[tsimionescu]

But aren't statins successful in preventing heart disease, in clinical trials?

My understanding was that other classes of medicine that reduce serum cholesterol levels have shown no effects on heart disease in clinical trials.

[ncmncm]

Sadly, no. Statins have been successful at preventing Nth heart attacks, N>1, with some evidence of preventing first heart attacks in people badly at risk, i.e. already with heart disease. It is far from clear how that works.

Vendors have eagerly sought for any hint of evidence of preventing heart disease, or anything else, for decades, and have come up empty. That does not stop physicians from prescribing statins for slightly elevated cholesterol. Pharmaceutical companies love drugs like statins that don't cure anything, so you have to take them every month, forever. They have proven very skilled at manipulating the opinions of medical doctors, e.g. scandalously in the case recent case of opioids.

Making your liver ignore signals to produce the cholesterol your body needs to function is a very bad idea, on par with irradiating your thymus gland when it becomes enlarged (which was done, and recently! Your thymus gland is part of your immune system, enlarged when it is working.)