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]
-
The
editorial presented the results of their own review of a total
of 8 predominantly primary prevention trials
-
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:
- 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?
- HealthCanada.com
-
Updated safety information regarding Crestor®
-
Abramson J, Wright JM. Are lipid-lowering guidelines evidence-based?
Lancet 2007;369:168-169
-
Jauca
C, Wright JM. Therapuetics letter: update on statin therapy. Int Soc
Drug Bull Newsletter. 2003;17:7-9
-
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
-
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
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The
Westin Price Foundation -
Cholesterol and Heart Disease--A Phony Issue By Mary Enig,
PhD