The Cochrane Collaboration says that the extreme lipid reductions brought about by statins change the probability of a cardiac event by less than four-tenths of one percent per year. This is hardly convincing evidence of lipids being causal. At the same time there are more than a few people like me, with extreme levels of "bad" cholesterol (my LDL alone is over 500) and zero plaque in coronary arteries by EBCT. Nobody knows what the differences are between those like me and those with CVD, and no one appears to be interested in finding out. It's just too easy and too profitable to promote cholesterol lowering.