Some common sense about cholesterol from a conventional doc goes down in flames
Oh! So close!
It started out so good…
Here’s the first line from a recent HealthDay News report: “Treating multiple factors that contribute to heart attack risk is better than simply focusing on lowering a patient’s cholesterol level, according to U.S. researchers.”
Refreshing? Yes!
Long overdue? Absolutely!
Could it really be? Has a mainstream study, appearing in Annals of Internal Medicine, finally worked past decades of misinformation about the dubious cholesterol/heart disease link?
Tailor-made
“We’ve been worrying too much about people’s cholesterol level and not enough about their overall risk of heart disease.”
That levelheaded quote is a surprise, coming from a professor of internal medicine (University of Michigan Medical School), who is also director of the Veterans Affairs Center for Health Services Research and Development.
His name is Dr. Rodney A. Hayward, and he led the Annals of Internal Medicine study that inspired him to add this remark: “Our fixation on just one factor, LDL cholesterol, is leading us to often treat the wrong people.”
Well, welcome to the conversation, Dr. Hayward! I mean, you’ve got to like a conventional physician who appears to be bucking the system and shouting “Enough!” to the insane overuse of statin drugs.
Dr. Hayward and his team examined several statin trials conducted between 1994 and 2009. They focused on two different treatment approaches: 1) “Treat-to-target”–an approach that uses statins to force LDL cholesterol to less than 70 for high-risk patients and no higher than 130 for people not at risk 2) “Tailored treatment”–an approach that gives far less importance to LDL level, while weighing multiple risk factors to develop a variety of treatments including exercise, diet modification, etc.
Results showed that tailored treatment prevented more coronary artery disease events while treating fewer subjects with high-dose statins. The authors wrote: “No circumstances were found in which a treat-to-target approach was preferable to tailored treatment.”
In a University of Michigan press release, Dr. Hayward said, “The bottom line message–knowing your overall heart attack risk is more important than knowing your cholesterol level.”
And if only–IF ONLY–he had just stopped talking right there, we’d have a happy ending.
But he didn’t. He added: “If your overall risk is elevated, you should probably be on a statin regardless of what your cholesterol is and if your risk is very high, should probably be on a high dose of statin.”
D’oh! Right! Off! The rails!
Come on, Dr. Hayward! After the results of your study, after making so much sense, why in the world would you recommend a statin? Even when cholesterol is LOW? Just because risk is ELEVATED? Complete nonsense!
Here’s HSI Panelist Allan Spreen, M.D., sharing one of the most important results of the Framingham Heart Study: “The largest, longest, and most prestigious heart disease study showed that total cholesterol levels (‘total,’ now, mind you, they didn’t talk a whole lot about LDL) that went below 160 caused heart disease problems to go back up! So it’s a curve that bottoms out at 160 instead of a line that gets better and better as you get lower and lower.”
In other words, if you take statins and drive cholesterol low enough, then THAT becomes one of your risk factors!
Even when these guys get it right, they get it wrong.
If you’re at risk of heart disease, you can find a complete game plan to help you overcome the threat in our exclusive HSI report 17 ways to beat heart disease without a single drug.” And you can be certain that nothing in this plan actually RAISES your risk.
To Your Good Health,
Jenny Thompson
Sources:
“For Heart Health, Focus on Risk Factors” HealthDay News, 1/18/10, healthscout.com
“Treat the Risk, Not the Cholesterol: Study Challenges Current Guidelines” University of Michigan press release, 1/18/10, med.umich.edu
“Optimizing Statin Treatment for Primary Prevention of Coronary Artery Disease” Annals of Internal Medicine, Vol. 152, No. 2, 1/19/10, annals.org
