Conventional Wisdom Still Wrong About Heart Disease

| November 30, 2012 | Comments (1)

This proves to me that conventional wisdom still has it all wrong when it comes to the prevention of heart disease: I encounter a steady stream of people in real life who exhibit a certain set of characteristics: they are men who by all measures are regarded as healthy, apart from the fact that they have ‘raised’ cholesterol. These men can be regular exercisers, be of a good body weight, have no evidence of raised blood pressure or diabetes, but their cholesterol is causing concern. Their doctor may have suggested that they swap cholesterol-reducing margarine for butter and cut back on cheese, eggs and red meat. However, if that doesn’t work (like it hardly ever does), the next step is to go on a statin.

What occurs to me when I see men like this is just how the ‘raised’ cholesterol sticks out like a sore thumb. I really have lost count of the number of men for whom ‘raised’ cholesterol is the only supposed abnormality in their blood markers of health as well as other measurements. How can it be that so many people have so much evidence of good health throughout the body, yet quite consistently fail in this one measure (cholesterol)?

Heart disease and ‘normal’ ranges

Well, one reason has to do with concept of ‘normal’ ranges of bodily substances.

When doctors order blood tests for things like sodium, potassium or thyroid hormones, the individual’s values are normally given alongside the ‘normal range’ for these things. Basically, the normal range is the range of values seen in a ‘healthy’ population of people. The middle of the normal range normally corresponds to the average level of a substance in a population.

However, for cholesterol, normal ranges are not set in this way. The upper level of cholesterol is not represented by the upper end of the normal range in a population. It is decided by panels of people who ‘weigh up the evidence’ and then set an arbitrary ‘upper limit’ of cholesterol over which, we are told, risk of heart disease is raised and efforts should be made to lower cholesterol.

Average cholesterol levels in the UK in men are about 5.5 mmol/l. The ‘recommended’ level of cholesterol is 5.0 mmol/l or lower. So, by definition, more than half of men are going to find themselves being diagnosed with a ‘raised’ cholesterol and at ‘increased risk of heart disease’, however healthy they are.

It should be noted that the upper recommended limit of cholesterol has seen a general downward drift over the years. Of course, as each recommendation is made, more and more people are seen as in need of cholesterol management, and become potential candidates for cholesterol-lowering strategies including statins.

Even if one believes the conventional wisdom around ‘raised cholesterol causing heart disease’ (I don’t), then the real issue men like the ones I describe above are faced with is how much they stand to gain for taking advice to modify their cholesterol. It’s generally assumed that putting downward pressure on cholesterol is inherently good, but what does the evidence show?

Based on the best available evidence:

• Taking dietary steps to reduce cholesterol by cutting back on saturated fat will not reduce the risk of heart disease, heart attack or overall risk of death.

• There is no evidence that eating cholesterol-reducing margarine benefits health.

• Taking a statin will not extend the man’s life by a single day.

• 50-100 men would need to be treated for 5 years to prevent one heart attack (so, only 1-2 per cent of men will benefit from treatment in terms of heart attack prevention).

• Of these 50-100 men, one or more men will develop type 2 diabetes as a result of the statin treatment.

• About 20 per cent or even more of men will develop adverse symptoms such as muscle weakness, fatigue and memory loss.

• Significant numbers of men will suffer from other adverse effects such as liver or kidney damage.

Once we go through the numbers in this way, then most men come to the conclusion that:

1. their cholesterol level is not really ‘raised’ at all.

2. doing something about their raised cholesterol is very unlikely to benefit their health, and quite likely to harm it.

3. they can get on with their healthy lives like before with no need to swallow drugs or highly-processed, chemicalised cholesterol-lowering ‘health’ foods like margarine.

Here’s to a healthy heart

Dr John Briffa
Editor
for The Cholesterol Truth

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Category: Heart Disease

Comments (1)

Testimonials are based on the personal experience of individuals. Results are not typical and the potential benefits of taking any drug or supplement may vary depending on your individual needs and health requirements. Please consult your GP before making any changes to your medical regimen.

  1. Tony Houghton says:

    Hi John

    your paragraph basically describes myself, i am a 48 year old non smoker who has exercised all my life to a reasonable standard. i do cardio at the gym 2/3 times a week, and i now do a lot of serious hiking at weekends (i love it!)

    i have had moderately high blood pressure for over 12 years and neen on ramiprill for this. over the last year i have had 3 blood tests all showing a bad cholestrol reading of about 8.0.

    i have been pressured by three G.P.’S and 2 practice nurses that i must take statins as i am risk of a stroke or worse. i tried to express my concerns about statins and that i believe my lifestyle to be relatively good, and it is only one part of the sum, i went through a questionairre – where i came out with good results on my exercise & diet, but this does not seem to be enough.

    i was refferd to a cholestrol specialist who told me exactly the same and that it is important that i must take statins, she prescribed rosuvastatin 5mg to me, saying they where the rolls royce of statins. very relunctantly i took them – because she can only prescribe 30 tablets, i was told to take 3 a week until i next see her & have a further blood test.

    i went back to my doctor because of a high blood pressure reading at the specialist, it was okay at the G.P’S but he has increased my dosage of ramiprill to 5mg, and again told me i must take the statins even though he is not a “statin doctor”.

    i mentioned to my GP about any further tests to confirm my artery health & he said they where a waste of time. i also said i have been taking coenzyme q10 for a while – he also said they where a waste of time.
    i must say that while i have take q10 i definately have had more energy and have had really good gym sessions (i don’t believe this to be a placebo effect)

    i myself was not concerned about my cholesrol level, as i am quite confident of my own lifestyle, but i have been badgered to the point of death? about this. since taking the statin for the last 3 weeks i struggle with sleeping and have had constipation on the days after taking them. i dont wish to be rude but of the 5 health proffesionals i saw – 3 in my opinion where obese. having read a lot of info about this i wonder if you could offer any advice.

    kind regards

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Testimonials are based on the personal experience of individuals. Results are not typical and the potential benefits of taking any drug or supplement may vary depending on your individual needs and health requirements. Please consult your GP before making any changes to your medical regimen.




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