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[stocks]

The Great Cholesterol Con

The definitive book on the non-dangers of dietary cholesterol and saturated fat was The Cholesterol Myths by Uffe Ravnskov, 2000. Anthony Colpo's book (GCC) has the advantage of being 6 years newer, thus much recent research has been included with individual citations in academic style. GCC also has the advantage that some more likely causes of heart disease are given, then constructive suggestions on lifestyle are given, and these are backed up by excellent references -- over 1400 of them (p xi). It is significant that the first forward is written by Ravnskov, MD, PhD, and a second forward by Duane Graveline, MD, MPH, who wrote Statin Drug Side-Effects, 2004.

In its 368 pages, 78 are references, and about 102 discuss why eating cholesterol and saturated fat do not cause heart disease. This leads to why the statin drugs such as Zocor and Lipitor are overpromoted and do not have a benefit because, even tho they can lower cholesterol levels, such lowering is shown not to be a benefit. About 73 more discuss what might actually cause heart disease. Another Section addresses overblown claims about other drugs to fight heart disease, better diets than low-fat, stress, supplements, alcohol and exercise. Appendices cover other interesting topics, such as lowering homocysteine levels and the false health claims of vegetarians, and of those who perform coronary angioplasty and bypass operations.

The actual evidence from studies in original peer-reviewed papers is presented, with clearly designed tables when the results of multiple trials were given. Colpo wrote the most detailed descriptions of the fraudulent work of Ancel Keys, MD, on the supposed toxicity of staturated fats, as well as on the misguided claims of Dean Ornish, MD, and Nathan Pritikin on low-fat diets I have seen. The unhealthy recommendations of several government agencies and NGOs are brought out. The instigation of Big Pharma is duly noted. On these topics, including recommending low-carb high-fat diets, and certain supplements, The Great Cholesterol Con is in good agreement with similar parts of my own recent book, Malignant Medical Myths (MMM), 2006, and gives much greater detail, and is easier to read, despite smaller print.


Colpo is very direct, working up finally to this Conclusion (p254): "There is every reason in the world to encourage people to exercise frequently, stop smoking, eat minimally processed foods, and find ways to get a handle on the stresses of modern life. The evidence for low-fat diets, on the other hand, is based on a mixture of erroneous assumptions, half-truths and downright lies."

http://www.amazon.co...o/dp/1430309334

[stocks]

The Politics and Economics of the Diet-Heart and Lipid Hypotheses

So if eating butter and eggs doesn't cause heart disease after all, how did this theory come to the fore? A massive right-wing conspiracy? No. According to Colpo, it rose to the fore because of a mix of personal vengeance and aimless bureacracy. Only after researchers developed effective cholesterol-lowering drugs did profit come into play; from there, the conflict-of-interest-loaded government agencies like the FDA and National Cholesterol Education Program (NCEP) locked into step and the theory became unbreakable.

Colpo describes Ancel Keys's performance of his famous Seven Countries Study and his subsequent rise to power at the American Heart Association (AHA) as acts of vengeance against the majority of researchers who originally flouted his theory. He quotes a later president of the AHA saying they massaged the statistics showing the supposed success of the anti-fat campaign at reducing heart disease to "get more money from politicians," and quotes members of the original McGovern Committee who made the first government recommendations to reduce animal fat in the diet as saying they were a "bunch of kids" who were essentially looking for something to do.

Chapter twelve is a phenomenal exposé showing the AHA to be essentially a for-profit corporation selling its heart-healthy logo to junk food companies in exchange for millions of dollars, headed by a CEO making a mind-boggling salary, rather than the non-profit do-gooder organization as which it masquerades. The American Dietetic Association gets loads of funds from pharmaceutical companies and other companies who have an interest in the high-carb low-fat diet it recommends to diabetics, a diet it even admits may cause blood sugar problems, but should be eaten anyway since it is "healthy."

Colpo describes how the NIH caved in to employee protest after it tried to institute conflict-of-interest rules, and how the FDA violated its own conflict-of-interest rules by waiving them over 800 times in the course of just two years, and how the New England Journal of Medicine got rid of its previously successful conflict-of-interest rule several years ago because the research community had become so dominated by pharmaceutical companies that it was becoming impossible to find sufficient material to fill the journal's pages.

And, of course, he describes the massive profits reaped from the cholesterol-lowering statin drugs - drugs that probably cause cancer, may wreck your brain, and arguably cause side effects more often than they save people from heart disease. But with over $37 billion raked in over the past year, it's no wonder a bad set of drugs could be held in such high esteem - when it comes down to it, a lot of people just love to make money.

http://www.cholester...sterol-Con.html

[Gary Smith]

in the 20 years I've been prescribing statins (which cost 9 bucks for a 90 day supply at Wal Mart and other places) there has been a dramatic decline in stroke, heart attack and peripheral vascular disease. Patients who came to them late (e.g. after a cardiovascular episode) have been disease free since taking them.

Who knows, maybe I only have healthy patients? No. I am very conservative about meds, but I use statins, blood pressure pills and encourage patients to treat their diabetes strongly. In fact, here's the key to health: lower cholesterol, blood sugar and blood pressure. Don't smoke. That's it.

Statins are good.

mm

MM, did you forget the major key to health or was it just implied if you want to lower cholesterol, blood sugar, and blood pressure - daily EXERCISE (and maintain a proper weight)

[maineman]

You know, of course, that people are responsible for their own actions? There are many people who eat well and exercise, and choose not to smoke. But there are many more who neglect their health for myriad reasons. As an Internist when I'm doing "preventive" teaching diet, exercise, smoking cessation, responsible lifestyle issues from seat belts, to child seats, vaccinations, cancer screening, health care directives, etc. and more are all on the table. But nothing is forced on a patient. My duty as a scientist is to keep up do date with medical research and distill it for the patient. As someone who is on the frontline every day for the past 20+ years I can tell you its tough out there. The poorer folks in the population tend to smoke more, eat worse, exercise less and drink more. Some days its hard to imagine I live in America, with IQs so low, common sense so low and general fund of knowledge so low. I have to do my best with the tools I can. At the other end of the spectrum I have a large group of highly intelligent, wealthy, "upper class" patients. Some "get it" and eat well, exercise, drink minimally, show up on time for mammograms, follow ups, etc. But some don't. Go figure. When one is trying to affect behavioral change the key is "readiness". I first try to assess the degree to which someone is ready to attempt change. When I get that sense, I put all my energy into it, whether its about proper diet, smoking cessation, whatever. If someone is not ready, they're not ready. All I was saying about statins is that the clinical evidence is overwhelming. They work. If you suffer from high LDL cholesterol, and cannot control it (keeping it well below 130) with diet consistently, its nice to know you have a safe, proven, and now cheap tool to prevent stroke, heart attack and peripheral artery disease. Along with healthy diet and lifestyle. mm

[Echo]

Proper diet, exercise, weight loss and medications form the four cornerstones in the lifelong treatment of high blood pressure, diabetes, and high cholesterol. The more any individual can do with regard to diet, exercise and weight loss, the less doctors need to do with medications. Sometimes aggressive action by the patient on the first three is enough to avoid the medications. Sometimes it is not. If not, the medications get prescribed. Of course for the patients who don't care to or can't get aggressive with the first three, they definitely get the medications and sometimes more of it... Doc

[stocks]

Burying of negative trial results much harder since 2005

The burying of negative trial results used to be quite easy, on the basis that many studies could be happily conducted in near-secrecy. This are different now, because there’s more pressure placed on drug companies and investigators to register trials before or early on in their conduct. Once registered, things look a bit fishy if the results of the study do not emerge in a timely manner.

An example of this was the so-called ‘ENHANCE’ study, which found that two cholesterol-reducing drugs caused more blockage in arteries than one. Two years after the completion of this study, the results had still not been published, and in fact needed to be forced out of the sponsors by a US Congressional enquiry.

A commentary published earlier this year [2] draws our attention to the fact that while initial (pre-2005) statin trials were overwhelmingly positive, more recent evidence has been generally negative. Specifically, since 2005, all but one statin trial has yielded neutral or negative results [3-11]. It was in 2005 that new regulations regarding the registration and publishing of clinical trials came into being.

The one positive statin study since 2005 is the so-called JUPITER trial [12]. However, this study has been the subject of considerable controversy, and scrutiny of its findings reveal numerous implausible results which have caused some to question the role of the study’s sponsors in the analysis and presentation of the data [13].


Link

[Echo]

A commentary published earlier this year [2] draws our attention to the fact that while initial (pre-2005) statin trials were overwhelmingly positive, more recent evidence has been generally negative. Specifically, since 2005, all but one statin trial has yielded neutral or negative results [3-11]. It was in 2005 that new regulations regarding the registration and publishing of clinical trials came into being.

This is about the stupidest most irresponsible reporting about statins I have seen yet. Most of those so called negative trials were exploring the benefits of statins on other types of heart disease than the traditional coronary artery disease/clogged arteries/heart attack which have overwhelmingly been proven to be of benefit.

Specifically, these negative trials were evaluating for benefit in aortic stenosis, heart failure, dialysis patients, etc, etc, NOT heart attack prevention per se.

One was a very promising trial of not a statin but a drug called Torcetrapib to RAISE good chol, but it was responsibly halted due to unacceptable side effects on raising blood pressure. In fact, a cousin of this drug called Anacetrapib has been found to be very promising in raising HDL and this was just announced today.

"Anacetrapib Wows Them in ChicagoThe results of the DEFINE trial (determining the efficacy and tolerability of CETP inhibition with anacetrapib) were presented at the recent American Heart Association meeting in Chicago and published jointly in the New England Journal of Medicine, November 17, 2010, issue. In short, the results were stunning.

Just over 1,600 patients were randomized to 24 weeks of anacetrapib or placebo. There was, over the study period, a significant reduction in LDL cholesterol (about 39% reduction) but most impressively was an increase in the HDL of 138% beyond that seen with placebo. The average HDL increased from 41 mg/dL to 101 mg/dL without the hepatic and vascular issues seen with the previous trial of torcetrapib.

Obviously, this is an intermediate-sized safety study but demonstrated clearly that when used in conjunction with statin therapy, anacetrapib had extraordinary effects on plasma lipids and may issue us into a new era of the treatment of vascular disease.

The clinical effects of this therapy on recurrent coronary events are yet to be determined. However, no one can deny the excitement obvious in the investigators themselves and other researchers in the area related to this potentially game-changing therapy."

Stocks, please stop with this radical statin bashing rhetoric. I used to be a debater in high school and you can ALWAYS find some fool who you can "quote" with marginal credentials to say just about anything you want or make any argument you want. It doesn't make it "right".

Echo

[stocks]

More on the Cochrane review of statin usage for primary prevention

14 trials were analysed -- but researchers allowed studies in which up to 10 per cent of participants were in the secondary prevention category. What this basically means is that their assessment of the data was not really focused on the primary prevention setting
A meta-analysis of data from individuals in the primary prevention category published just last year [2] (reported here), no reduction in overall risk of death was found with statin therapy.

Of the 14 studies reviewed, four of them were not double-blind in design (double-blind studies, where neither the researchers not the participants know whether they are taking the active drug or placebo are considered the ‘gold standard’ for good clinical research).

11 of the 14 studies recruited individuals who, while perhaps not having a history of cardiovascular disease, nonetheless had what would traditionally be regarded as at least one major risk factor for cardiovascular disease such as raised blood fats, high blood pressure or diabetes.

2 major trials were stopped prematurely. This is as cause for concern as may lead to “an over-estimation of treatment effects…”

All but one of the studies was industry-funded. According to the authors, “It is now established that published pharmaceutical industry-sponsored trials are more likely than non-industry-funded trials to report results and conclusions that favour drug over placebo due to biased reporting and/or interpretation of trial results.”

The study participants were ostensibly white, male and middle-aged (average age 57), and the authors of the Cochrane review question the appropriateness of this data in, say, older individuals and women.

There was no evidence of significant adverse effects, though about half of the studies did not even report adverse effects. (For more on adverse effects, see the blog post I link to above).

There was little or no significant evidence on the cost-effectiveness of statins in primary prevention.

There was little or no significant evidence on the effects of statins on quality of life

Statins

Jo says:
Wow, you put your case very well Dr Briffa. The BBC are clinging on to the idea that statins are still a wonder drug. Their resident doc seems to push the conventional wisdom, but I imagine that’s what a state run news broadcaster is expected to do so she has to tow the line. My doc prescribed statins to me despite my cholesterol being in the ‘green’ area (they think we’re so stupid we need a traffic light system to understand).

[stocks]

Archives of Internal Medicine -- Statin Use and Risk of Diabetes

Talking about statin side-effects opens up a real can of worms. The side effects are numerous and statins may eventually be found to reduce lifespans.

CONCLUSIONS:
Statin medication use in postmenopausal women is associated with an increased risk for Diabetes.

statins


Video

500 women would need to be treated with statins for one to develop diabetes
150 would need to be treated to prevent a heart attack or stenting or some other cardiac event.
Just let the second figure sink in for a bit. For each 150 women treated, 149 will not benefit in terms of saving them from a cardiac event

link

Edited by stocks, 18 January 2012 - 04:55 PM.

[stocks]

FDA adds diabetes, memory loss warnings to statins

U.S. health regulators will add warnings to the labels of widely used cholesterol lowering drugs, such as Lipitor, to indicate that they may raise levels of blood sugar and could cause memory loss.

The Food and Drug administration announced the changes to the safety information on the labels of statins such as Pfizer Inc's Lipitor, AstraZeneca's Crestor and Merck & Co's Zocor.


link