This podcast episode explores the debate surrounding the causal role of LDL cholesterol in heart disease. Despite the counter-argument that high LDL cholesterol is not a causal factor, the speaker presents strong evidence from epidemiology, clinical trials, and genetics to support the causality of LDL. The complexity of LDL cholesterol and its relationship to heart disease risk is discussed, highlighting the importance of considering other factors and circumstances that can modify its causality. The role of the liver in cholesterol metabolism and its significance in cholesterol-lowering interventions are also examined.