Ask A Cardiothoracic Surgeon: Why Is Cardiovascular Disease Still The #1 Killer In The USA?

Added: 2026-05-22

[00:00:00]Hi everyone, I'm Dr. Michael Rich, I'm a double board certified cardiothoracic surgeon.

[00:00:05]So in today's video, I'm going to answer a question that is always being asked, but usually in a derogatory or an accusatory fashion.

[00:00:15]If statins are so great, how come cardiovascular disease is still the number one killer of men and women in the United States? And it's a valid question, but I think it's very logical the answer. So but before we tackle that, couple things, public service announcement. First of all, if you don't have a productive comment, just like don't say it, like restrain yourself, it's really not that hard. Okay? Stop saying everybody knows or everybody thinks, who's everybody?

[00:00:44]None of you can answer that who ask these ridiculous questions, or they say, who's they? Okay? Stop telling me I look tired, I'm really tired, yes, cuz I work really hard and then I try and answer everybody's question personally. Tell me one doctor who does that on social media, I don't know one. Okay? Stop telling me I look ill.

[00:01:04]You look ill, I just don't say it, and I'm not ill, I'm really healthy. Okay?

[00:01:09]So I don't need to hear it.

[00:01:11]And then finally, unless you have something productive, just don't say it, okay? Like just restrain yourself because I'm going to just start deleting things and blocking them. Okay.

[00:01:24]So that's out of the way. Let's get back to the main question.

[00:01:29]Why are so many people dying if statins are a great drug? Well, first of all, you're making an assumption that everybody in the United States gets tested for high cholesterol, and that's hardly the case. The majority of people in the United States never have cholesterol testing. Okay, so that should be obvious. Why is cardiovascular disease the number one killer? Well, if we were testing everybody and treating everybody properly, it wouldn't be. Okay, so one, we're not testing people properly or enough.

[00:02:03]Second, we are not testing people properly. In other words, regular testing misses up to 50% of the population who has abnormal cholesterol.

[00:02:13]It tells them they're normal. So, in other words, if we measure the people in the cars and not the cars, we miss 50% of the population. Okay? And, you know, let's just go back in time a little bit.

[00:02:25]1967, Dr. Fredrickson, who wrote uh the cholesterol classification, how we classify cholesterol, wrote in the New England Journal of Medicine, the premier journal, and I'm going to paraphrase. He said, "Atherosclerosis or blocking of the arteries is a lipoprotein disorder. In other words, it's a dis- disease of the cars. It's a disorder of the cars, having too many cars. It's not a cholesterol disorder, in other words, or the people in the cars, but we're still measuring the people in the cars. Okay? So, those are the first two reasons.

[00:02:59]Third reason, even when we identify people, people are being under-treated if you use regular testing all the time, people are being under-treated. In other words, they may be on medicine, but they're not not optimally treated. And as soon as you measure their lipoprotein, you're like, "Wow.

[00:03:19]Okay, they're they're normal. The people are normal, but the cars are totally abnormal." And then the fourth reason, which is you guys think that for some reason, um once your numbers are normal, that you're cured and you can just stop medicine or, you know, your doctor uh stops the medicine or drops the dose, which is like complete craziness or insanity because we didn't cure anything. We treated. Okay? Which goes against the argument that many of you make that doctors um don't want to cure things, they just want to treat things. No, we want to treat things that are treatable and we want to cure things that are curable, okay? So, with that hope you listen.

[00:04:06]Hope you learn something.

[00:04:07]And start being kind to everybody, okay?

[00:04:11]Goes a long way. So, hope everybody has a good day.