Lowering Your Cholesterol Doesn’t Guarantee Good Health

| December 13, 2011

I get a steady stream of emails asking me about cholesterol reduction and which remedies are most effective here. The most recent enquiry concerned what is known as ‘red yeast rice.’ I emailed back saying I didn’t know very much about this agent or its effects on cholesterol. I explained that the impact red yeast rice has on cholesterol is not important – it’s the impact it has on health that counts.

Cholesterol levels are widely recognised as a marker for heart disease, and so the logic goes that reducing cholesterol levels will help prevent this condition. In this case, cholesterol is being used as what is known as a ‘surrogate marker’. The assumption is that a positive change in surrogate marker levels will translate into benefits for health.

However, is this always true? Scientific research yields examples of changes in surrogate markers which have not converted into health benefits. In some cases, the reverse was actually found to be true. For example, recent evidence links aggressive lowering of blood sugar in diabetics with worse health outcomes and an increased risk of death.

So, is cholesterol reduction beneficial to health? The widest view of the impact of any intervention on health is its effect on overall risk of death (also known as ‘total mortality’). Here’s what we know about different therapies and their impact with regards to cholesterol reduction:

1.Drugs called resins reduce cholesterol but do not reduce total mortality.

2. The drug ezetimibe reduces cholesterol but does not reduce total mortality.

3. Dietary change can reduce cholesterol but does not reduce total mortality.

4. Drugs called fibrates improve the ratio of ‘good’ and ‘bad’ cholesterol but don’t reduce overall mortality.

5.Hormone replacement therapy improves the ratio of ‘good’ and ‘bad’ cholesterol but doesn’t reduce overall mortality and increases the risk of cardiovascular disease.

The situation with statin drugs is slightly different. In primary prevention (in essentially healthy individuals) statins do not reduce risk of mortality. In secondary prevention (those who have already had, say, a heart attack or stroke), they do. However, the fact remains that even in high risk individuals, the great majority of people who take statins do not stand to benefit from them at all.

In other words, the ‘magic’ of cholesterol reduction does not seem to materialise in the real world. So how come we’ve managed to get so obsessed with cholesterol reduction rather than what really matters?

Well, there are many likely factors, one being that health agencies and doctors can dole out simple messages and encourage treatments with a defined goal in mind.

However, no doubt there’s been some influence from the pharmaceutical industry here too. Focusing on cholesterol as a surrogate marker, has allowed companies to develop and profit from drugs that have no proven health benefits whatsoever. Even when studies are done which show this, and perhaps show adverse effects on health too (fibrates have been linked with enhanced risk of death in healthy individuals), sales can continue and profits can increase as if there’s nothing at all wrong with this.

Here’s to a healthy heart

Dr John Briffa
Editor
for The Cholesterol Truth



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Category: Latest Cholesterol News, The Great Cholesterol Con, What Doctors Don't Tell You

Comments (2)

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. charlesnesbitt69 says:

    I have never had a heart attack, but a valve replacement. The doctors put me on a statin drug as a precaution. I cut it from one half tablet a day, to one forth, and try to eat better, do a lot of running,P90X exercises, and weightlifting. Also have my blood checked each month by the VA. Cholesterol is great and so is my heart and titanium valve, which was put in, in 2004.

  2. Roger Charlesworth says:

    Red Yeast Rice is apparently just another statin, produced “naturally”.

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