Lowering bad cholesterol really aggressively helps prevent heart attacks and strokes in people who already have heart disease, but it doesn’t actually help them live longer — which scientists call the 'cholesterol mortality paradox'.

Lowering bad cholesterol really aggressively might not help people live longer because while it prevents heart attacks, it could also cause other problems that balance things out.

If you have high 'bad' cholesterol, lowering it more aggressively can help you live longer, especially if your levels are really high to begin with. Doctors should decide how hard to treat based on how high your cholesterol is and your overall heart risk.

If your 'bad' cholesterol is 100 or higher, lowering it more aggressively helps prevent heart-related deaths. But if it's already below 100, lowering it even more doesn't seem to help much — there might be a cutoff where treatment stops adding extra benefit.

Doctors shouldn't automatically put everyone on strong cholesterol-lowering treatment after a heart problem—instead, they should talk to each person and decide together based on their unique situation and what they want.

If you've already had heart problems, keeping your 'bad' cholesterol really low—below 55—might help prevent future heart attacks or strokes compared to aiming for a higher level.