The primary focus for managing cardiovascular disease should be addressing metabolic dysfunction.

“we can look at LDL and if you have somebody who has all the fires going on you want to talk about lowering their cholesterol values to help delay the progression of the disease process while you manage the fires there could be rational arguments put in place for that but if you don't have the fires present just stratifying people by an LDL value or an ail B value and saying we need to smash everyone's values down low even though there's no fires present is a relatively tenuous argument to make”