The New Statin Guidelines: Rolling The Cardiac Dice

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The New Statin Guidelines: Rolling The Cardiac Dice

There is a wonderful scene from the 1955 movie musical "Guys and Dolls, " when the charming rogue Nathan Detroit questions the validity of a pair of dice that big time gambler "Big Julie" has brought to the film's climactic crap game.

ND:  Your own dice?

BJ: I had 'em made especially in Chicago                

ND: But these dice ain't got no spots on 'em.  They're blank.    

BJ: I had the spots removed for luck. But I remember where the spots formerly were.                

ND: You are going to roll blank dice and remember where the spots were?

BJ: Detroit... do you doubt my memory?

OK.  It looks to me like the pharmaceutically-sponsored American Heart Association and College of Cardiology have just removed the spots from the dice.  Never mind what your cholesterol numbers say.  Never mind if you appear to be healthy in every conceivable way.  We know if you are at risk and we'll tell you so, numbers or no numbers.

In the wake of this pronouncement which NY Times science writer Gina Kolata and a chorus of other has decried, I thought it would be interesting to test my own level of risk, as determined by these organizations.  I've done this several times before by looking at my HDL cholesterol and LDL particle size, my triglyceride and blood sugar levels, my homocysteine and c-reactive protein, and most recently, by assessing my magnesium sufficiency, all of which my research has taught me are well known, significant variables that factor into the cardiovascular risk equation.

Nevertheless I decided to try the new, "improved" methodology for calculating my cardiac risk.

I started off by finding the CHD risk calculator that was posted online by the National Institutes of Health (NIH, last updated May 2013).  As requested, I put in my age, my gender, my race, my total cholesterol and HDL and systolic blood pressure, whether I was on blood pressure medication, had diabetes or was a smoker.  The calculator took just a moment to do its calculating:  I was pleased to see that according to the NIH, my risk of having a heart attack in the next 10 years was 3 out of a hundred, or 3%.

Next I googled "CHD risk calculator November 2013" and found the just-released version.   Same questions, same format.  Hmmm.... This time my risk of cardiovascular disease had jumped to 8%.  That's a 267% increase – pretty darn big.  Given that the new "acceptable" level of risk is under 7.5%, that puts me squarely in the population of those that would benefit from a daily statin pill, according to the new recommendations.

Apparently my risk of a heart attack increased almost threefold between October and November and I have joined the ranks of some 45 million Americans who "should" be swallowing statins

There's one problem. I do not believe we should swallow anything quite so readily, be it a statin or a lie. 

In fact, I think we would be a healthier population at large if we took statins out of circulation almost entirely.

Why? Study after study, that is, those not sponsored by Big Pharma,  has found that lowering cholesterol has miniscule, if any effect on subsequent heart disease, and no effect on overall mortality.  From Drs. John Abramson of Harvard Medical School and James M. Wright of the University of British Columbia, we learned almost seven years ago that in a combined review of all published statin drug studies  there was no evidence for a reduction in cardiac mortality 1

Amidst the abundance of confirmatory articles I reviewed, I found a terrific book, The Great Cholesterol Myth (2012) by well-known cardiologist Dr. Stephen Sinatra and nutritionist Johnny Bowden.  Among their findings:

  • The hypothetical link between high levels of total cholesterol and heart disease has never been proven. Rather, it's a convenient diagnosis established by profit-seeking companies in search of lifelong customers.  
  • Cholesterol levels have shown to be weak predictors of heart attacks. Only about 50% of heart attack victims have high cholesterol levels, and 50% of people who have high cholesterol do not have heart disease.
  • Recent studies suggest statin drugs are associated with a higher risk of diabetes,  a major risk factor for heart disease (noted above as elevated blood sugar levels)

For women, high cholesterol actually seems to play no role in heart disease whatsoever, and in the very elderly (>85), cholesterol has been found to be protective ( Low LDL and HDL levels were both associated with a 2- to 3-fold increased risk of dying from an infection.) 2

What's more, statins are known to cause to muscle weakness, fatigue, memory loss and other nasty side effects.

Cholesterol appears to be the ambulance that appears when there is a cardiovascular quandary.  But the evidence for it causing heart attacks is about as unsubstantiated as the evidence for ambulances causing heart attacks.

So what really causes heart disease?  While space prevents a longer discussion of each risk factor, I encourage you to do some research on your own.  Here are your search terms:

  • Magnesium deficiency and heart disease
  • Inflammation and heart disease
  • High blood sugar and heart disease
  • High triglycerides and heart disease
  • Homocysteine and heart disease

Remember, these risk factors are extensively documented and largely manageable in your own hands.  Best of all, they can be modified by simple alterations  to the diet such as the addition of raw nuts, leafy greens, Omega 3 fats, a daily magnesium supplement -  and the avoidance of sugar and refined carbohydrates. 

Keep in mind that you also get to choose who and what to believe.  For my money, I'll pass on the advice of Big Pharma, just as I would not ask the fox for advice on the best way to keep the hens healthy.

In other words, don't let those with vested interests roll a pair of spotless dice for you – better to roll your own, or work with a trusted holistic practitioner to help you find out if you are truly at risk for CHD, or merely a data point in somebody's quarterly earnings expectations.

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References

1.Abramson JWright JM Lancet, Are lipid-lowering guidelines evidence-based? 2007. Jan 20; 369(9557):168-9.

2, Weverling-Rijnsburger, AWE, et al. (2003)  High-density versus low-density lipoprotein cholesterol as the risk factor for coronary artery disease and stroke in old age. Archives of Internal Medicine, July 14; Vol. 163. 1549-54.

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