Cholesterol

See introduction below. Here is an amazing update in June, 2023:

Cholesterol fraud and statin harm

I just spoke to a cardiologist alum of Carleton College Dr. Dubroff, who sent me topic medical journal articles he has written the past few years showing that cholesterol levels are unrelated to risk of heart disease, that statins do not reduce the risk of heart attacks, and that statins have many harmful side effects that increase the risk of heart disease, cancer, depression, and more. I encourage you to read these and bring them to your physicians.

You may be old enough to recall when ulcers were caused by stress, and we should just learn to relax.  It took 20 years before medicine accepted the discovery that ulcers are caused by a bacterial infection that can be cured by antibiotics, or peptobismol!

Today we are learning that heart disease risk can be reduced by lifestyle change – diet and exercise – NOT by statins, whose use just benefits pharmaceutical companies.  Here is the new evidence. Links are to published medical journal articles:

 

  1. Over the past 10 years cholesterol levels have been falling while the number of Americans dying of heart disease has been steadily climbing. This apparent paradox compels us to question whether lowering cholesterol is the best way to prevent coronary heart disease.
  2. Cholesterol Paradox: a correlate does not a surrogate make: The global campaign to lower cholesterol by diet and drugs has failed to thwart the developing pandemic of coronary heart disease around the world. Some experts believe this failure is due to the explosive rise in obesity and diabetes, but it is equally plausible that the cholesterol hypothesis, which posits that lowering cholesterol prevents cardiovascular disease, is incorrect. The recently presented ACCELERATE trial dumbfounded many experts by failing to demonstrate any cardiovascular benefit of evacetrapib despite dramatically lowering low-density lipoprotein cholesterol and raising high- density lipoprotein cholesterol in high-risk patients with coronary disease. This clinical trial adds to a growing volume of knowledge that challenges the validity of the cholesterol hypothesis and the utility of cholesterol as a surrogate end point. Inadvertently, the cholesterol hypothesis may have even contributed to this pandemic.
  3. Fat or fiction: the diet- heart hypothesis -The preponderance of evidence indicates that low-fat diets that reduce serum cholesterol do not reduce cardiovascular events or mortality. Specifically, diets that replace saturated fat with polyunsaturated fat do not convincingly reduce cardiovascular events or mortality. These conclusions stand in contrast to current testimony to the contrary, a behaviour called confirmation bias. Others have noted the limitations of targeting a single risk factor potentially lead to heart disease. There are several possible explanations. Foremost, we must consider that the diet-heart hypothesis is invalid or requires modification. Moreover, some experts may selectively cite evidence that validates their own viewpoint while disregarding evidence-based medicine opinion and debate.

Over the past 10 years cholesterol levels have been falling while the number of Americans dying of heart disease has been steadily climbing. This apparent paradox compels us to question whether lowering cholesterol is the best way to prevent coronary heart disease. A number of recent studies suggest that cholesterol, specifically LDL- C, may not be a primary risk factor for coronary heart disease and other markers, such as insulin resistance or remnant cholesterol, may be much more important. Furthermore, therapies designed to prevent coronary heart disease by lowering cholesterol with drugs or diet have yielded inconsistent results. Despite the widespread utilization of cholesterol-lowering statins in Europe, observational studies indicate that there has been no accompanying decline in coronary heart disease deaths. This new evidence should give us pause as we try to understand why the campaign to prevent heart disease by lowering cholesterol has not achieved its goals.

  1. The Fallacy of OTC Statin Therapy – The report by Nissen et al (1) confirms that consumers eligible for nonprescription rosuvastatin therapy can be reliably identified through technology-assisted self-selection. Whether over- the-counter statin therapy for primary prevention would positively affect public health is debatable. We already have an over-the-counter preventive therapy for cardiovascular disease that is highly effective, widely available, and has no risk. It is called a healthy lifestyle and was completely ignored in this paper. The simplicity of taking a statin pill is likely to fuel patients’ complacency about being “protected” from heart disease, at the expense of engaging in more protective lifestyle interventions.
  2. The health risk to you from taking a statin– Muscle Pain and Weakness, neuropathy, heart failure, dizziness, cognitive impairment, cancer, pancreatitis, and depression.

Introduction to LDL, HDL, cholesterol

Roc’s conclusion on ideal cholesterol: based on 7 papers reviewed below: Total cholesterol is safest between 210-249 mg/dl.  LDL of 140 seems best. So aim for HDL below 150.  Take antioxidant vitamin C  twice a day and E once a day to minimize ox-LDL.   High triglyerides are harmful. Statins should be avoided unless cholesterol can be maintained at 250, and LDL at 140.

Bathum, 2013 Conclusion. These associations indicate that high lipoprotein levels do not seem to be definitely harmful in the general population. However, high triglyceride levels in females are associated with decreased survival.

Madsen, 2017 Conclusion Men and women in the general population with extreme high HDL cholesterol paradoxically have high all-cause mortality.

Ravnskov_2016 High LDL-C is inversely associated with mortality in most people over 60 years.

Yi_2019_ TC had U-curve associations with mortality in each age-sex group.
TC levels associated with lowest mortality were 210–249 mg/dL

 BMJ 2020: LDL (140 mg/dL) live the longest.

A ratio of TC to HDL below 3.5:1 is considered very good.

From BMJ 2020: Low and high levels of LDL-C were associated with an increased risk of all cause mortality in individuals in the general population. Similar results were seen for cancer and other mortality whereas no association was found for cardiovascular mortality overall. Also, individuals in the general population with a concentration of LDL-C of 3.6 mmol/L (140 mg/dL) live the longest. This finding, if confirmed in more studies, will have important clinical and public health implications.

Vitamin C dose over 700 mg/day reduces heart disease! Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts Paul Knekt et al Am. J. Clinical Nutrition, Dec 2004; 80: 1508 – 1520. Design:A cohort study pooling 9 prospective studies that included information on intakes of vitamin E, carotenoids, and vitamin C and that met specific criteria was carried out. During a 10-y follow-up, 4647 major incident CHD events occurred in 293 172 subjects who were free of CHD at baseline. Results:… Compared with subjects who did not take supplemental vitamin C, those who took >700 mg supplemental vitamin C/d had a relative risk of CHD incidence of 0.75…Supplemental vitamin E intake was not significantly related to reduced CHD risk. Conclusions:The results suggest a reduced incidence of major CHD events at high supplemental vitamin C intakes.

Our results are in agreement with the existing evidence about positive association between statins and vascular calcification. They enlighten to a certain extent the possible mechanisms through which statins may enhance calcium accumulation in arterial wall, namely, by inhibition of vitamin K dependent proteins and functions involved in vascular protection. THIS INDICATES STATINS CAUSE HEART ATTACKS BY CALCIFYING ARTERIES!