Malcolm Kendrick, MBChB
Scottish general practitioner (GP); author and medical blogger
A GP and long-time radical critic of the lipid hypothesis. He argues raised cholesterol is an "unimportant bystander" and proposes an alternative thrombogenic model of heart disease centred on endothelial damage and clotting. His reframing of atherosclerosis as a clot-and-repair process is intellectually interesting even where his rejection of LDL is not accepted.
Position (a lossy summary - the nuance is below)
LDL: benign to causal
-0.95 (strongly toward "LDL benign")
Among the most radical skeptics: argues LDL cannot meaningfully cross the endothelium to cause plaque, that cholesterol reduction does not track clinical benefit, and that heart disease is fundamentally a clotting/repair disorder - a near-total rejection of LDL causality.
Statins: anti to pro
-0.70 (strongly toward "Anti-statin")
Argues any statin benefit comes from pleiotropic (anti-inflammatory, anti-clotting) effects rather than LDL lowering, and is skeptical of the trial evidence for cholesterol-driven benefit.
A radical skeptic whose thrombogenic hypothesis reframes atherosclerosis as damage-clot-repair rather than cholesterol deposition. His emphasis on endothelial and glycocalyx health is interesting; his claim that LDL cannot cross the endothelium is contradicted by transcytosis research.
Key arguments
- LDL cannot meaningfully cross the endothelium, so it cannot be the cause of plaque (disputed by transcytosis research).
- Cholesterol reduction does not correspond well to clinical benefit across trials.
- Heart disease is a clotting/repair disorder (the thrombogenic hypothesis).
Positions on specific claims
- Does LDL cholesterol actually cause heart disease?
Rejects LDL causality; proposes a thrombogenic (clotting) model instead.
Conflicts of interest
Book sales ("The Great Cholesterol Con", "The Clot Thickens") and a popular blog built around the cholesterol-skeptic position.
Fair criticisms
- A GP rather than a cardiologist or lipidologist; critics say he lacks specialist standing to overturn the field.
- His claim that LDL cannot cross the endothelium is contradicted by substantial transcytosis research.
- Mainstream reviewers consider his reading of trial data selective.