Uffe Ravnskov et al. argue that recent literature suggesting statins reduce heart-disease risk by lowering total (TC) and LDL cholesterol (LDL-C) is flawed, as is the broader belief in the inverse relationship between TC and LDL-C and heart disease. The authors note: “The usual argument in support of the lipid hypothesis is that numerous studies of young and middle-aged people have shown that high TC or LDL-C predict future CVD. This is correct, but association is not the same as causation.” TC or LDL-C may be effective markers for atherosclerotic risk within an untreated (or minimally treated) population, but this does not mean these markers are causal in the disease state.