Pre-approval clinical trials, run by drug makers, reported a sub-2% discontinuation rate due to side effects. Post-market observational data reveals a starkly different reality: approximately 10% of patients stop taking statins due to adverse effects like muscle pain.

The number of Americans recommended for statins ballooned from 13 million to 56 million due to progressively lowered cholesterol thresholds. The expert committees setting these guidelines often had members with financial ties to drug makers, creating a conflict of interest.

Of 7 million Americans annually who think they are having a heart attack, only a fraction are. Because the GIK therapy is extremely safe and non-toxic, it can be administered to all 3.5 million people with convincing symptoms. Treatment can be safely stopped for those not having an attack, ensuring the ~1.5 million who are get protected immediately, a strategy of 'treat broadly, then confirm'.

Taking a statin may create a false sense of security. One study, dubbed 'Gluttony in the Age of Statins,' found that over 10 years, statin users were more likely to gain weight and become sedentary, likely believing the pill negated the need for a healthy lifestyle.

A $2,000 preventative injection like a PCSK9 inhibitor sounds expensive. However, its cost is likely justified when calculated against the massive societal and individual expense of future medical bills, plus the economic value of additional healthy, productive years.

The idea of preventing disease by managing measurable risks like cholesterol was a paradigm shift in medicine, born from observing 5,000 residents of Framingham, MA over decades, an unprecedented study that began in 1948.

A major challenge in managing high cholesterol is patient adherence to daily medication for life. New therapies like Inclisiran use mRNA silencing and require only two injections per year, dramatically improving adherence for busy or non-compliant individuals.

Focusing solely on LDL is a mistake. Even individuals with a genetic mutation leading to lifelong low LDL levels can still have cardiovascular events if they have other unmanaged risk factors like metabolic syndrome, obesity, or diabetes, highlighting the need for a comprehensive approach.

The silent nature of high cholesterol creates a psychological barrier. Patients who feel perfectly healthy are often unwilling to commit to lifelong treatment, even when their risk is high, leading to preventable cardiovascular events.