The New Cholesterol Guidelines - Haelan LifeStream Center

Armed with some truth which has been elucidated in the past 3 Journal writings, 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 past decades.

LDL Particle Number and Particle Size

I have written, as have many others, 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 in a specialized lab study that I have used successfully with clients for the past decade.

This lab is called a LipoProfile study and is available now from most community laboratories. This analysis is a study of LDL particle number and LDL particle size.

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”. 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.

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 natural healing intelligence. One only needs to learn how to guide and support this intelligence.

Signing off form Crestone and Beyond.

Related Reading:

Effects of statin therapy on diagnoses of new-onset diabetes and worsening glycaemia in large-scale randomised blinded statin trials: an individual participant data meta-analysis…posted here on 8-10-24 is this important recent publication in The Lancet from March 27, 2024. This study confirms that statins increase diabetes risk, with high-intensity statins raising the risk by 36%. This validates concerns first raised by the 2008 JUPITER trial. Statins may also increase risks of cancer, cataracts and neurological issues. Long-term use is associated with higher pancreatic cancer risk, particularly after five years of use.
The Great Cholesterol Scam and The Dangers of Statins; Exploring the Actual Causes and Treatments of Heart Disease…a June 30, 2024 Substack writing by The Midwestern Doctor, an anonymous author who publishes very well thought out and researched pieces which usually exhaust the subject matter, if not the reader.
Relative Risk Reporting & Statins…posted here on 6-17-23 is a review article calling into question the validity of statin use. “A recent review paper adds to the growing concern over clinical trial data related to the efficacy of statin drugs being reported in a misleading way…As the authors note, the reporting of relative risk rather than absolute risk (thus potentially conveying an overinflated benefit) would not be as problematic if statins were not associated with extensive side-effects, such as new-onset type 2 diabetes, cognitive dysfunction, kidney damage, and myopathy.”
High dose and long-term statin therapy accelerate coronary artery calcification…posted here on 12-9-21. A publication in the International Journal of Cardiology. “Despite a greater CAC increase with high dose and long-term statin therapy, events did not occur more frequently in statin treated patients. This suggests that CAC growth under treatment with statins represents plaque repair rather than continuing plaque expansion.” At the end of this abstract is a listing of similar articles.
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…another website writing on this subject.
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.
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.
45 Habits Cardiologists Wish Everyone Would Follow…cardiologists may be wising up. Did the cardiologist described in reference # 16 follow these bits of advice? Everything in this collection of recommendations is good. However, #16, getting annual flu vaccinations is highly questionable. Vaccinations carry significant risks. See this article about vaccine safety, from the same day as this cardiologist recommendation article, which is 12-16-17. I have not had a vaccination since I received my 5 childhood vaccinations in the 1950s.
Curcumin enhances cholesterol-lowering effects of phytosterols in patients with dyslipidemia…Designs for Health has excellent curcuminoid and phytosterol compounds which are linked in this article. I have used these compounds successfully in treating lipid derangements.
25 Most Dangerous Drugs…this is from mainstream MSN
Cholesterol: New Benefits for This Old Friend–Yes, Friend!…benefits of cholesterol are explained per recent research, posted here on 6-2-18.
High cholesterol in late life may mean better brain health…a study of older people has found that having a total cholesterol level higher than it was in midlife is tied to a lower risk of marked cognitive decline in those aged 85–94.
The 6 Greatest Cholesterol Myths Debunked…cholesterol is an essential molecule for our health.
Seemingly Straightforward Study on Cardiorespiratory Fitness and Mortality Raises New Questions About Cholesterol…more information here which supports ongoing reexamination of the cholesterol question.
New Questions About the Role of LDL-C in Cardiovascular Disease…posted here on 12-9-18, this summary explains new doubts about the currently prevailing status quo medical industry shortsightedness regarding statin use in treating LDL.
Red Yeast Rice: Benefits, Side Effects, and Dosage…red yeast rice is the natural substitute I recommend when cholesterol needs to be lowered. It works well.
Red Yeast Rice–Lower Cholesterol Naturally…in this short article from Designs for Health, dated 2-15-19, several lines of research are presented which attest to the efficacy and safety of red yeast rice as a treatment to lower cholesterol.
Statins Archive…a compendium of writings from Chris Kresser whose research based analytical mind is well honed and critically developed to cut through misinformation of all sorts.
Associations of statin use with glycaemic traits and incident type 2 diabetes…a study published in the British Journal of Clinical Pharmacology in March, 2019, concludes: 1) there was no association between statin dose and diabetes risk, since even people on low doses of statins were at increased risk, 2) the increase in diabetes risk while taking statins was significantly higher in those who were overweight or obese (which now constitutes more than two-thirds of the U.S. population), and 3) the longer patients took statins, the higher their risk of diabetes….Instead of prescribing statins as first-line therapy for high cholesterol, maybe clinicians should prescribe diet and lifestyle change and then provide the support necessary (e.g., nutritionists, health coaches, personal trainers) to make it possible for patients to succeed with these changes.
Is There Really a Connection Between Egg Consumption & CVD?…posted here on 4-18-19, this article critically analyzes a recent attempt to misinform the general public about the health benefits of eating eggs.
Statins Work…for Less Than Half of Patients…more negative information about a bad drug.
Should We Be “Targeting” LDL With Statins?…a 6-1-19 article on the controversy.
Looking at Cholesterol and Parkinson’s Disease…posted here on 12-15-19, this article raises important points about cholesterol and brain health.
The Truth about Statin Drugs…Chris Kresser has a new comprehensive writing on the subject, posted here on 1-24-20.
Red Yeast Rice–Support normal cholesterol…”unlike pharmaceuticals that can’t boast of additional health-promoting components, RYR also delivers polyketides, unsaturated fatty acids, phytosterols, pigments, and at least 13 different types of monacolins. Besides lowering cholesterol, it reduces blood pressure and has been shown to have anti-inflammatory, antidiabetic, anticancer, and osteogenic properties. Collectively, these additional benefits of RYR make it shine as a beneficial nutraceutical for cardiovascular health.”
10 Facts About Cholesterol and Why a Personalized Approach is Best…posted here on 2-11-21. This article is based on the evolving science of nutrigenomics. This one comes from the people at mygenefood.com, which is a service that analyses genetic information to determine one’s best diet type from a selection of 20 diet types. This article is informative about 10 key points about cholesterol.