), which he co-authored. The review analyzed trials evaluating LDL cholesterol targets across diverse risk populations and concluded that achieving specific LDL target levels through drug therapy did not confer consistent cardiovascular benefit, questioning the direct relationship between LDL-C lowering as a surrogate target and cardiovascular event reduction. A subsequent 2022 systematic review and meta-regression in JAMA Internal Medicine (PMID 35285850) evaluating statin trials similarly concluded that a conclusive relationship between the magnitude of absolute LDL-C reduction and individual clinical outcomes (all-cause mortality, myocardial infarction, stroke) was not established.

0:54:26supportedlowtheir own paperIt's Not Cholesterol. Inflammation Is What's Actually Causin

A 2016 systematic review of observational cohort studies in people over age 60 found an inverse association between LDL cholesterol and all-cause mortality.

"2016, and the reason we did this, me and a number of international scientists, we decided to do a systematic review of observational data looking at people over 60. ... but what was surprising was there was an inverse association with LDL cholesterol and all-cause mortality. In other words, statistically, if you're over 60, the higher LDL, the less likely you are to die." (said at 0:54:26)

A 2016 systematic review by Ravnskov et al. (published in BMJ Open) evaluated 19 cohort studies comprising 30 cohorts and 68,094 participants aged 60 years and older. The authors reported an inverse association between LDL cholesterol and all-cause mortality in 16 of the 28 cohorts where all-cause mortality was recorded (representing 92% of analyzed participants), with no association found in the remaining cohorts. Because the underlying evidence base consists of observational cohort studies susceptible to reverse causation (e.g., frailty, terminal illness, or malnutrition lowering cholesterol levels prior to death) and residual confounding, the certainty of evidence for this observational association is low.

0:55:08supportedlowtheir own paperIt's Not Cholesterol. Inflammation Is What's Actually Causin

A 2016 systematic review of observational cohort studies found no association between LDL cholesterol levels and cardiovascular disease in individuals aged 60 and older.

"So we looked at: was there first of all any association if you're over 60 with LDL cholesterol and heart disease? We found none." (said at 0:55:08)

A 2016 systematic review by Ravnskov and colleagues evaluated 19 cohort studies (30 cohorts, 68,094 individuals aged 60 and older) examining LDL cholesterol and mortality outcomes. Regarding cardiovascular mortality across 9 cohorts where it was assessed, seven cohorts found no association with LDL-C levels, and two cohorts found cardiovascular mortality was highest in the lowest LDL-C quartile. For all-cause mortality, an inverse association or lack of association was observed. Because this evidence is derived entirely from observational cohort studies prone to reverse causation and residual confounding, the certainty of evidence is low.

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