Statin effectiveness in reducing small dense LDL
On the Dec 18 Huberman Lab podcast, Dr. Robert Luskin, who Peter interviewed on episode 14 of The Drive, says ( beginninng at 2:02:20) that statins are ineffective as a primary prevention for reducing heart disease and offers as the reason that statins are effecitve at reducing large buoyant LDL but not effective at reducing small dense particles. After listening to that podcast I did some research online and I believe Dr. Luskin is not quite right. I was able to find a paper from 2010 in the National Library of Medicine titled "Statins do not decrease small, dense LDL" but the title seems misleading when you look at the data. The study is relatively small but the data show that the absolute values for both AOPB and small dense LDL are lower in the statin group compared to the control group but the proportion of small dense LDL is slightly higher in the statin group and the proportion of large buoyant LDL is slightly lower. It would seem the strongest statement one could make based on this study is that statins seem to be relatively more effective at reducing large buoyant LDL compared to small dense LDL. I believe that AOPB as a measure captures small dense LDL particles so if statins are effective at lowering AOPB then they are effective at lowering small dense. Your take on this complex topic would be appreciated. Thanks.