LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

cholesterol

7 FACTORS FOR HEART DISEASE–ARE YOU IN THE 1%?

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By now we can all accept that heart disease is almost entirely lifestyle in origin.  I’m sure there are a few events per year that were entirely mediated by genetics, but, in general, if you have heart disease, it’s because of the choices you have made.  And likely continue to make.

Everyone out there who is looking forward to their first heart attack please raise your hands.  Great…now everyone who has had a heart attack and wants a second, you can raise your hands now.  Lastly, those of you who just can’t wait to have your sternum cracked open with a spreader, your circulatory system put on a bypass around the heart and veins stripped from your leg to re-plumb your heart, go ahead and send both hands up.

Looking around, there is not a single hand in the air.  Imagine that–not a single person has a desire to experience a cardiac event.  Go figure.  NOW let’s ask the important question…

Who is willing to make changes to their lifestyle to avoid the aforementioned events?

Not so many hands, I’m guessing.

Why is that?  It really is that clear cut.  Does society think that medicines will save us from these outcomes?  If so, think again.  You could not be further from the truth.  Medicine is very, very bad at preventing events.  Sure, we run around telling everyone “our numbers are under control,” but this house of cards soon falls after the first heart attack.

Look at this particular study here.  Researchers looked at 7 cardio-protective behaviors:

  1.  Ideal healthy diet
  2. Physical activity
  3. Ideal body mass index
  4. Non-smoking
  5. Ideal blood pressure
  6. Low total cholesterol
  7. Low fasting blood glucose

That’s it.  7 simple factors.  I could easily add another 10 and tighten up what they consider “healthy diet.”   But, overall, pretty basic guidelines.  So, how many people (out of 14,500, aged 20 and above) had all seven of the factors present?

Are you sitting down?

Less than 1%.  That is flat out sickening and extremely disappointing.  There is a massive disconnect in this society between what WILL happen and what we think will NOT happen to us.

Are you in the 1%?  If not, what will happen to those you leave behind?

STATINS–THE WONDER DRUG THAT ISN’T

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In 1997, Pfizer partnered with Warner-Lambert to release the drug atorvastain calcium, or Lipitor. It quickly rose to become one of the best selling drugs in history. It’s pretty well accepted that statins cut the rate of heart attacks in half. Sounds pretty good at the surface. But when you dig deeper, this 50% number will make you a little heartsick.

The class of statin drugs has reached godly status among drugs used in America, as exemplified by the ridiculous assertion by some cardiologists that statins should be added to the water supply. I would argue that not a single doctor in favor of the use of statins actually understands a shred of statistics. You see, there is a difference between absolute risk reduction and relative risk reduction.

If I told you that 2 people in the US per year got carcinoma of the tip of the pinky finger (fictional…) and someone found a drug that, when given to the entire population of the US would cut that number down to 1 person per year. Just how many would be in line to pop this pretty little pill down their throats, especially if there was a long list of side effects? I’m thinking few of us would.

However, if you are marketing this drug, you would stand proudly in the waiting room of every doctor’s office and proclaim that this drug will reduce the rate of carcinoma of the tip of the pinky by a whopping 50%. Patients, doctors and staff alike would listen in awe, jaws lowered, at how amazing this drug would be. After all–who wants to experience carcinoma of the pinky? The line to get the prescription would remind many of us the 1979 deaths of people crushed to death while attending a Who concert..

But if that same rep stood up on the Today show and stated that this fantastic new drug would cut the absolute risk by 1% when taken by 100 people for 3 years, the yawns and disinterest would be legendary. But this is the consistent data we see with all the statins. Treat 100 patients for 3 years and you’re lucky if one less person has a heart attack. Not death. Heart attack. You can eat a walnut per day and beat this.

So, we have a class of drug that is the best selling in history and, quite frankly, it sucks at preventing a heart attack. What’s worse is that the list of side effects has gotten quite long and include:

  • Potential increase in the risk of cancer
  • Increased risk of chronic muscle diseases
  • Problems with the functioning of the heart
  • Reduction in cognitive function
  • Increases the risk of your muscles melting, a condition called rhabdomyolosis
  • Increases risk of long term muscle damage, even after discontinuation
  • Nullifies–YES, nullifies, the positive effects of exercise on the heart

The list is actually longer. This particular study actually looked at the production of oxidative stress in the muscles of patients taking statins. Overall, the damage was enough to begin to cause the deaths of muscle cells. Not a good thing.

AM I GOING TO HAVE A HEART ATTACK?

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This is the question everyone wants to know. It boils down to “risk.” Just what is my likelihood of dropping dead of a massive heart attack and leaving my family to fare without me?

My question is…why? If we’re honest, from a mainstream medical standpoint, the risk is predicted purely to decide when to medicate. Do we start Lipitor at a cholesterol of 230, 208 or 260?? 

From a personal standpoint, we want to know risk so we can put into perspective healthier lifestyle choices. Our doctor determines we’re at very low risk? McDonalds on the way home follow by an evening as a couch potato. High risk?  Maybe get the salad and go for a walk when we get home…

Sound too simplistic? For me, the perfect world would have no estimation of risk because everyone would be living a life free of processed food and stress and exercising consistently. We don’t need to know our risk, and we could care less because we’re going to do the right things anyway.

But alas, McDonald’s and Kraft still exist.

So, why this topic? Because if we use our estimated risks to determine how our lifestyles should be lived, we may be way off the mark. I’ve covered the concept of surrogate end markers and how this is a house of cards in medicine in previous posts. This particular study compared the relationship between risk factors identified in observational studies and cardiovascular disease and the same relationship seen in actual clinical studies.

As an example, let’s say that, when we looked at a population of 100,000 people, cholesterol levels are determined to be associated with cardiovascular disease. So we then decide to use cholesterol to determine someone’s risk of having a heart attack. So someone with elevated cholesterol now thinks they are at high risk of having a heart attack and makes a decision to take a statin drug to “protect” themselves.

But what happens when we then look at the studies used to determine if these drugs work at lowering the rates of heart attacks? Turns out, in many cases, the risk was not quite so strong as we thought. On average, the risk was actually about 25% lower than was seen in the observational studies.

What does this mean? It means that we use medications to treat what we think are risk factors for disease states (in this case cardiovascular disease). We use the medication when that lab value creeps high enough. But, in reality, what we are doing is using drugs to lower the risk of a disease based on overblown data. The result? Not quite the protection we were looking for, but at great cost.

The beauty of lifestyle changes is that they cut across a single risk factor. That group in the observational study that had lowered risk of a heart attack not only had lower cholesterol, but had higher HDL, lower triglycerides, an ideal body weight, lower hsCRP, low blood pressure, low uric acid, lower liver enzymes… You get the idea.

SHOULD WE BE LOOKING AT CHOLESTEROL AT ALL?

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Everyone not living in a cave understands that total cholesterol is linked to heart disease.  We understand this almost entirely thanks to the development of the class of drugs called statins, of which Lipitor is king.  But is this REALLY true?

Let’s take a moment a review the process by which drug therapies are developed, researched and marketed.  We identify a condition such as heart disease.  Then we study a large group of people and look at their rates of heart disease and try to find lab values that correlate with disease risk.  In thas case, researchers found that those with low rates of heart disease had low total cholesterol levels.  This is called an observational study and we use it to determine associations.

Then we find a drug that can modify the risk factor that we found.  The drug than lowers the level of the risk factor (in this case, cholesterol) and the drug gets approved to lower risk of death for the disease.  Did you notice that we skipped a step?  These drugs were NOT approved based on their ability to lower the risk of the disease, but rather the RISK FACTOR for the disease. 

So what if we were wrong in the observational study in the first place?

What if this $20 billion + a year drug class is based on weak data?

This particular study looks at how close the observational studies were to what is seen in the studies done later when statins were used in clinical trials.  The conclusions of the authors are pretty powerful….

“If our findings are generalizable, clinical and public health recommendations regarding the ‘dangers’ of cholesterol should be revised. This is especially true for women, for whom  moderately elevated cholesterol (by current standards) may prove to be not only harmless but even beneficial.”

Still want to refill your prescription for your statins, which, by the way, increase your risk of diabetes…?

 

PROTECTING OUR ARTERIES WITH GARLIC

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PROTECTING OUR ARTERIES WITH GARLIC.  I always remind patients that cholesterol all by itself does NOT cause damage to our arteries.  It is not until cholesterol becomes oxidatively damaged (now called an oxysterol) that it becomes to cause damage to our arteries.  So, regardless of what your cholesterol level is, we need to protect our cholesterol.  How do we do this?  (hint:  statins DON’T protect cholesterol)  Shockingly, it’s a high phytonutrient, plant based diet.

In this particular study, researchers looked at the use of garlic to protect cholesterol and protect our blood vessels.

 

USE PLANT STEROLS FOR CHOLESTEROL PROBLEMS

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CHOLESTEROL PROBLEMS? SKIP STATINS AND USE PLANT STEROLS.  For some strange reason, mainstream medicine seems absolutely enthralled with the use of statins for “prevention,” although this is a disturbing definition of the term.  However, we know, without a doubt, that a plant based diet with lower cholesterol equally as well.

Here’s the difference…a plant based diet improves physiology.  The body is happier.  All systems and all markers (blood pressure, cholesterol, triglycerides, blood sugar, HbA1c, hsCRP, etc…) get better.  These markers get better because the dietary changes have improved the way the body is working.  The improvement in the numbers is merely a side effect.  Statins, on the other hand, ONLY fix the number (in this case, cholesterol) in an artificial manner.  This increases chance for risks (of which there are many) and does NOT make the physiology happier.  Good sources of phytosterols?  Beans, whole grains, nuts, oranges, flaxseed.

WHICH DISEASE HAS INFLAMMATION BEEN ASSOCIATED WITH?

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Feeling inflamed? Try B6… Inflammation has been associated with pretty much every chronic disease you can think of, but most notably heart disease.  Mainstream medicine has been slow to adopt the concept of hsCRP as a marker of inflammation and a risk for heart disease, despite quite a few years and quite a few studies.

Part of this may be because there has been no drug that has been shown to effectively lower hsCRP levels.  As the relationship between high cholesterol and heart disease has been decimated, there have been some desperate attempts to find a better use for the multi billion dollar statin class of drugs.

However, the studies show that it’s pretty weak at lowering hsCRP.  But who needs a drug when B6 can do it along w/ fish oils, exercise and stress management?

ARE YOUR TRIGLYCERIDES ELEVATED?

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Triglycerides elevated? Statins AREN’T the answer. Time and time and time again I see patients come into my office that have been given a statin (Lipitor, Crestor, etc..) for their cholesterol. However, while most know their cholesterol numbers, few know their triglycerides. If the triglycerides are elevated and HDL (good) cholesterol is low, there is a very, very good chance you’re pre-diabetic.  And guess what? That drug will make your numbers look better, but will do ZIP to change your progression to diabetes.  Tens of billions of dollars per year and it ain’t fixing the problem…