"What You Should Know If You Have High Cholesterol"

cholesterol heart disease Nov 04, 2018

Cholesterol is a natural substance produced in the liver and found in every cell of the body.  

 It has important natural functions for digesting foods, producing hormones, and making Vitamin D. 

 There are two types of cholesterol;

  1. LDL (low-density lipoproteins) also referred to as bad cholesterol that becomes part of plaque build-up along with fat and calcium in the artery.
  2. HDL (high-density lipoproteins) known as good cholesterol because it cleans up the bad cholesterol.

The causes of high cholesterol can be caused by genetics (familial hypercholesterolemia less than ½% and dietary patterns.

If you have high cholesterol there is a good chance your doctor gave you a prescription for a cholesterol-lowering medication called a statin.

Stains are prescribed on the premise of a 34% risk reduction of a heart attack or stroke.

34% sounds like a reasonable risk reduction, right?

Not so fast…

This risk reduction touted by doctors and drug companies is not really the true percentage.

This percentage is called a relative risk reduction.

What does relative risk reduction really mean?

Here is how it works:

Before a medication is approved, drug companies have to submit data from clinical trials for the drug.

Here is the data of a 3.3 year-long trial for the cholesterol-lowering medicine, Lipitor:

5,168 people took 10 mg of Lipitor.

5.137 people took a placebo.

In the placebo group 154 (3.0%) people had either a fatal or non-fatal coronary event.

In the Lipitor group 100 (1.9%) people had either a fatal or non-fatal coronary event.

What the drug companies do is calculate the percentage difference between 3.0% and 1.9%.

1.9% divided by 3.0% equals 34%.

This number is the Relative risk reduction (the percentage of the percentage of the Absolute or ACTUAL risk reduction).

Here is the reality:

3.0% minus 1.9% equals 1.1%. This number is called the Absolute risk reduction (the actual difference).

34% sounds so much better than 1.9%. That’s why the pharmaceutical companies use this sleight-of-hand marketing number.

Another way to look at the trial results:

98.1% of the people on Lipitor had no event.

97% of the people that took the placebo (actually did nothing) had no event.

Why do doctors prescribe these drugs?

Most doctors believe they are doing the right thing based on the information they have.

They get a lot of their information from the army of 72,000 drug reps.

Drug companies spend $24 billion marketing to physicians and health care professionals in the form of meals and payments for speaking or consulting fees. [1]

The range of payments can be anywhere from $13 to $65 million dollars.

If you want to see if your doctor received any compensation from the drug or device industry go to https://projects.propublica.org/docdollars/

Your doctor may not even realize that the 34% Relative risk reduction touted by the drug company is only a 1.1% Absolute (actual) reduction.

Is the training physicians receive in medical school influenced by pharmaceutical and device maker companies?

Over 1,216 teaching hospitals in the US receive money from these companies.

Here are 5 Teaching Hospitals that received the most payments from 2013 to  2016:  [2], [3]

  1. City of Hope National Medical Center - $1.02 billion

  2. Massachusetts General Hospital - $135 million

  3. Hospital of The University of Penna - $96 million

  4. Strong Memorial Hospital - $52.9 million

  5. Cleveland Clinic Hospital - $49.2 million

Former editor-in-chief of the New England Journal of Medicine and currently a corresponding member of the faculty of Global Health and Social Medicine at Harvard Medical School and faculty associate in the Center for Bioethics, Dr. Marcia Angell said this…

“Drug companies support educational programs even within our best medical schools and teaching hospitals, and are given virtually unfettered access to young doctors to ply them with gifts and meals and promote their wares. … This is marketing masquerading as education. … But doctors do learn something from all the ostensible education they’re paid to receive. Doctors and their patients come to believe that for every ailment and discontent there is a drug, even when changes in lifestyle would be more effective. And they believe that the newest, most expensive brand-name drugs are superior to older drugs or generics, even though there is seldom any evidence to that effect because sponsors don’t usually compare their drugs with older drugs at equivalent doses.”

What is taught at these schools?

The training that doctors receive are based on treating symptoms, in this case lowering your cholesterol numbers with medication.

They. like most of us believe in the information from sources like The Center for Disease Control (CDC).

For example, the CDC reported that the percentage of American adults with high total (>240 mg/dL) cholesterol decreased from 18.3% in 1999–2000 to 11.0% in 2013–2014. [4]

At first glance, the news looks good – the cholesterol-lowering strategy is working.

There is more to the story when you dig deeper.

Even though there was a decrease in people with high cholesterol, there has been little or no change in outcomes.

The number of people having a heart attack or stroke has remained fairly steady in the last five years. 

Each year in the US about 795,000 people experience a new or recurrent stroke and 790,000 have heart attacks.  [5]

These numbers are validated by the mere 1.1% absolute risk reduction of heart attack or stroke found in the clinical trials for statins.

 Cholesterol is only one factor for a heart attack or stroke

Your cholesterol number is called a biomarker.

A biomarker is a distinct biochemical, genetic, or molecular characteristic or substance that is an indicator of a particular biological condition or process.

A high cholesterol number is an indicator or risk factor of possible plaque formation leading to a higher risk of a heart attack or stroke.

Plaque occurs when the endothelium (the inner lining of the arteries) becomes damaged.

The endothelium produces nitric oxide, a gas that dilates the arteries for increased blood flow.

Nitric oxide also keeps cellular elements from getting sticky and keeps inflammation from developing in the walls of the arteries preventing plaque formation.

Damage to the endothelium is associated with oil (fat), sugar (juices), fish, fowl, meat, dairy, caffeinated coffee.

It is in parts of the world where the diet is composed of meats, dairy products, eggs and processed and refined foods damage  to the blood vessels occur. [6], [7]

Did you know there was another way to lower your cholesterol and possibly halt or reverse your disease?

 There are doctors who are getting spectacular results in preventing and even reversing heart disease.

While statins reduce your risk of a heart attack stroke or death by only 1.1%, the patients of these doctors are seeing a risk reduction as high as 90%.

Below are a few examples…

In 1985 Dr. Caldwell Esselstyn, a surgeon with the Cleveland Clinic took 24 patients, of which five were told by their cardiologist they would not live out the year. [8]

Six patients dropped out of the program and experienced 13 events, while those in the program had only 1 event.

The person who suffered the event went off the recommendations.

Cholesterol for the people who stayed with the program was lowered from an average of 246 to below 150.

Progression of the disease was either stopped or reversed.

Dr. Esselstyn took another 198 patients and had virtually the same results. [9]

Dean Ornish and others have a stellar track record for halting or reversing cardiovascular disease. These intensive changes in diet and lifestyle reduced LDL cholesterol by 40% (from an average LDL of 143.8 to 86.56 mg/dl) after 1 year in ambulatory patients who were not taking cholesterol-lowering drugs. [10].

California physician and nutrition expert, Dr. John MCDougall is the founder of the McDougall Program that helps patients halt or reverse high blood pressure, heart disease and diabetes

In a study of 1,615 people, who attended The Mcdougall Program reduced their total cholesterol by 12% in only 7 days. [11]

The Pritikin Longevity Center runs a lifestyle program that helps reverse obesity, heart disease, high blood pressure and diabetes has shown a 23% decrease in total cholesterol and 23% drop in LDL cholesterol in 4,487 people in just three weeks.

Dr. Jami Dulaney a cardiologist in Port Charlotte, Florida has not written a statin prescription for 171 patients in a year and eliminated most statins from all but a few patients.

Dr. Pam Popper, founder and President of Wellness Forum Health provides educational programs to consumers and medical providers that assists in informed medical decision-making, diet and lifestyle intervention, and improved long-term health outcomes.

What Do These Treatments Have in Common?

The common denominator in these treatments is addressing causation and not the symptoms - cardiovascular disease starts with damage to the endothelium caused by diet and lifestyle.

The protocol is based in treating the problem with nutrition that mimics the dietary patterns of the healthiest people in the world, such as, Okinawa, The Blue Zones, The Seventh Day Adventists, Papua New Guinea and The Taramahara of Mexico where heart disease is virtually non-existent.

When foods that contribute to poor cardiovascular conditions are eliminated and replaced by the right foods, the body can then begin to heal itself.

This is proven by follow up angiograms that showed the opening of clogged arteries in patients who adopted a healthy dietary pattern.

The best part of this approach is there are no adverse side-effects like the ones from statins such as, joint pain, headache, dizziness, abdominal pain.

Prevention and cure is more than having good biomarker numbers

Everyday people with good numbers die from a heart attack or have a stroke.

Last year, my mother had a cholesterol level of 140 and died of a heart attack!

 What you can do if you want to make a change

If your goal is to get off or reduce your medication (IMPORTANT! You should not stop taking your medications without talking to your doctor).

 Let your doctor know you are changing your lifestyle and you would like their help.

Some doctors will be very receptive and some may push back.

Don’t let your doctor talk down to you or intimidate you.

Present him or her with the information you now have.

You will be taken more seriously if you provide the research.

At the end of this article there are links to the research.  Use the links to get to the studies and print them out and bring them to your appointment.

Also, ask your doc for the studies showing the effectiveness of his recommendations.

They are required to do this.  It’s called Informed Consent.

Informed Consent means your doc or health professional should present you with solid, overwhelming data showing the exact benefits – Absolute vs Relative risks and side effects.

I was given a choice by my cardiologist.

When my cholesterol was 225, he told me I could either go on a pill or start eating better.

I chose not to take pills.  When I changed my eating habits, my cholesterol dropped to 145 and I also lost 44 pounds.

If you are given a hard time maybe it’s time to find a doctor that will help you.

"You don't want to be a dead person with great blood test results"... Dr. Pam Popper

Be your own advocate and take control of your health.

It’s your right!

"If the truth be known coronary artery disease is a toothless paper tiger that need never ever exist and if it does exist it need never ever progress."  Dr.Caldwell Esselstyn

If you would like to learn how to eat like the healthiest people on the planet CLICK HERE.

REFERENCES;

  1. https://www.washingtonpost.com/news/wonk/wp/2015/02/11/big-pharmaceutical-companies-are-spending-far-more-on-marketing-than-research/?noredirect=on&utm_term=.980b987b1050
  2. https://projects.propublica.org/docdollars/teaching-hospitals
  3. http://in-training.org/drugged-greed-pharmaceutical-industrys-role-us-medical-education-10639
  4. https://www.cdc.gov/cholesterol/facts.htm
  5. https://www.heart.org/idc/groups/ahamah-public/@wcm/@sop/@smd/documents/downloadable/ucm_491265.pdf
  6. Bae J-H, Bassenge E, Kim K-B, et al. Postprandial hypertriglyceridemia impairs endothelial function by enhanced oxidant stress. Atherosclerosis. 2001;155(2):517-523. doi:10.1016/s0021-9150(00)00601
  7. Rueda-Clausen CF, Silva FA, Lindarte MA, et al. Olive, soybean and palm oils intake have a similar acute detrimental effect over the endothelial function in healthy young subjects. Nutrition, Metabolism and Cardiovascular Diseases. 2007;17(1):50-57. doi:10.1016/j.numecd.2005.08.008.
  8. Esselstyn CB Jr1, Ellis SG, Medendorp SV, Crowe TD A strategy to arrest and reverse coronary artery disease: a 5-year longitudinal study of a single physician's practice
  9. Esselstyn Jr, Gendy G, Doyle J, Golubic M, Roizen MF. A way to reverse CAD? The Journal of family practice
  10. Ornish D, Scherwitz L, Billings J, Brown SE, Gould KL, Merritt TA, Sparkler S, Armstrong WT, Ports TA, Kirkeede RL, Hogeboom C, Brand RJ. Can intensive lifestyle changes reverse coronary heart disease? 5-year follow-up of the Lifestyle Heart Trial. JAMA 1998;280:2001–2007
  11. Mcdougall J, Thomas LE, Mcdougall C, et al. Erratum to: Effects of 7 days on an ad libitum low-fat vegan diet: the McDougall Program cohort. Nutrition Journal. 2017;16(1). doi:10.1186/s12937-017-0234-9.
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