For people who already have heart disease, lower 'bad' cholesterol (LDL) is linked to lower chances of dying — and going really low, even under 70, doesn’t seem to raise risks. The sweet spot might be around 56 mg/dL.

What we've found so far is that for people who already have heart disease, lower LDL cholesterol levels are linked to lower chances of dying. Our analysis of the available research shows no evidence that very low LDL levels increase mortality risk in this group [1]. We reviewed 59 studies or assertions, all of which support the idea that lower LDL cholesterol is associated with better survival outcomes in people with existing heart disease [1]. None of the evidence we analyzed refuted this pattern. In fact, the data suggests that going below traditional LDL targets—such as dropping under 70 mg/dL—does not appear to raise risks. Some findings point to a possible sweet spot around 56 mg/dL, where benefits may be greatest [1]. We want to be clear: this is what we’ve found based on the current body of evidence we’ve analyzed. We’re not saying very low LDL causes better outcomes, nor are we claiming it’s safe for everyone. We’re reporting that the existing data consistently shows a link between lower LDL and reduced mortality risk in people with heart disease. There are no studies in our current analysis that contradict this pattern. Still, we recognize that evidence can evolve. Our understanding is based on what’s been studied and reported so far—not on a final or complete picture. The takeaway: If you have heart disease, the evidence we’ve reviewed leans toward lower LDL cholesterol being better, with no signal so far that going very low increases your risk of dying. Talk to your doctor about what cholesterol targets make sense for you, based on your overall health and medical history.