Armed with the truth which has been elucidated in the past 3 articles, I hope that the reader can discern the propaganda campaign recently espoused (in early November, 2013) by the American Heart Association and the American College of Cardiology, who announced “new treatment guidelines calling for a focus on risk factors rather than just cholesterol levels.”
The American Heart Association has a calculator for the risk factors on their website. You can go check it out if you want to, and there is a link to the calculator in the writing below.
I want to register some points regarding this new medical industry and Big Pharma effort to disempower your health accountability knowledge, intelligence, and practices; and also assist their bottom line.
The current generic mainstream laboratory cholesterol limits of normal were always utterly inadequate, and the new risk guidelines are even more misleading. I have attempted to clarify these issues in the previous 3 Journal entries. Please bear in mind that cholesterol is a high priority molecule for a healthy life for all of the reasons that every cell in your body is very intelligent about.
The current/former lab numbers which usually trigger the physician to write a statin prescription are: total cholesterol of over 200, an HDL of 60 or below, and an LDL that is above 100. This may be all of the scrutiny applied by a physician in the consideration of writing the mainstream medical statin prescription; thus retaining patient referrals, and placating physician’s overblown malpractice fears. Patients move along out of the office quicker and quicker these days….the doctors are on a compressed timeline and there is an overhead to finance.
The electronic medical record monster used by your physician to record medical data about you must also be fed. The face to face and the human to human interface in the doctor-patient relationship is dissolving, and it may disappear altogether some day.
As Voltaire said back in the 1700’s, “Doctors are men who prescribe medicines of which they know little, to cure diseases of which they know less, in human beings of whom they know nothing.”
I concur with Voltaire’s 300 plus year old assessment. It seems to still be a valid assessment. I might add that doctors know so little of human beings perhaps because they know so little of themselves and the Divine Intelligence which lives in all of us. The medical industry seems intent on ignoring and overriding this Divine Intelligence of healing in its attempts to “outsmart” it.
The new guidelines for your future statin use include such considerations as: 1) diabetes, 2) evidence of heart disease, 3) so called “bad cholesterol” of greater than 190 (this is usually a congenital lipid metabolism disorder; a legitimate concern), and 4) a 10 year risk factor of greater than 7.5%.
In addition to these 4 guidelines, the 10 year risk is a “potpourri” which includes considerations like one’s blood pressure, family history, and a consideration of factors from the old Framingham Study of yore.
Spinning Misinformation with Celebrities
The corporate pharmaceutical, medical, and the mainstream media machines have recently tapped into a personality paragon of popularity and believability who is a “big influencer.” We have all seen this kind persona. This nice man is one of the voice pieces being used to announce to a hoodwinked public the new and supposedly wholesome cholesterol guideline movement.
People Magazine’s 2003 Sexiest Man Alive, practicing neurosurgeon Dr. Sanjay Gupta, M.D., has been reeled in by his mainstream journalistic employers at CNN and has been well paid to prop up this Big Pharma campaign with his charming smile, presence, and spoken words.
From CNN’s Health News broadcasts you can see a description of the new guidelines and CNN’s well paid health correspondent, Dr. Sanjay Gupta, M.D.’s commentary and explanations here.
After this article you can peruse the over 4700 comments from readers who are your peers. Please take a tour through some of this commentary from discriminating people.
Please bear in mind and consider the estimate that these new guidelines will increase statin usage in America from the current number of about 35 million users to some 72 to 79 million users. Imagine that as you contemplate the many objective studies which show no significant benefit of statin use except in a small population of users. And please consider the numerous negative side effects of statin usage.
LDL Particle Number and Particle Size
I have written, as have many others who are wiser than I, about the risks of statin usage. You can peruse the 3 prior Journal entries for a fair and broad perspective. You can also learn about advanced blood testing for cholesterol particle number and particle size from a laboratory that I have used successfully with clients for the past decade.
This lab is called LipoScience (www.LipoScience.com) and the important refined studies offered there, among others, is a LipoProfile study of LDL particle number and LDL particle size.
Another very good laboratory offering for the study of cholesterol particles, particle size, and other important cardiovascular health parameters is SpectraCell Laboratories which you can visit at www.SpectraCell.com. The Lipoprotein Particle Profile is a good study, as are their various add-on tests.
In addition to these 2 lab services, there are now another of other labs which offer this kind of analysis and so you have multiple choices available to inquire about and use.
In brief, LDL particle number which is high and particle size which is small confers greater atherosclerotic risk. On the contrary, LDL particle number which is low and particle size which is large confers lower risk. As you can imagine there are intermediate gray zones in these particle size and number extremes, and so there are other advanced lab variables to consider in assessing individual and unique patient chemistries.
It’s important to realize that statin drugs, while aggressively lowering your cholesterol levels, do not modulate LDL particle size. What’s worse, statin drugs in and of themselves actually promote inflammation and accelerate heart disease. A 2012 study published in the journal Atherosclerosis showed that statin use is associated with a 52 percent increased prevalence and extent of calcified coronary plaque compared to non-users. Coronary artery calcification is the hallmark of potentially lethal heart disease.
As a general rule, regardless of your LDL particle number, chances are you do not need a statin drug to address high cholesterol. The only people who may truly benefit from a statin drug are those with the genetic defect called familial hypercholesterolemia. The only way to make sure your LDL particles are large enough to not get stuck and cause inflammation and damage is through your diet and lifestyle.
A Similar Viewpoint and Analysis of the New Guidelines
I direct the reader’s attention to functional medicine expert Chris Kresser’s well thought out viewpoints which explain some of the fallacies with the new cholesterol recommendations. The title of his article, published on November 22, 2013 is “3 reasons Why You Should Be Skeptical of the New Cholesterol Guidelines.”
I have reprinted his article below, and you can also see it on his website here.
Here is Kresser’s commentary:
“I’m sure you’ve heard by now that the leading heart organizations in the U.S. have released updated treatment guidelines for cholesterol-lowering drugs (statins). The changes include discarding the specific numerical targets that have been used to monitor treatment for decades and recommending a statin for everyone with a 10-year risk of heart attack or stroke of 7.5% or higher, as determined by a new risk calculator.
The new guidelines have received a lot of media attention of the past several days, including criticism from no less than the former president of the American College of Cardiology. I’m happy to see this, because as I will argue in this article, the new guidelines are problematic and would put millions at risk due to unnecessary and prolonged treatment with statin drugs.
Here are 3 reasons why you should be skeptical of the new cholesterol and statin guidelines.
#1: They dramatically overestimate risk
Two Harvard Medical School professors, Dr. Paul M. Ridker and Dr. Nancy Cook, have pointed out that the new risk calculator overestimates risk by 75 to 150 percent, depending on the population. (1) For example, a man whose risk was actually 4 percent might show up as having an 8 percent risk—which would move him from the “no treatment recommended” group to the “prescribe a statin” group.
Dr. Steven Nissen, a former president of the American College of Cardiology, entered information for some hypothetical patients into the new risk calculator to see what it would recommend. He was shocked to find that the calculator showed a risk of 7.5 percent for a 60 year-old healthy African-American non-smoking male with no risk factors, a total cholesterol of 150, HDL of 45, and systolic blood pressure of 125. He also found that the calculator suggested a risk factor of 7.5 percent for a 60 year-old healthy white male with no risk factors. If we use this new calculator, Dr. Nissen said, it would lead to almost all healthy men over the age of 60 getting treated with a statin, even if they’re in the lowest-risk group. (2)
#2: They’re based on flawed, incomplete, or outdated evidence
In an excellent paper in the journal Mayo Clinic Proceedings, Dr. Allan Sniderman and colleagues argue that so-called “evidence-based medicine” is problematic because of limitations in the evidence used as the basis of treatment guidelines and recommendations. (3) As an example, he points to the role of statins in primary prevention (i.e. prescribing statins to healthy people without pre-existing heart disease as a means of preventing it). Most doctors now believe that the highest doses of statins are the best choice solely on the basis of a single meta-analysis (an analysis of several individual studies) that involved 5 dose-comparison studies. However, as Dr. Sniderman points out, the meta-analysis is flawed and does not support the conclusion that higher doses of statins are more effective than lower doses for prevention of heart disease in healthy people.
Another problem is that treatment guidelines are often based on outdated evidence. This turns out to be the case with the new risk calculator, which uses data from studies performed two decades ago to determine how risk factors like cholesterol and blood pressure predict actual heart attacks and strokes later in life. Data from these studies are no longer valid because the participants are from a different era with different behaviors and risk. For example, in the early 1990s more people smoked and heart attacks and strokes occurred earlier in life.
#3: They’re subject to conflicts of interest
Numerous studies have shown that conflicts of interest are a real problem in scientific research. (4) According to Lisa Cosgrove, an associate professor at the University of Massachusetts, “When individuals have commercial ties they are vulnerable to developing subtle, but sometimes powerful, pro-industry ways of thinking.” (5) Dr. David Antonuccio put it even more plainly in his excellent article “Antidepressants: A Triumph of Marketing Over Science”:
Company-sponsored experts, whether they are researchers or educators, are by definition company employees. They will be retained only if they offer consistently favorable treatment to the company’s products.
This explains why groups like the Institute of Medicine recommend minimizing or eliminating conflicts of interest in guideline development groups. They wrote that, “whenever possible, guideline development group members should not have conflicts of interest… and the chair or co-chairs should not be a person(s) with conflicts of interest.” (6)
The American Heart Association and American College of Cardiology did not follow the sensible recommendation of the Institute of Medicine when they assembled their expert panel. Of the 15 panelists that authored the new guidelines, 6 reported having recent or current ties to pharmaceutical companies that sell or are developing cholesterol-lowering medications. Among the companies listed are Merck, Amgen, AstraZeneca, Pfizer, Amarin, Roche, and Abbot Laboratories. (For a full list of disclosures, see page 51–57 of the new guidelines.)
Strangely enough, I’ve seen some people criticizing the idea that conflicts of interest would affect statin prescriptions because most statins are no longer protected by patent are thus not profitable for drug manufacturers. Nothing could be further from the truth. Over the past 5 years, statin prescriptions in the U.S. have grown 20 percent to 264 million a year (a shockingly high number in a country with a population of 314 million). Total global sales of cholesterol-lowering medications, including statins, were $35 billion in 2012. Statin sales amounted to $29 billion worldwide and $10 billion in the U.S. (7) Those are enormous figures. In fact, statin drug sales account for approximately 10% of all drugs sold in the U.S., with a single statin (Lipitor) generating almost $8 billion in sales alone. (8) I think it’s pretty safe to say that drug companies are making a killing selling statins.
30 years ago the then-CEO of Merck (Harry Gadsen) told Fortune Magazine that he wanted Merck to be more like chewing gum maker Wrigley’s. It had long been Gadsen’s dream to make drugs for healthy people so that Merck could “sell to everyone”. (9) If implemented, these new cholesterol guidelines would certainly help Gadsen’s vision to become a reality.
Fortunately, it appears that the guidelines as currently designed won’t be accepted due to serious flaws that have been pointed out by leading cardiologists around the country. In the meantime, if you’re wondering what to do (or not do) about high cholesterol, make sure to read my recent series called The Diet-Heart Myth.”
Crestone and Beyond
At some point in the near future, I believe the pandemic of statin use will be viewed as a fallacy, a malpractice, and a Big Pharma play. It is already viewed as such, in the opinion of many.
Here is another opinion from a popular and well informed source.
People should educate themselves from good sources and become critical and discerning thinkers in order to escape the pitfalls of the medical industry and its pharmaceutical overlord, and become self accountable to the development and maintenance of their own health.
There is no way to outsmart our innate Divine healing Intelligence. One only needs to learn how to guide and support this Intelligence.
Signing off form Crestone and Beyond.
- Independence Day for Cholesterol Misinformation…a July 4, 2013 writing on this website about cholesterol truth and non-truth.
- Revisiting Cholesterol…more good information on cholesterol with a variety of references.
- Revisiting Cholesterol, Part II…this website writing features an interesting video from The Catalyst.
- Statins stimulate atherosclerosis and heart failure: pharmacologic mechanisms…how statin drugs derange important life chemistry.
- Here is further elucidation and clarity on Big Pharma’s intention to misguide you…from the website of Dr. Malcom Kendrick, M.D., please read this article.
- New study recommends statin use for the primary prevention of cardiovascular disease…a new study from 11-14-16, published in JAMA calls for the use of statins in a preventative fashion. The authors advocate the use of low to moderate dose statins in adults ages 40 to 75 years without a history of cardiovascular disease (CVD) who have one or more CVD risk factors (dyslipidemia, diabetes, hypertension, or smoking) and a calculated 10-year CVD event risk of 10% or greater. Read this article to understand the mistaken thinking about what is being promoted here, and the other important concerns, such as vitamin K2, which the medical industry currently ignores.
- Cholesterol Buzz…a fresh consideration of dietary cholesterol consumption vs. consumption of other types of foods which create oxidative stress, inflammation, and vascular endothelial dysfunction.
- An excellent update from Chris Kresser on 2-3-2017…The Functional Medicine Approach to High Cholesterol
- Coronary Artery Calcium: Better Indicator for Cardiovascular Risk?, posted here on March 24, 2017. This article presents a case for Coronary Artery Calcium (CAC) scanning, also known as Electron Beam Coronary Tomography (EBCT), to evaluate those who already have coronary calcification in progress as an important risk determinant to be used in guiding statin therapy recommendations.
- Why Has the American Approach to Heart Disease Failed, posted here on April 21, 2017.
- The Cholesterol Myth Has Been Busted–Yet Again, posted on May 3, 2017…recommended.
- Statin Drugs: Worse Than We Thought?…this is an important briefing, posted on May 12, 2017.
- LDL is Your Friend…an article by holistic neurologist David Perlmutter, M.D. citing a 2014 study published in the prestigious journal Neurology.
- Experts Warn Statin Drug Trend Puts Lives at Risk…an opinion from the Mercola website, August 9, 2017, nearly 4 years after this Journal entry was originally posted here.
- Multivitamins Improve Heart Function–But Only if You Don’t Take Statins…statins cause problems that all users should educate themselves about.
- American Heart Association President Suffers Heart Attack at Age 52…was he following the advice of the AHA?