A healthy 50 year old male ponders this current ad for Lipitor®. "80% of people who have had a heart attack have high cholesterol" it says. This sounds very persuasive yet it is misleading because it all depends upon your definition of high cholesterol.
During my 23 years of general practice, before the era of cholesterol causality, the normal range of cholesterol was 100 to 300. Then overnight it seems, a new disease was created known as hypercholesterolemia and everyone with a cholesterol level of 200 or higher was afflicted with it.
This was the beginning of what I have come to call the cholesterol craze and the drug companies' progressive development of cholesterol lowering drugs, culminating in 1988 with the statins. Since then the acceptable, lower level of cholesterol has fallen from 200 to 170, then 150 and now 130, so this "80% of people who have had heart attacks have high cholesterol" is now true because nearly all people are "caught" by this newest lower value of 130. At the rate of change seen these past twenty years, soon our acceptable level of cholesterol will be 110 and statin makers will be able to say with complete honesty that almost 100 percent of people who have heart attacks have high cholesterol simply because nearly everyone has high cholesterol if you lower the desirable level sufficiently.
The reality that cholesterol levels are completely normal in more than half of new heart attack cases is what convinced Uffe Ravnskov, MD ( The Cholesterol Myths ) and Kilmer McCully, MD ( The Homocysteine Revolution ) that the theory of cholesterol causation was wrong. It just did not fit the facts.
http://www.spacedoc.com/cholesterol_heart_disease
Dr. G says it well. There is a lot of misinformation about statins. The real risk to manage is out of control blood glucose. If you can stabilize your glucose, you reduce the other symptoms of disease and your risk of contracting them. Not to mention - while you are alive, you live, instead of limping along preserved by statins and other meds.
When a statin commercial says something as banal as "80% of people who have had heart attacks have high cholesterol" you should listen for what that means (nothing, correlation is not causation), as well as for what they do not say - which is that lowering cholesterol has not been proven to reduce all cause mortality. All cause mortality is the only meaningful statistic when evaluating a therapy. Bottom line: statins should only be used for a specific population with specific criteria, not for every SOB with "high cholesterol". Caveat emptor.
During my 23 years of general practice, before the era of cholesterol causality, the normal range of cholesterol was 100 to 300. Then overnight it seems, a new disease was created known as hypercholesterolemia and everyone with a cholesterol level of 200 or higher was afflicted with it.
This was the beginning of what I have come to call the cholesterol craze and the drug companies' progressive development of cholesterol lowering drugs, culminating in 1988 with the statins. Since then the acceptable, lower level of cholesterol has fallen from 200 to 170, then 150 and now 130, so this "80% of people who have had heart attacks have high cholesterol" is now true because nearly all people are "caught" by this newest lower value of 130. At the rate of change seen these past twenty years, soon our acceptable level of cholesterol will be 110 and statin makers will be able to say with complete honesty that almost 100 percent of people who have heart attacks have high cholesterol simply because nearly everyone has high cholesterol if you lower the desirable level sufficiently.
The reality that cholesterol levels are completely normal in more than half of new heart attack cases is what convinced Uffe Ravnskov, MD ( The Cholesterol Myths ) and Kilmer McCully, MD ( The Homocysteine Revolution ) that the theory of cholesterol causation was wrong. It just did not fit the facts.
http://www.spacedoc.com/cholesterol_heart_disease
Dr. G says it well. There is a lot of misinformation about statins. The real risk to manage is out of control blood glucose. If you can stabilize your glucose, you reduce the other symptoms of disease and your risk of contracting them. Not to mention - while you are alive, you live, instead of limping along preserved by statins and other meds.
When a statin commercial says something as banal as "80% of people who have had heart attacks have high cholesterol" you should listen for what that means (nothing, correlation is not causation), as well as for what they do not say - which is that lowering cholesterol has not been proven to reduce all cause mortality. All cause mortality is the only meaningful statistic when evaluating a therapy. Bottom line: statins should only be used for a specific population with specific criteria, not for every SOB with "high cholesterol". Caveat emptor.
I had a 6 heart bypass with normal cholesterol ,plus I never smoked. Yet a friend of mine has cholesterol that is at the max scale of the range , and he smokes. There is nothing wrong with him. Surely something else than cholesterol is the cause.
ReplyDeleteYou are right good levels of cholesterol is not the cause of ill health; infact low cholesterol levels causes ill health, including neuropathy, myopathy (remember your heart is a muscle and Statins cause heart muscle failure or heart failure.).
ReplyDeleteChronic Inflammation is the cause of CVD.
Rising cholesterol is seen in those people who have Hypothyroidism; further CVD is prevelent in those suffering Hypothyroidism; however, those with Hypothyroidism suffer chronic inflammation and it is this which is the cause of their CVD.
If people with rising cholesterol levels are given thyroid hormone their cholesterol levels will drop without the use of Statin drugs. Further, so too will their chronic inflammation levels. In fact they become well and are no longer at risk of CVD, Diabetes, Depression, gynae probs, Sight probs, Liver disease, Osteoporosis and so on and on the list is endless. They become so well they don't need the myriad of other drugs treating their myriad of other symptoms either.
This of course isnt a fact the drug companies want people to know.
CRP or C-reactive Protein is a marker for chronic inflammation; the higher the number the higher the risk.
Homocysteine levels which are raised is another well known marker for CVD; the higher the number the higher the risk.
Cholesterol levels which are raised are not a good enough marker for CVD - however, selling the myth about rising cholesterol level has become exceeding profitable to Drug companies and Drs and processed food companies that it is in their interest to continue the myth and this cycle is a perpetual self serving lie which is dangerous to patients.