Thursday, November 21, 2013

New Recommendations for Statin Therapy

Harvard professors claim the new online cholesterol calculator is flawed and overstates a person’s risk of heart disease.
Monday, November 18, 2013

The new guidelines were developed by the American Heart Association (AHA) and the American College of Cardiology (ACC).

Under the new guidelines, people will be advised to take statins based on a number of different health risk factors. These risk factors include if they already have heart disease, if their LDL cholesterol is extremely high (180mg/dl) or if they’re middle aged with type 2 diabetes.

In addition, people between 40 and 75 years of age with an estimated 10-year risk of heart disease of 7.5% or more are advised to take a statin. Experts say this new rule could greatly increase the number of patients who will now be advised to take these drugs.


MY TAKE:
Forty-nine percent of Americans over the age of 60 currently take statin drugs. Statins are the most commonly written prescription in the United States. Statistically, statin drugs reduce the risk of sudden heart attack by one third. That seems like pretty compelling evidence to support statin use. However, the risk of sudden heart attack is only three percent and statin drugs reduce it all the way down to two percent. That’s a whopping decrease of one percent! Furthermore, more than half the population’s suffering their first heart attack have normal or even low cholesterol. The ACC has countered that statistic by suggesting that statin drugs should be added to our drinking water so everyone will be treated.

Statin drugs work (when they work) because they reduce inflammation, not because they lower total cholesterol and LDL cholesterol. In fact, the disruption of cholesterol metabolism by statin drugs causes cardiac myopathy (heart muscle disease) in ten percent of patients. Cholesterol is the raw material necessary for the body to create sex hormones, vitamin D, and a host of other complex chemicals needed for the body to function properly.

The most common cause of high cholesterol is an excess of saturated fat and trans-fats in the diet. Although the AHA and ACC both claim that dietary changes are the cornerstone of treatment, little or no attention to diet occurs in practice. The second major cause is an underactive thyroid. Synthroid (synthetic thyroid hormone) is the second most commonly prescribed medication in the United States. It is estimated that at least one third of cases of hypothyroidism are autoimmune in nature. Clinically, I estimate that number is closer to half of all cases. Although Synthroid alleviates some symptoms, it does not treat the underlying cause or reduce the cardiac risk associated with hypothyroidism.

The number three cause of high cholesterol is an imbalance in the flora of the digestive tract. Unhealthy bacteria can produce an estrogen analog, a chemical that resembles estrogen. The body absorbs this estrogen look-a-like and it stimulates cholesterol production. Overproduction of cholesterol from genetic flaws is the forth most common cause of high cholesterol. This can be determined by a simple blood test, the L(p)a. Elevation of the L(p)a is the only lipid blood test that does correlate with an increased risk of heart disease. The test is seldom run before placing a patient on statin drugs. Despite being genetically controlled, both niacin and gingko leaf extract have been shown to be very effective in reducing the L(p)a in several studies.

THE BOTTOM LINE:
Talk to your doctor about truly implementing a serious program of diet and exercise before resorting to statin drugs. You must be an active participant in your health care. Have through laboratory testing to include a thyroid profile, glycohemoglobin A1c, fibrinogen, homocysteine, and CRP (high sensitivity C reactive protein) in addition to the serum lipids. If you and your physician still decide you need to take a statin, add Co Q 10 to your supplements to offset some of the side effects of this drug.