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Level -> Cholesterol and statins (1/19/2008 7:22:40 PM)
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People with high cholesterol live the longest. This statement seems so incredible that it takes a long time to clear one´s brainwashed mind to fully understand its importance. Yet the fact that people with high cholesterol live the longest emerges clearly from many scientific papers. Consider the finding of Dr. Harlan Krumholz of the Department of Cardiovascular Medicine at Yale University, who reported in 1994 that old people with low cholesterol died twice as often from a heart attack as did old people with a high cholesterol.1 Supporters of the cholesterol campaign consistently ignore his observation, or consider it as a rare exception, produced by chance among a huge number of studies finding the opposite. But it is not an exception; there are now a large number of findings that contradict the lipid hypothesis. To be more specific, most studies of old people have shown that high cholesterol is not a risk factor for coronary heart disease. This was the result of my search in the Medline database for studies addressing that question.2 Eleven studies of old people came up with that result, and a further seven studies found that high cholesterol did not predict all-cause mortality either.
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For almost forty years, the lipid hypothesis or diet-heart idea has dominated medical thinking about heart disease. In broad outlines, this theory proposes that when we eat foods rich in saturated fat and cholesterol, cholesterol is then deposited in our arteries in the form of plaque or atheromas that cause blockages. If the blockages become severe, or if a clot forms that cannot get past the plaque, the heart is starved of blood and a heart attack occurs.
Many distinguished scientists have pointed to serious flaws in this theory, beginning with the fact that heart disease in America has increased during the period when consumption of saturated fat has decreased. "The diet-heart idea," said the distinguished George Mann, "is the greatest scam in the history of medicine."And the chorus of dissidents continues to grow, even as this increasingly untenable theory has been applied to the whole population, starting with lowfat diets for growing children and mass medication with cholesterol-lowering drugs for adults.
But if it ain't cholesterol, what causes heart disease? We don't know enough to say for sure but we do have many clues; and although these clues present a complicated picture, it is not beyond the abilities of dedicated scientists to unravel them. Nor is the picture so complex that the consumer cannot make reasonable life-style adjustments to improve his chances.
http://www.westonaprice.org/moderndiseases/hd.html
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The Cause Of Heart Disease: High Cholesterol or Excess Calcium?
by Eric Jacobson
The cholesterol controversy has been waged now for over five decades. Volumes of books, articles, and journals have been written on the subject of the role cholesterol and diet plays in the arterial disease process.
Since the 1950's the "Lipid Hypothesis," also known as the "Diet-Heart Idea", states that saturated fat and high cholesterol play a major role in the causation of atherosclerosis and cardiovascular disease, and gained increasing support from the majority of the medical and scientific communities.
But over the last two decades, with marked advances in science and technology, the most recent research into lipid chemistry and coronary pathology are revealing that the "lipid theory" or "diet-heart" hypothesis might not be as definitive as once thought as being the major cause of coronary heart disease.
In fact, much of the latest research that has been done on cholesterol shows just how vital a role this group of fats, called sterols, really are to every cell, nerve, and major organ of the body.
http://www.newstarget.com/022398.html
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Martin Winn's cholesterol level was inching up. Cycling up hills, he felt chest pain that might have been angina. So he and his doctor decided he should be on a cholesterol-lowering medication called a statin. He was in good company. Such drugs are the best-selling medicines in history, used by more than 13 million Americans and an additional 12 million patients around the world, producing $27.8 billion in sales in 2006. Half of that went to Pfizer (PFE) for its leading statin, Lipitor. Statins certainly performed as they should for Winn, dropping his cholesterol level by 20%. "I assumed I'd get a longer life," says the retired machinist in Vancouver, B.C., now 71. But here the story takes a twist. Winn's doctor, James M. Wright, is no ordinary family physician. A professor at the University of British Columbia, he is also director of the government-funded Therapeutics Initiative, whose purpose is to pore over the data on particular drugs and figure out how well they work. Just as Winn started on his treatment, Wright's team was analyzing evidence from years of trials with statins and not liking what it found.
Yes, Wright saw, the drugs can be life-saving in patients who already have suffered heart attacks, somewhat reducing the chances of a recurrence that could lead to an early death. But Wright had a surprise when he looked at the data for the majority of patients, like Winn, who don't have heart disease. He found no benefit in people over the age of 65, no matter how much their cholesterol declines, and no benefit in women of any age. He did see a small reduction in the number of heart attacks for middle-aged men taking statins in clinical trials. But even for these men, there was no overall reduction in total deaths or illnesses requiring hospitalization—despite big reductions in "bad" cholesterol. "Most people are taking something with no chance of benefit and a risk of harm," says Wright. Based on the evidence, and the fact that Winn didn't actually have angina, Wright changed his mind about treating him with statins—and Winn, too, was persuaded. "Because there's no apparent benefit," he says, "I don't take them anymore."
Wait a minute. Americans are bombarded with the message from doctors, companies, and the media that high levels of bad cholesterol are the ticket to an early grave and must be brought down. Statins, the message continues, are the most potent weapons in that struggle. The drugs are thought to be so essential that, according to the official government guidelines from the National Cholesterol Education Program (NCEP), 40 million Americans should be taking them. Some researchers have even suggested—half-jokingly—that the medications should be put in the water supply, like fluoride for teeth. Statins are sold by Merck (MRK) (Mevacor and Zocor), AstraZeneca (AZN) (Crestor), and Bristol-Myers Squibb (BMY) (Pravachol) in addition to Pfizer. And it's almost impossible to avoid reminders from the industry that the drugs are vital. A current TV and newspaper campaign by Pfizer, for instance, stars artificial heart inventor and Lipitor user Dr. Robert Jarvik. The printed ad proclaims that "Lipitor reduces the risk of heart attack by 36%...in patients with multiple risk factors for heart disease."
So how can anyone question the benefits of such a drug?
For one thing, many researchers harbor doubts about the need to drive down cholesterol levels in the first place. Those doubts were strengthened on Jan. 14, when Merck and Schering-Plough (SGP) revealed results of a trial in which one popular cholesterol-lowering drug, a statin, was fortified by another, Zetia, which operates by a different mechanism. The combination did succeed in forcing down patients' cholesterol further than with just the statin alone. But even with two years of treatment, the further reductions brought no health benefit.
http://www.businessweek.com/magazine/content/08_04/b4068052092994.htm
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