The Dr. Hyman Show
The Cardiologist Who Stopped Prescribing Statins Explains the Real Cause of Heart Attacks | Dr. Aseem Malhotra - ENCORE
24 Dec 2025
Chapter 1: Why did a cardiologist stop prescribing statins?
So today we're revisiting one of our most popular episodes of 2025. My conversation with esteemed UK cardiologist, Dr. Asim Malhotra, a physician who went from being a top prescriber of statins to one of their most vocal and well-informed critics. A stance that ultimately cost him his job and led to a major legal battle with the media.
In this eye-opening conversation, Dr. Malhotra pulls back the curtain on the commercial distortions of scientific evidence that have shaped our understanding of cholesterol and heart disease.
He explains the statistical sleight of hand often used in clinical trials, the data pharmaceutical companies don't want the public to see, and why our decades-long obsession with lowering LDL cholesterol may have done more harm than good. This conversation sparks so much engagement, reflection, and change within our community, and it deserves another spotlight.
Whether you're revisiting the conversation or hearing it for the first time, we hope it brings you inspiration, insight, and nourishment in this holiday season. So thanks for being part of our podcast family. We'll be back in the new year with brand new episodes we can't wait to share with you. The fall into winter seasons is when our immune systems need the most support.
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Chapter 2: What are the misconceptions about LDL cholesterol and heart disease?
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Yeah, it's so nice to see you again, Mark.
I think, yeah, we did. It's been about six years since I last podcast. That's right. Got a lot of a lot of interest. So I think, yeah, let's.
We did.
Chapter 3: How do inflammation and insulin resistance affect heart health?
So as you heard from the introduction, it seems an esteemed cardiologist from the UK. who's been a vocal critic of a lot of the mainstream ways of thinking about cardiovascular risk, cardiovascular health, and the use of statins as our primary therapy for reducing cardiovascular disease, which is, after all, the number one killer in the world. We're going to dive deep into that.
the issues around these drugs, around what we need to actually be looking at for cardiovascular disease. And I think your opinion is going to be a little bit jarring for people because it goes against the conventional wisdom, which isn't necessarily always wise.
And I think it's a much more nuanced conversation that people need to be having around cardiovascular disease than high LDL cholesterol, bad cholesterol, take a statin, end of story. Essentially what we all do in medicine, if we're trained in traditional medicine, high cholesterol equals statin. And if statin causes side effects, you can play with a bunch of other drugs like PCSK9 inhibitors.
But we're going to start out at the end, which is this lawsuit that was filed by two of your colleagues that you were going to be a part of but decided not to be for various reasons because you couldn't actually talk about the issues that you care about, which I guess has a lot of integrity. But the case was brought by Zoe Harcombe and Dr. Malcolm Kendrick against...
Associated Newspapers, which is the publisher of the Mail on Sunday. And there were a series of articles published in March of 2019 that were part of a campaign called Fight Fake Health News. This was even before COVID and the whole misinformation. And in these articles, they named the claimants and statin deniers, including you.
which isn't actually true, and they accused you and your colleagues of spreading misinformation about statins, which they described as, quote, deadly propaganda. The newspaper's article suggested that their statements led people to avoid taking statins, which was a big public health risk.
In response to these articles, your colleagues filed a defamation lawsuit, arguing that these articles falsely portrayed them as deliberately spreading lies about statins. Now, the High Court has seen multiple legal arguments, particularly around the public interest defense under the Defamation Act of 2013 in the UK. But in 2024, just recently,
The case was ruled in favor of your colleagues, against the newspaper. So in some ways, you've been vindicated by the legal system that what you're raising in terms of concerns about Stans, and I'm kind of quoting from you at this point, which is their data is flawed on Stans.
it's over-emphasized, it's over-prescribed, it has risks, and there are other factors that need to be considered that are often being missed. And it's a more nuanced view that you have. It's not just drugs are bad, food is good, or drugs are bad and wheatgrass is good.
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Chapter 4: What legal battles have emerged around statin criticisms?
But how many doctors have got the time or the skill to try and cut through, you know, all the stuff that they're getting through medical journals, looking at independent evidence, and then, you know, being able to try and get to something that,
in a level of information that they can utilize for really benefiting when helping their patients so it comes down to informed consent and for me one thing that you know i think it was mark twain that said that truth often lies in simplicity and the most elegant analytical framework we have
for teaching and practicing medicine is called the evidence-based medicine triad right published in the bmj in 1996 i love this it's beautiful i put it up in my talks it's one of the first slides and i say listen this is the most important side of my talk if you get this you can probably not not only understand why our health is going the wrong direction but you can probably explain most problems in the world as well right so what does that mean okay in the middle of the of the triad our role as healthcare practitioners as doctors is to improve patient outcomes manage risks
Treat illness, relieve suffering. How do we do that? There are three inputs. Our clinical experience, our knowledge, our intuition as doctors over many, many years. The best available evidence on a drug, on a lifestyle, on a surgical intervention, on ordering a test. And last but not least, David Sackett said... taking it into consideration individual patient preferences and values, right?
That's where the informed consent comes in. So what's the problem? What are the limitations? Why have we not really advanced evidence-based medicine?
Well, that's really, I just want to double-click on that too, because when we hear evidence-based medicine, what it usually is interpreted as is only what the science says, not what the patient says. is experiencing or what the clinician expert understands from their decades of experience, which are part of the evidence-based trial. 100%. And that's really the failure here.
And evidence-based medicine is held up as this wholly... kind of idle in a sense that we bow to, but often we kind of think misinterpret what it means. And I think your explanation of it is really important because it's not just what the data show and it's also which data and who funded the data and what wasn't studied. And the absence of evidence isn't the evidence of absence.
So there's a whole bunch of stuff that's going on.
So then you pick up, so then the next stage is, okay, so if you accept this as a pretty solid framework for improving patient outcomes, It doesn't take a rocket scientist to figure out that if there's anything wrong with one or all of these, at best, you're going to get suboptimal outcomes, and at worst, you're going to do harm. So in terms of these inputs, right?
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Chapter 5: What role does commercial influence play in medical prescriptions?
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It may prevent a heart attack. Yes. If 100 people take it. One. It'll prevent one heart attack. Exactly. So 99 people taking it for five years will have no benefit. Yeah.
So this again comes back to, now, this is just my opinion. It's like, oh, is the CMH just cherry picking statistics here? 2009, Gerd Gigerenze, the director of the Max Planck Institute for health literacy in Berlin. This is the same institution that Einstein taught and trained in. Brilliant guy.
He wrote in a WHO bulletin in 2009, it is an ethical imperative for every doctor to understand the difference between absolute risk reduction, numbers need to be treated, and relative risk reduction. And he said, to protect patients from unnecessary anxiety and manipulation.
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Chapter 6: How can lifestyle changes impact cardiovascular health?
He's exploiting people for his own agenda. He's trying to make money off all nonsense. And that was so relentless.
That they then, um, I, in 2018, I got an, an email from the, the new chair of the Royal colleges saying that the campaign that I had started or was that they had took on and instigated that I was no longer part of that because of, of, of stuff that I apparently said publicly on statins, even though everything in the newspapers that was written about stands for me was coming from medical journals and I was very strong advocate for informed consent.
But again, don't confuse me with the facts. My mind is made up. Well, exactly.
so this is what they do and of course it does have his personal toll and then it culminated coming back to where we started is that because we were having an effect mark and of course you're absolutely doing the same thing one of my inspirations right revolutionaries Mahatma Gandhi and one of his quotes which I love is you know and he took on the system I mean he got British colonialists out of India I mean it almost single-handedly and he says first they ignore you I think Britain was bigger than the pharma companies you know
It was. Absolutely. I mean, America was founded on anti-corporate sentiment, taking on the British East India Company, right? It was a big corporate tyrannical system. And now we've come back to the same problem right now. But what he said was, first they ignore you, then they laugh at you, then they fight you. then you win. Yeah.
So when you're getting attacked, you're getting, you're over the target and you're closing to, you're getting closer to winning, but you have to, it's, it's tough.
It's tough. So let this, so, so essentially this is interesting legal case that we started out with has sort of indicated that you and your colleagues were speaking truth to power. Yeah. So let's get into the details here because everybody's listening. I'm going, yeah, well, my doctor checked my cholesterol and my LDL was high and they recommend a statin. And, um,
Like we said, it's the number one prescribed drug in the world. 75% of the prescriptions are for preventing heart attacks if you've never had one. It's called primary prevention. There's very weak data to show that that actually works, especially for women, especially for over a certain age. There is benefit for people who've had a heart attack, no doubt.
It's not like taking an antibiotic for a stripped throat, but there is a benefit. And let me sort of unpack how you came to go from being a trained cardiologist who basically swallowed the gospel to one who understands and has looked at the literature and has come to a different conclusion. Because it's not just that you're anti-drug or you're anti-medical care, anti-the system.
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Chapter 7: What evidence exists regarding the efficacy of statins?
Never predicted that would happen. But that's where I started from. And when I looked into the issue of obesity, And I concluded that one of the root causes, Mark, if not the main root cause, was this flawed hypothesis that we should have low-fat diets to prevent heart disease. Food industry exploited that, increasing sugar intake, increasing refined carbohydrate intake. It became quite clear.
There was a clear correlation between that change in guidance in the late 70s in the US and early 80s in the UK when the obesity epidemic started to then take its trajectory down the wrong way.
Yeah, and I covered a lot of this in my book, Eat Fat, Get Thin, which we sort of unpacked the whole history of how we got this low-fat craze that led to this high-sugar-starch craze that then led to this dramatic rise in obesity, which now, of course, we're treating with another drug, the GLP-1 agonist, and, you know, just Epatide and some Glutide or Zempic and Majora. It's kind of crazy, right?
You just kind of flipped it upside down.
Chapter 8: How can individuals better understand their heart health?
Oh, absolutely. So when I looked at that, I started looking at the data and spending years and months and years looking at it and looking at different bits of data, I was able to put it all together. And I wrote a piece in the BMJ in 2013 called saturated fat is not the major issue, right?
I read it. That's how I first came across it.
Yeah. And that got a lot of attention, right? It was international news and British news and CNN international and whatever, you know, because obviously suddenly you've got a cardiologist busting this myth that we think butter has been bad for our cholesterol.
But when I did that, okay, so what I looked at the data and it was very clear, there was no clear association with saturated fat consumption and heart disease. So if that's true, then, and we know saturated fat raises LDL cholesterol, that means LDL cholesterol can't be that important. So, and if LDL cholesterol or total cholesterol isn't that important as a risk factor, how does statins work?
But I knew statins had a separate effect to lowering cholesterol, which is their anti-inflammatory and their anti-clotting. And I knew this even, it's well known within cardiology circles. You know, I trained as an interventional cardiologist and that means keel heart surgery, stents, for example. Patient comes in, we didn't even check their cholesterol.
Maybe some of the thinking was the lower the better, which we'll come on to as well. So it doesn't matter what their cholesterol is starting from. The lower your cholesterol, the better.
In fact, 2011, our cardiologist, one of the editors, I think, of the American Journal of Cardiology wrote an article, which I mentioned in my book, A Statin-Free Life, which was entitled, It's the Cholesterol Stupid, right? And what did he say in that? He said, you can be an obese diabetic smoker that doesn't exercise. It sounds crazy, right?
But as long as your cholesterol is low enough, you're not going to get heart disease. That's crazy. Like, really? So, okay, I had to unpick that. And what I also then did moving forward from 2003, so that's how I got down this track, realizing that our obsession with LDL lowering has been a problem.
So you looked at the saturated fat literature and you weren't impressed, and data showed that it didn't seem to be.
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