Nick Norwitz cites 7 years at 700 mg/dL to challenge LDL cutoffs

The push here is that LDL and ApoB aren’t switches with a fixed cutoff, they’re inputs into a messier risk calculation that depends on context. This resurfaced as a cardio case study arguing the usual “above X, treat with Y” playbook is too algorithmic and misses physiology, history, and tradeoffs in the actual patient in front of you.

The example leans on extremes: a reported 56% LDL drop on ezetimibe, nearly 7 years with total cholesterol around 700 mg/dL, and follow-up coronary CT angiography with AI plaque quantification down to cubic millimeters. The claim isn’t that high LDL is good, ApoB is still part of the causal pathway, but that elevated numbers alone don’t automatically settle whether to intervene.