'Healthy' People Dying After Heart Attack

Most authoritative organisations providing information about heart disease typically list several main risk factors, that they say, need to be managed in order to minimise our risk of dying from a heart attack. Hundreds of millions of dollars are spent every year educating doctors and the general public about these risk factors, such as: high blood pressure, high cholesterol, smoking, diabetes and a family history of heart disease.

However, a recent study published in the Journal of the American Medical Association, found that people who have the above risk factors are LESS likely to die after a heart attack than people who do not have the above risk factors. 

The study included more than 500,000 people who had a heart attack without any previously known  about cardiovascular disease. The researchers also accounted for other influences such as age and weight. 

In this study, the people who had NONE of the above risk factors were 50 percent MORE likely to die after a heart attack, than people with all of those risk factors. 

Some of the people who had these risk factors would have been on medications, so there is a suggestion that these medications may have prevented some of them from dying after the heart attack. In some cases this may be true, however, we know the 'benefits' of medications are all too often exaggerated, so it is impossible to say how much the medications would have influenced the results.

Of course, some of the above risk factors are valid, but overall, this study is telling us that the conventional model of how heart disease develops is fundamentally flawed. 

The conventional view of  cardiovascular disease is very narrow-minded and puts far too much emphasis on risk facts, in particular, risk factors that pharmaceutical companies have medications to treat. 

Cardiovascular disease is caused by a wide range of nutritional, lifestyle and environmental factors. The basic mechanism involves a build-up of inflammation that becomes in effect, out of control. Several nutritional factors are associated with this. Toxins can also damage our arteries. So can infections. In addition, excessive stress and a lack of social support are far more damaging to the heart than an arbitrary cholesterol reading.  This broader understanding of how cardiovascular disease develops is much more scientifically coherent than a short list of profit-driven risk factors. 

References:

Reuters News Story: More "healthy" patients die after heart attacks. November 15 2011

Canto, JG et al. Number of Coronary Heart Disease Risk Factors and Mortality in Patients With First Myocardial Infarction JAMA 2011;306(19):2120-2127

New Study Reminds Us of the Most Fundamental Flaw in the Cholesterol Hypothesis

The American Journal of Cardiology has released a study showing cholesterol levels in America have been declining since 1976. The authors claim that this is due to increased awareness about cholesterol and increasing use of cholesterol-lowering medications. However, there is a problem with this explanation: much of the decline in cholesterol levels happened before the widespread use of cholesterol drugs.

Back in 2005, there was a similar study published in the Journal of the American Medical Association (JAMA). But this study went back and traced cholesterol levels from 1960. When you look at the JAMA study and the more recent one, it is clear that cholesterol levels have been steadily declining regardless of any intervention or public 'health' messages. 

This trend is also seen in countries like the UK, where cholesterol levels were also going down before billions of pounds was spent on cholesterol-lowering.

Governments in developed countries spend billions of dollars each year trying to tackle a fictitious cholesterol problem. All the attention directed towards cholesterol leads us to assume that our cholesterol levels have risen. But it is crystal clear that cholesterol levels have been reducing on their own for the last five decades.

Cholesterol levels are now lower than back in the days when so few people had blocked arteries that doctors didn't even bother to study heart disease. 

The cholesterol hypothesis is nonsense, and a complete waste of more than 100 billion dollars: the more we reduce our cholesterol, the more heart disease we get.

The recent study also showed, unsurprisingly, that obesity has increased. But this has happened while cholesterol levels have gone down. Have you ever felt uncomfortable about the way that cholesterol and obesity are thrown together and described as somehow related? I certainly have. For example, the justification for giving kids cholesterol-lowering drugs is that we have a childhood obesity problem - we have fat kids, so we must feed them toxic cholesterol medications for the whole of their life. Cholesterol is linked with obesity in order to reinforce this illusionary cholesterol problem.

Triglyceride levels are also still increasing according to the study. This is a direct result of the advice people are given to follow a low-fat/high-carbohydrate diet – which has been shown in at least twelve published dietary trials to increase triglycerides.  

Medical Director of the British Heart Foundation Supports Cholesterol Hypothesis

Yesterday there was an article in the Daily Mail newspaper titled Statins: Should You Be Taking Them?

Professor Peter Weissberg attempts to present a case for the use of statins. Professor Weissberg is the medical director of the British Heart Foundation.

The first thing to notice about Professor Weissberg’s comments is that he avoids mentioning any actual data for the benefit of cholesterol-lowering statins.

There are numerous comments made by Weissberg that I would take issue with. For instance, he states that the average cholesterol level in the UK is:

 “high compared to, say, China, where it is 3.2mmol/l and where there are significantly fewer cases of heart disease”

While this comment about China is correct, it should be looked at in the context of other data published by the British Heart Foundation.

 

For example, the average cholesterol level for women in the U.K. is the 12th lowest on a scale of 45 countries. A similar pattern is found for men in the U.K., who are the 15th lowest on the same scale of 45 countries. Despite this, the U.K. of course has one of the highest rates of heart attacks in the world.

Cholesterol levels in the UK have been declining for some time. For example, between 1994 and 2006 the percentage of men aged 65 to 74 with ”high” cholesterol decreased from 87 percent to 54 percent. Despite this, the rate of coronary heart disease for this age group stayed about the same. Other age groups have experienced an increase in the rate of heart disease as the number of people with “high” cholesterol has decreased.

Ticino in Switzerland has the highest cholesterol level of all regions studied in the World Health Organisation MONICA project. The region has the highest percentage of men with cholesterol levels above 7.8mmol/l. They eat more saturated fat than men in the U.K. Yet they have one of the lowest rates of heart attacks. 

Men in Moscow, have one of the lowest rates of high cholesterol, but they have a much higher rate of heart attacks than men in Ticino. 

Men in Glasgow, U.K. have lower cholesterol levels than men in Ticino, but their rate of heart attacks is more than two and half times greater. 

All of this data is published by the British Heart Foundation and is available from their statistics website www.heartstats.org. 

Some time ago the British Heart Foundation published a booklet about lowering cholesterol. This booklet contained a diagram showing that 46 percent of people in the U.K. who had died of heart disease had 'high' cholesterol. Of course, this means that more than half of the people who die of heart disease do not have “high” cholesterol: they have low cholesterol.

Thyroid Medication Tested for Lowering Cholesterol

A study on an experimental thyroid medication that lowers cholesterol levels has just been published in the New England Journal of Medicine. This highlights an important issue and the failings of our current health care system.

We have known for more than 50 years that low-thyroid function increases cholesterol levels. I have mentioned this connection in my book and on this site.

Dr Broda Barnes (the pioneering endocrinologist) frequently saw this connection. He repeatedly found that the correct administration of thyroid hormones lowered cholesterol levels.  

With such a strong and well-established connection, we might expect that people with higher cholesterol levels are urged to consider the possibility of a low-thyroid function. However, in general, they are not. 

The current medical system is so heavily influenced by large powerful pharmaceutical companies that preference is given to interventions that generate billions of dollars for these companies. Even  when less expensive, safer, and more effective treatments are available.

Drug companies have of course known for decades that many of the people they are recommending statins to, don't need statins – they need to fix their thyroid. 

So this week we get a study showing that a thyroid medication lowers cholesterol. But the researchers were clever enough not to use this thyroid medication on its own. They gave one group of people a placebo and the other group the thyroid medication in addition to a statin.

If they used the thyroid medication on its own, the results might indicate that this new medication could be used as an alternative or substitute for statins. 

You can't blame drug companies for trying to show that two medications may be needed instead of one. After all, these companies have to increase profits and grow their business. These commercial pressures remain the same, whether patients benefit from the drugs or not.

Incidentally, this was another study where the researchers only looked at the effect on cholesterol levels without regard to any actual real benefits in terms of actual lives saved or reduced incidence of disease.

An ideal hypothetical conversation:

[Mrs Smith goes to see her doctor for the results of her cholesterol check]

Doctor:  “Mrs Smith, I have the results of your tests and your total cholesterol level is 280 mg/dl (7.2 mmol/l). According to the latest guidelines, your cholesterol level is way too high. However, in reality, we know from the largest study ever done that cholesterol levels can vary between 105 mg/dl (2.8 mmol/l) and 343 mg/dl (8.8 mmol/l) in healthy people without heart disease. So, any cholesterol level within this broad range is normal. We also know that cholesterol is not a reliable indicator of the risk for heart disease. 

However, a significant change in your personal cholesterol level can indicate a problem at another level. I have looked through your records and your cholesterol level two years ago was 220 mg/dl (5.6 mmol/l). This increase in your individual cholesterol level does not in itself increase your risk for cardiovascular disease, however, it may be an indication of a problem with the metabolism of cholesterol or a problem at another level. We are going to work through this together to investigate what might be happening. One possibility is that you have hypothyroidism. We will also take a good look at your diet and lifestyle.“ 

Mrs Smith: “But are you not going to recommended statins to lower my cholesterol and cardiovascular risk?”

Doctor: “Well, billions of dolars have been spent on statin clinical trails. Despite all of this research, there is still no strong evidence that statins benefit women of any age. Within the medical profession there is a general belief that statins will benefit women, but this largely stems from the pre-occupation with lowering cholesterol. There is a general feeling that lowering cholesterol must some-how benefit women, even if this has not been shown in any of the large scale studies. Unfortunately, so many of my colleagues have accepted the supposed 'dangers' of cholesterol without looking at the actual evidence.  If I were to prescribe statins for you, it is extremely unlikely that you will benefit, but highly likely that you will suffer adverse effects associated with the medication.

This list of adverse effects associated with statins is growing all the time. Statins are associated with a greater risk for type 2 diabetes, depression, sleep disturbances, memory loss, sexual disfunction, lung disease, muscle related problems, cognitive loss, neuropathy, pancreatic and hepatic dysfunction. 

Adverse effects can also persist once the drug has been stopped.

Then there are the unknown risks. Within the medical literature, there is a well documented connection between low cholesterol levels and cancer. At least 12 studies have shown this connection. Stain manufacturers have been very keen to dismiss any idea that their products increase the risk for cancer but significant questions remain.

So, no, Mrs Smith, I'm not recommending statins for you.”

Reference: 

Ladenson, PW et al. Use of the Thyroid Hormone Analogue Eprotirome in Statin-Treated Dyslipidemia. New England Journal of Medicine 2010; 362:906-16

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