Cholesterol fairy home to roost

Bandolier 86 we asked why it was that we have to take our statins (usually) in the evening. We thought it might have been a simple pharmacokinetic explanation (short half-lives meaning that statins were more effective in the evening). Some of you wrote with the half-lives (many thanks), but pointed out that with time this should not matter much, even if cholesterol synthesis was higher at night.

Hard evidence was hard to find. What was required was a large study demonstrating that normal doses of evening statin produced convincingly lower cholesterol levels than normal doses of morning statin. A number of readers sent suggestions about papers we should read, and some of these we had read ourselves.

But even so, no convincing evidence. As best we can understand it, the evidence, such as it is, comes from a single study in Japan done 10 years ago [1]. It is a good study, but it doesn't answer the question.