Do Cholesterol-Lowering Drugs Really Work?
When Mevacor (lovastatin) was first introduced in 1990 it was heralded as the first of a new classification of drugs that would reduce heart attacks and strokes by at least 25%. These drugs, known as statins, are now the most popularly prescribed drugs in the world with Lipitor being number one, accounting for 20 billion dollars of sales worldwide.
However, if you look at the statistics, these drugs do not seem to work at all. We know for sure that they lower your LDL (low density lipoproteins) and your total cholesterol number but if you examine the rate of heart attacks and strokes in North America there does not seem to be any change.
In 1990, 38% of all deaths in Canada were due to cardiovascular disease. By the year 2002 the rate was reduced to just 34% but this coincided with a drastic reduction in smokers from approximately 35% of our population in 1990 to about 23% by the year 2002. By the year 2005 there were 15 million prescriptions written in Canada for cholesterol-lowering drugs but in that year deaths from cardiovascular disease still remained at 34% of our population.
According to the latest statistics from the Canadian Heart and Stroke Foundation, heart attacks are still the number one cause of death in our country, followed by Cancer at number two and strokes at number three. If you look specifically at the Canadian adult population between the ages of 40 and 80 years, cholesterol-lowering drugs are the most prescribed and taken by 37% of the people in that age group. However recent studies published in the British Medical Journal, The Lancet, and then duplicated by researchers here in Canada at the University of British Columbia show that for every 19,600 people who take a cholesterol-lowering drug daily for 5 years, one cardiovascular death may be prevented. However, when you examine the side-effects caused by these drugs, (rhabdomyolysis or muscle breakdown) almost 2.2 deaths will occur for every person in this group.
Because these are statistics it is important to understand that when dealing with numbers such as these there may be a variance of from one to three percentage points each way. In either case, these drugs do not seem to prevent our population from having heart attacks and strokes and the question is, how did they become so prevalent in our society?
The History of Cholesterol Research
In the 1950’s, two theories competed for attention among heart disease researchers. It had been known for decades that cholesterol was a component of atherosclerotic plaques, and people who are genetically predisposed to high cholesterol levels typically have clogged arteries and heart attacks. Their research was aimed at how the lipoproteins floating in the blood stream wound up as arterial plaque.
In the late 1960’s biochemists found a way to measure cholesterol inside the different types of lipoproteins—high density, low density and very low density. The National Institutes of Health financed a handful of studies to determine whether “cholesterol fractions” could predict the risk of cardiovascular disease. In 1977 they reported their results: total cholesterol turned out to be surprisingly useless as a predictor. At the same time, the Framingham Heart Study was just starting to show results after years of research. They found that in men and women, 50 years or older in their heart study,” total cholesterol per se is not a risk factor for coronary heart disease.”
The cholesterol in low-density lipoprotein (LDL) was deemed a “marginal risk factor” for heart disease. Cholesterol in high-density lipoproteins was a more accurate indicator and just the reverse; the higher the amount of HDL, the lower the risk for heart disease. These studies led to the designation of the label “bad” cholesterol to low density lipoproteins and “good cholesterol” to high density lipoproteins, or better known as LDL and HDL. The question still remained about how serum cholesterol became cholesterol plaque and whether abnormalities in serum cholesterol accounted for heart disease.
What we had here was a turning point in that for years medical students were taught that cholesterol was the healing substance of our bodies; that it repaired all the oxidative damage caused by breathing in large amounts of oxygen and that without cholesterol we would die. Now cholesterol was being touted as an agent of disease. What the Framingham researchers meant in 1977 when they described LDL cholesterol as a “marginal risk factor” is that the majority of people who suffer heart attacks and strokes have relatively normal levels of LDL cholesterol which is approximately 4.0 millimoles per litre of blood serum. Normal levels of HDL or good cholesterol were considered to be 1.1 or higher. Therefore the average cholesterol number for an adult was a range of 5.2 to 5.8 with allowance for the higher range as people aged.
During the 1980’s research biochemists found that Chinese people who ate a form of rice which contained a type of yeast known as red rice had very low levels of cholesterol. When they examined the extract from the red rice, they discovered the active ingredient, lovastatin which interfered with Coenzyme A in the livers of these people and suppressed the production of both LDL and HDL cholesterols.
Once the pharmaceutical company, Merck, synthesized the active ingredient, lovastatin, in their lab, they now had a drug that could reduce the liver’s output of cholesterol. They also had a tool to measure serum cholesterol and it was easy to show with a simple blood test that these drugs could lower serum cholesterol by 20 to 40%. At this point they were not concerned whether serum cholesterol was good, bad or caused heart attacks. Nor did they care about the original question of whether arterial plaque was caused by serum cholesterol or another form of cholesterol. They simply jumped a step and formulated their own conclusions. Assuming that high levels of LDL might cause cardiovascular disease, they now had a drug that could lower LDL and prevent it. What they also did not tell the public was that the drug also lowered HDL or good cholesterol and high levels of good cholesterol were much more important in preventing heart attacks. They actually mislead physicians in their literature and say that even though the drug reduces LDL it somehow increases the amount of HDL (good cholesterol) but give no explanation as to how this can happen.
The drug was an instant success. Heart attacks are the number one cause of death in North America. This drug should save thousands of lives by lowering cholesterol. Everybody should take the drug and heart attacks will become a thing of the past. Other drug companies came out with similar versions but the majority of them all belonged to a family of drugs known as statins.
As the competition between them grew, Pfizer, the manufacturer of Lipitor, the number one selling statin in the world, convinced the FDA, the Food and Drug Administration in the United States that even lower blood serum cholesterol levels could save even more lives. That is how the acceptable range of 5.2 to 5.8 became 4.0 and even lower. Many doctors arbitrarily tell a patient they want their total cholesterol level below 3.0 without giving any plausible explanation of why this is important. But the new lower numbers almost tripled the sales of these drugs.
When it comes to pharmaceutical companies, greed has no boundaries. It was also Pfizer that developed a new blood test for cholesterol that now included triglycerides. Although triglycerides are made out of cholesterol, elevated levels are actually an indicator of Type II diabetes. Nonetheless, the new number was added to the LDL and HDL numbers and before long there was not an adult left who did not need cholesterol-lowering medications.
Most physicians receive these drugs gratis from pharmaceutical companies because they are told how important they are and how they must protect their health for their benefit and for their patients. They are so convinced that these drugs save lives that they feel they are doing the right thing when they prescribe them for the patients. In fact, physicians are so brain-washed by the pharmaceutical manufacturers, that even when the patient complains of the main side-effect, muscle pain, which is actually a severe breakdown of the cells in the muscles, the physician insists they keep taking the drug and usually will prescribe another drug for the muscle pain. Somehow your doctor has lost sight of the fact that the heart is the main muscle in your body and these drugs could kill you. They honestly feel that they are saving lives and preventing heart attacks and most of them tend to ignore the side-effects. Unfortunately, if they really read all that beautiful literature and independently researched the material, they would find that these drugs primarily enhance the profits of pharmaceutical companies and have little or no medical value.
A conclusion has been formed that does not survive rigorous scientific testing. In spite of almost 18 years on the market and hundreds of millions of people taking these drugs, the incidence of cardiovascular disease has not changed. It is the opinion of this writer that the rationale for the use of statin drugs is based on junk science and these drugs are simply a cash grab for the pharmaceutical industry.
As long as the public is convinced that there is a drug out there that will prevent heart attacks they may never do the right thing and eat sensibly. We cannot watch television without being inundated with commercial after commercial of cholesterol-lowering drugs. Just this month Pfizer pulled the ads in which Dr.Robert Jarvic, the creator of the artificial heart, was promoting their drug Lipitor. It seems that Dr.Jarvic does not practice medicine and does not see any heart patients. We all know that the main source of most diseases in North America is a nutrient-poor diet combined with a sedentary life style. In Europe, cardiovascular disease accounts for 12% of all deaths compared to 32 to 35% in North America.
As long as we remain gullible and believe everything our physicians tell us and believe those pseudo-physicians in television commercials we will never change our dietary habits and continue to die from cardiovascular disease in record numbers.