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Treating Cholesterol with Statin Drugs - treating a problem or creating one?

Statin drugs lower cholesterol levels. Lipitor, a statin drug, is the most widely prescribed drug in the United States. The conversation now is that children should be taking statin drugs. Is a high level of cholesterol actually a problem? Elevated cholesterol levels in the bloodstream are often said to be a potent risk factor for so-called ‘cardiovascular’ disease - something which can ultimately lead to unwanted and potentially fatal events such as heart attack and stroke.[1]

There are two approaches to prescribing statin drugs. Primary prevention is giving someone with no evidence of existing cardiovascular disease but a high cholesterol level a prescription in the hopes of preventing a heart attack or stroke. The second approach is to prescribe them to someone diagnosed with cardiovascular disease. This is referred to as 'secondary’ prevention.

Studies have found that in secondary prevention, statin drugs can reduce the risk of death from cardiovascular events such as heart attacks and strokes. This translates into a reduced risk of overall risk of death, too. So it has been generally assumed that these benefits also apply to the primary prevention setting, but do they really?[1]

In the January 2007's copy of the Lancet, an editorial examined this issue:[3]

  1. The editorial presented the results of their own review of a total of 8 predominantly primary prevention trials

  2. This showed that statin therapy was NOT effective in reducing overall risk of death. The study found that risk of cardiovascular events such as heart attacks and strokes were reduced by statin therapy, but that this amounted to a real reduction to the tune of 1.5 per cent. What is more, 67 individuals would need to be treated for 5 years for just one ‘event’ to be prevented. One of the most startling findings of this review was that there was no apparent benefit seen in women (of any age) nor in men over the age of about 70.[3]

These results are further weakened by the fact that 8.5 per cent of the individuals in these studies were actually in the secondary prevention category. To get a true picture of how ineffective statin therapy and primary prevention really is, it would be necessary to analyze pure primary prevention data separately. That data was not available.1

So who has this data. Well there is a group of scientists known as the Cholesterol Treatment Trialists’ (CTT) collaboration. This group has assessed the data from past studies which include both primary and secondary prevention.[5] These scientists have the data they need to calculate the effect of statin therapy in a purely primary setting. One wonders why they haven’t done this crucially important work.

History suggest this may have more to do with politics and money than patients' health. Back in 2004, a group known as the National Cholesterol Education Program (NCEP) expert panel (in the USA) recommended the acceptable levels of cholesterol was dramatically lowered. After its recommendations were published and accepted as fact, it came out that 8 out of 9 members of the panel had financial links with drugs companies making statin drugs. The report’s publisher, when pressed on this point, described the omission of these clear conflicts of interest as an “oversight”. I’d be inclined to agree with that understatement.

I suppose this wouldn’t matter too much if the recommendations to lower cholesterol upper limits were based on good science. The scientific basis for the recommendations made by the NCEP expert panel was published in the Annals of Internal Medicine in 2006. The authors stated: “In this review, we found no high-quality clinical evidence to support current treatment goals for [LDL] cholesterol”. They went on to say that the recommended practice of adjusting statin dose to achieve recommended cholesterol levels was not scientifically proven to be beneficial or safe [6].

Blood cholesterol levels between 200 and 240 mg/dl are normal. These levels have always been normal. In older women, serum cholesterol levels greatly above these numbers are also quite normal, and in fact they have been shown to be associated with longevity. Since 1984, however, in the United States and other parts of the western world, these normal numbers have been treated as if they were an indication of a disease in progress or a potential for disease in the future. [7]

"To date, none of the large trials of secondary prevention with statins has shown a reduction in overall mortality in women. Perhaps more critically, the primary prevention trials have shown neither an overall mortality benefit, nor even a reduction in cardiovascular end points in women. This raises the important question whether women should be prescribed statins at all. I believe that the answer is clearly no." - Malcolm Kendrick MD[9]

I know this sounds like some kind of blasphemy? Everyone knows high cholesterol is a health problem. If you don't, have your levels treated and see what your doctor says when the levels exceeds the current acceptable "normal" level. What if I told you the most of the people who die of heart attacks have normal levels of cholesterol. So, in the words of Dr. Ladd McNamara, take this statin drug so that we can get your cholesterol level down to the one where most people die. 

Worse than that, statin drugs have a side affect that could be actually worse than what is supposed to be curing. Statin drugs lower your levels of Co-Enzyme Q10. Your muscles require CoQ10 to function properly. Your heart muscle needs it more than any other muscle.

In June 2004, Crestor, a statin drug, issued a Dear Healthcare Professional Letter to advise Canadian healthcare professionals about an association between Crestor and rhabdomyolysis, a rare but serious muscle disorder. Rhabdomyolysis is a condition that results in muscle breakdown and the release of muscle cell contents into the bloodstream. Symptoms of rhabdomyolysis include muscle pain, weakness, muscle tenderness, fever, dark urine, nausea, and vomiting. In severe cases, rhabdomyolysis can result in kidney failure and can be life-threatening.[2][8] No doubt caused by low levels of CoQ10.

Dr. James M Wright of the University of British Columbia, Vancouver, co-author with Dr. Abramson in "Are Lipid-Lowering Guidelines Evidence-Based?", thinks physicians should be honest with their patients about the lack of evidence for the use of cholesterol-lowering drugs in low-risk patients.

Says Dr. Wright: "If you take a male who is 50 years old, a smoker, with high blood pressure, who eats the worst diet in the world . . . then if I were an honest physician, I would tell him that maybe he should be taking a statin. And if he asked how much would that reduce his risk, I would have to tell him that it would only reduce his risk by 2% over the next five years. If he understood that information, he would say, You're expecting me to take a pill everyday for five years? And it's going to cost me two dollars a day? You're crazy! I'm not going to do it." If physicians were truly honest with their patients, the doctor says,"I think there probably would be very few people being treated for primary prevention with a statin drug." [HeartWire Jan. 27, 2007][12]

So now that I have blurred the accepted information in your mind, if cholesterol is not the problem than what is the problem? First off it is the lifestyle we have chosen. We eat too much meat, processed foods, prescription drugs, soda pop, diet soda pop, etc. With that said, according to Dr. Ladd McNamara, "One major factor in maintaining heart and arterial health, is to prevent oxidation. Antioxidants provide a better antioxidant effect than statin drugs, and without side-effects.  Although, treatment with antioxidants are not the standard of care for the treatment of high cholesterol or heart disease, we need to be thinking about maintaining heart health and maintaining cholesterol health.

This is how Dr. McNamara explained it in Minneapolis 'Free radicals attack cholesterol in your blood system. When the free radicals steal electrons from the LDL, it becomes a free radical. This makes it sticky and attracted to the walls of your arteries. And if you homocysteine levels are high from eating excessive animal flesh (meat), that will "rough" up the walls like sandpaper and make the sticky LDL stick more. The result is you have plaque on the walls of your arteries. Over time your immune system can't deal properly with this issue and it build up more and more. More times than not, the first symptom of cardiovascular problems is death from a heart attack. (Read the article on Homocysteine.)

How do you make a difference? Homocysteine levels can be reduced by B Vitamins, Folic acid and Fish Oil. You can also reduce your homocysteine levels by reducing your intake of animal flesh (meat). If you are going to eat meat, eat only the amount your body requires for protein. Americans eat way too much protein. Most cultures consider meat as a side dish, not the main course. Most cultures eat to live rather than live to eat.

Antioxidants are the best means to reduce free radicals. According to Dr. Ray Strand, our current generation is the most under attack one ever from free radicals. Our culture and environment is full of them. We get them the pollution we breathe, the chemicals we have blindly allowed into our nest, our processed food, etc. You can find foods with antioxidants but our current lifestyle is so full of free radicals that you cannot eat your way out. Powerful, pharmaceutical grade supplements of grape seed extract, turmeric, olive extract are the best way to fight for your health.

So who is going to tell the patients

Sources:

  1. DrBiffa.com - Statin drugs shown to be largely ineffective for the majority of people who take them, but why does this fact seem to have passed researchers by?
  2. HealthCanada.com - Updated safety information regarding Crestor®
  3. Abramson J, Wright JM. Are lipid-lowering guidelines evidence-based? Lancet 2007;369:168-169

  4. Jauca C, Wright JM. Therapuetics letter: update on statin therapy. Int Soc Drug Bull Newsletter. 2003;17:7-9

  5. Cholesterol Treatment Trialists’ (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomized trials of statins. Lancet 2005; 366: 1267-1278

  6. Hayward RA, et al. Narrative review: Lack of Evidence for Recommended Low-Density Lipoprotein Treatment: a solvable problem. Ann Int Med 2006;145:520-530

  7. The Westin Price Foundation - Cholesterol and Heart Disease--A Phony Issue By Mary Enig, PhD

  8. Linus Pauling Institute - Coenzyme Q10

  9. BMJ.com - Should women be offered cholesterol lowering drugs to prevent cardiovascular disease? No

  10. NYTimes - New Questions on Treating Cholesterol By ALEX BERENSON, New York Times January 17, 2008 

  11. Dr. Ladd McNamara - The Cholesterol Conspiracy

  12. lewrockwell.com - Who Will Tell the People? It Isn't Cholesterol! by Bill Sardi

Links:

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Cholesterol Friend or Foe? Duane Graveline MD MPH Former USAF Flight Surgeon Former NASA  Astronaut Retired Family Doctor - excellent article on the value of cholesterol to your health and survival. Cholesterol is perhaps the most important substance in our lives.

 

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