Heart disease prevention for the helpless, ignorant, or non-compliant

The media outlets are gushing with the "research"/marketing spinoff of the JUPITER trial, an analysis conducted by Dr. Erica Spatz of Yale University, that suggests that statin use should be expanded to many millions more Americans.

USA Today: Study: 11M more should get statins

MedPage: JUPITER Findings Could Boost Statin Use by 20%

Health Day: Millions More Americans Might Be Placed on Statins

WebMD: More May Benefit From Cholesterol Drugs: Study Shows More Would Qualify for Statin Treatment if Levels of C-Reactive Protein Are Considered

You may recall that the JUPITER trial (discussed previously in a Heart Scan Blog post) studied the cardiovascular event risk in people with "normal" LDL cholesterols (calculated, of course, not measured) of 130 mg/dl or less, along with increased c-reactive protein, a crude inflammatory measure, of 2.0 mg/dl or greater. A 54% (relative) reduction in cardiovascular events occured in the group taking Crestor 20 mg per day.

What I see is a confluence of events that have brought us to the "statin drugs are necessary for everybody" mentality:

--The low-fat diet advice of the last 40 years has increased non-fat or low-fat foods that increase LDL, since removing fat from the diet provokes small LDL particle production and increases the inflammatory measure, c-reactive protein (CRP).

--The proliferation of "healthy whole grains" in the diet have also caused an enormous boom in small LDL particles, which is interpreted to the uninformed as "high cholesterol." It has also provoked CRP substantially.

--The advice to reduce salt intake has brought a broad re-emergence of iodine deficiency. When thyroid hormone production flags due to lack of iodine, LDL cholesterol (both large and small) increase.

--Our lives, which are increasingly conducted indoors, have worsened the already substantial vitamin D deficiency. While deficiency of vitamin D primarily reduces HDL cholesterol and increases triglycerides, it can also cause an increase in small LDL and a large increase in CRP.

In other words, a collection of events have converged to provide the appearance of high LDL cholesterol and high CRP. This creates the appearance of a "need" for statin drugs. The JUPITER trial now exploits both the LDL-reducing and CRP-decreasing effects of statins.

I view the foisting of Crestor via the JUPITER argument on the public as taking full advantage of the helpless situation many Americans find themselves in: Reduce fat intake, eat more healthy whole grains and . . . cholesterol and CRP skyrocket! "You need Crestor! See, I told you it was genetic," says the doctor after attending the nice AstraZeneca-sponsored drug dinner.

The notion of using a drug like Crestor to suppress inflammatory patterns is absurd. There are far better, easier, cheaper ways to achieve this goal, along with dramatic reduction in cardiovascular risk. But, to the ignorant, the helpless, or non-compliant with real change in diet and lifestyle, then Crestor does serve a purpose.

I can only hope that the excessive pushing of statin drugs on the public will sooner or later trigger a revolt.

Comments (9) -

  • Anonymous

    1/20/2009 6:16:00 PM |

    Before going on a low carb diet, my total cholesterol was 245. Doc wanted me to take statins, I said no. So I went on a Low carb diet. After 5 months of keeping the carbs <50 mg daily, my total cholesterol went down to 164. That's all you need to know about this "high cholesterol" scam.

  • renegadediabetic

    1/20/2009 8:24:00 PM |

    After JUPITER, they should be restricting statin presecriptions to those with high inflammation who don't want to give up their inflammatory diet & lifestyle.  When Crestor was tested for lowering cholesterol, they found that is was NOT shown to prevent heart attacks, per the fine print on Crestor ads.  When it preformed better when targeting inflammation, that shoud tell you what the real culprit is.

    The greedy drug companies don't want to lose their cholesterol revenues.  They only want to increase sales.

  • Paul Kelly

    1/20/2009 8:57:00 PM |

    Why am I not surprised at the media coverage of this story?

    A little off topic - but a quick question regarding fish oil gelcaps. I read where fish oil goes from being beneficial to hurtful when it becomes oxidized. Are we better off with gelcaps or liquid? Are the gelcaps protective to prevent the fish oil from becoming rancid?



  • vin

    1/21/2009 9:39:00 AM |

    Crestor is the last statin drug developed and one which is still patented. As far as I know there are no other statins being developed; at least not for lowering LDL levels.  So I guess they will push Crestor as long as they can to recover costs and rake in the profits the company had exepected.

    Once the patent ends then they will stop pushing. Just have to wait.

  • Olga

    1/21/2009 2:57:00 PM |

    Hi Dr. Davis:

    I would like you to fo a post about iodine.  I am a 42 year old mother of two.  To make a long story short, I was misdiagnosed with a thyroid neoplasm which resulted in a hemithyroidectomy following my second pregnancy.  After 5 years of ill health, I figured out on my own that I had a goiter and that high levels of iodine supplementation was required to regain my health.  I was told to eliminate salt from my diet 20 year prior because of a high incidence of heart disease in my family, despite the fact that I have low blood pressure. I am currently seeing a doctor who is helping me stabilize my thyroid function.  The reason I am writing to you is that I also have familial hypercholesterolemia.  Thanks to your program, my HDL and triglycerides are excellent.  Is it possible that the LDL will also come down if I can get my iodine into an optimal range?  Thanks for all the great information.

  • Quelle

    1/21/2009 10:11:00 PM |

    "The proliferation of "healthy whole grains" in the diet have also caused an enormous boom in small LDL particles, which is interpreted to the uninformed as "high cholesterol." It has also provoked CRP substantially"

    Which studies are you talking about in this paragraph?

  • Ricardo Carvalho

    1/21/2009 10:52:00 PM |

    I think this cartoon explains the "logic" behind all this "health" industry - http://www.naturalnews.com/023014.html

  • JPB

    1/22/2009 11:08:00 PM |

    The scary thing here is that there are parts of the medical care industry who are pushing for mandatory testing/drugs/etc. in exchange for lower "health" insurance rates (i.e. "preventative care").  
    I think that we need to preserve free choice for individuals.  I don't know exactly how to ensure this, but I do know that I don't want to be forced into mandatory lipid testing and/or treatment!  Anyone have any ideas on this?

  • Trinkwasser

    1/23/2009 11:49:00 AM |

    Same story here. trigs 380 HDL 25 LDL 165 so I was put on a Healthy High Carb Low Fat Diet, which put my LDL up to 200. The simvastatin reduced this to 75 without greatly affecting the dangerous components.

    Reducing my carbs until my BG no longer spiked (60 - 100g carefully spread through the day) has given me trigs 39 HDL 47 LDL 105

    Now my previous doctor died "unexpectedly" which is a good indication of his competence level, blamed me for not complying with the diet and failed to notice I was actually diabetic.

    My current docs are obviously singing off the same hymn sheet as many of you in the "Blogosphere", their main problem is being forced to follow outmoded protocols. She wasn't fussed by my LDL being over 100 in view of the improvement in the other lipids and though she was a bit wary of my latest experiment of eating more saturated fats which put my HDL up to 55 and brought my LDL down to 93 she can't argue with the result!

    Next experiment will be to drop the statin and see what my unmedicated lipids look like now the insulin resistance has been kicked into touch.

    The big problem here in the UK is accountants, who decree no test strips for Type 2s, TChol instead of Full Lipid Panel and no possibility of a CRP test. Hey they have to cut back somewhere in order to afford all the statins . . .