Cholesterol-How Low Should You Go?
September 2004 Vol.1 No. 8
Neswletter from Dr.Ray Strand
Cholesterol—How Low Should You Go?
Last month the American Heart Association
and the federal government released new
guidelines for acceptable cholesterol levels.
I’m not surprised. For decades, the numbers they
have been giving us have been dropping, and
dropping consistently.
When I first began my practice 30 years ago,
the “normal” range for total cholesterol was
150 to 320. When we began checking HDL or
LDL cholesterol levels, the numbers dropped to
240 and then to 200. Before this latest
recommendation by the American Heart
Association, it was felt that you needed to have
your LDL cholesterol below 130. If you already
had heart disease or were at high risk for heart
disease, your recommended LDL cholesterol was
100 or below.
The new guidelines state that individuals who are
at the highest risk of suffering a heart attack
should lower their LDL cholesterol below 70.
Individuals who have a high or moderately high
risk of developing coronary artery disease should
lower their LDL cholesterol below 100. These
new guidelines will mean that 7 million
Americans will be added to the 36 million
Americans who are encouraged to take
cholesterol-lowering drugs. 95% of the patients
who come to me have LDL cholesterol levels
greater than 70. In lieu of these new
recommendations I would need to place over 50%
of my patients on cholesterol-lowering drugs!
The cholesterol-lowering “Statin Drugs” are the
number one selling class of drugs in the world
today. Drugs like Zocor, Lipitor, Mevacor,
Pravachol, etc. earned their makers $26 billion
worldwide last year. The pharmaceutical
industry spends billions of dollars in “educating”
(advertising) the public. It also spends billions of
dollars in research, trying to convince you and
your physicians that you need to be taking their
drugs.
The next time you have a checkup, many of you
will be strongly urged by your physicians to begin
taking one of these cholesterol-lowering drugs.
But when they ask, remember this thought
provoking fact: The average LDL cholesterol
level has dropped significantly over the past
decade, primarily due to the fact that almost
everyone is taking statin drugs. However, the
number of heart attacks in this country has
NOT dropped during this same time period.
This fact leads us to two critical questions. First, is
there a conflict of interest in these research
studies? Second, has our battle against heart
disease been too narrowly focused on
cholesterol?
A careful examination of the evidence gives a
resounding answer of “Yes” to both questions.
A Conflict of Interest?
The new guidelines were based on the results of
5 drug studies conducted since 2001. In addition
to the authors, about 80 experts reviewed and
endorsed them. It is important to realize that
almost all of these studies were actually
conducted and financed by the
pharmaceutical companies who are trying to
sell the drugs. Merrill Goozner of the Center for
Science in the Public Interest said “The people
who are giving you this advice have their research
funded by a party (the pharmaceutical companies)
who has a self interest in the outcome of that
research.”
Many of the authors of these studies have
received direct financial gain from the
pharmaceutical companies. Dr. Sidney Wolfe,
co-founder of Public Citizen’s Health and
Research Group, stated very boldly that people
who are receiving significant payment of money
from pharmaceutical companies should be
disqualified from being the principal authors of
studies that carry the stamp of approval from our
government. The conflict of interest is obvious.
What is even more concerning is that many of the
drug studies are never even published if they
don’t come to a conclusion that the study is
beneficial to the pharmaceutical company that is
conducting the research. They are just filed away
and never released to the public. The American
Medical Association has urged the creation of a
comprehensive, government-run registry for all
drug study results to prevent unfavorable ones
from being buried.
A Focus that is too Narrow?
If you have read two of my latest books, What
Your Doctor Doesn’t Know about Nutritional
Medicine may be Killing You or Death by
Prescription, or if you have heard any of my
lectures in the last few years, you now know that
heart disease is NOT a disease of cholesterol
(Over half of the patients who suffer a heart attack
actually have normal cholesterol levels!). Heart
disease is caused by inflammation of the fine
lining of your arteries. It not only causes plaque
build up, but also causes plaque instability and
plaque rupture, which is the initiating event for the
most heart attacks.
LDL cholesterol is not “bad.” It only becomes
“bad” once it has been modified or oxidized by
excessive free radicals. Oxidized LDL cholesterol
is a risk factor for heart disease because it causes
inflammation. Lowering your LDL cholesterol will
lower the relative amount of oxidized LDL
cholesterol. Studies are now showing that the
major benefit of most statin drugs is that they help
decrease inflammation in our arteries, and
decreasing inflammation lowers the risk of heart
disease.
However, oxidized LDL cholesterol is only one of
several culprits that cause irritation to this fine
lining of your arteries. According to a major
study reported in the New England Journal of
Medicine (January 14, 1999), the main causes
of inflammation of your arteries are excessive
free radicals.
Free radicals are caused by:
1. High blood pressure.
2. Diabetes.
3. Cigarette smoking.
4. Central obesity—abdominal fat cells
release inflammatory products.
5. Elevated homocysteine levels.
6. A fatty meal.
7. A high-glycemic or high sugar meal.
8. Elevated insulin levels—especially in
individuals who have insulin resistance.
9. Excessive emotional stress.
10. Oxidized LDL cholesterol.
Many of these causes of inflammation have also
been found to be independent risk factors for
heart disease because they lead to a vicious cycle
that causes a build up of plaque in our arteries. In
fact, physicians are also now beginning to realize
that when markers for inflammation (highly
sensitive C-Reactive Proteins—hs CRP) are
increased, the risk of having a heart attack is
greatly increased. Testing for hs-CRP is a better
indicator of future risk of heart disease than is
checking your cholesterol levels.
An Issue of Life and Death.
Since World War II, heart disease or coronary
artery disease has become the number one cause
of death in the US, Canada, Australia, and the
western world. In the US alone, there are over
750,000 deaths each and every year due to
heart attacks. Over one-third of these deaths are
in individuals who are under the age of 65. One
third of the time, the first sign of heart disease is
sudden death, killing before the patient can even
get to a hospital.
But before you begin taking drugs as the cure, the
risks of these drugs must also be weighed. Statin
drugs are not risk free, especially when you
realize the fact that you would have to remain
on these drugs for the rest of your life. Some
of the main side effects are liver damage, muscle
weakness, muscle damage (rhabdomyolysis), and
death. Statin drugs work by blocking the
production of cholesterol, but they also block the
production of an important antioxidant and
nutrient called Coenzyme Q10. Long-term use
leads to deficiencies in our body’s CoQ10 levels.
Some studies are now linking CoQ10 deficiencies
to an increased risk of all cancers, which is now
being documented in patients that have been on
statin drugs for more than 8 years.
The Healthy Lifestyle Alternative
Cholesterol is still a concern and cannot be
ignored. There are hundreds of studies that show
that the higher your cholesterol levels the greater
your risk of heart disease. But the first step for
anyone who has an increased risk of heart
disease is to try to decrease or eliminate ALL
of the causes of inflammation caused by free
radicals, not just cholesterol. Three positive
adjustments in your life can make this happen:
1.) Eat a healthy diet that contains the good
fats, good proteins, and good carbohydrates
(those that do not spike your blood sugar).
2.) Have a consistent, modest exercise
program.
3.) Take complete and balanced nutritional
supplements at optimal levels.
It’s simple and it works. A plan for a healthy
lifestyle is detailed for all members of my web
pages, complete with specific
recommendations and a system to track your
progress. When you combine all three of these
elements, you can either eliminate or significantly
decrease ALL of the causes of inflammation.
Every patient deserves a trial of these healthy
lifestyle changes before beginning a lifetime
regimen on statin drugs. After a 4 month trial,
have your cholesterol levels rechecked.
Remember, drugs should be used as a last
resort—not a first choice. If you must take statin
drugs you should also take CoQ10 supplements
(200 mg of powder form CoQ10 or 60 mg of gel
form CoQ10) and you should still engage in a
healthy lifestyle.
Try to get your LDL cholesterol below 130. If you
already know you have heart disease, get your
LDL cholesterol below 100. This is achievable in
the overwhelming majority of patients who eat
right, exercise regularly and take appropriate
nutritional supplements. Yes, oxidized LDL
cholesterol is a culprit but only one of many
causes of inflammation.
Adopting a healthy lifestyle will decrease your
LDL cholesterol levels and decrease all the other
causes of inflammation that lead to heart disease.
It’s the natural, drug-free way to a more
vibrant and healthy life.
Neswletter from Dr.Ray Strand
Cholesterol—How Low Should You Go?
Last month the American Heart Association
and the federal government released new
guidelines for acceptable cholesterol levels.
I’m not surprised. For decades, the numbers they
have been giving us have been dropping, and
dropping consistently.
When I first began my practice 30 years ago,
the “normal” range for total cholesterol was
150 to 320. When we began checking HDL or
LDL cholesterol levels, the numbers dropped to
240 and then to 200. Before this latest
recommendation by the American Heart
Association, it was felt that you needed to have
your LDL cholesterol below 130. If you already
had heart disease or were at high risk for heart
disease, your recommended LDL cholesterol was
100 or below.
The new guidelines state that individuals who are
at the highest risk of suffering a heart attack
should lower their LDL cholesterol below 70.
Individuals who have a high or moderately high
risk of developing coronary artery disease should
lower their LDL cholesterol below 100. These
new guidelines will mean that 7 million
Americans will be added to the 36 million
Americans who are encouraged to take
cholesterol-lowering drugs. 95% of the patients
who come to me have LDL cholesterol levels
greater than 70. In lieu of these new
recommendations I would need to place over 50%
of my patients on cholesterol-lowering drugs!
The cholesterol-lowering “Statin Drugs” are the
number one selling class of drugs in the world
today. Drugs like Zocor, Lipitor, Mevacor,
Pravachol, etc. earned their makers $26 billion
worldwide last year. The pharmaceutical
industry spends billions of dollars in “educating”
(advertising) the public. It also spends billions of
dollars in research, trying to convince you and
your physicians that you need to be taking their
drugs.
The next time you have a checkup, many of you
will be strongly urged by your physicians to begin
taking one of these cholesterol-lowering drugs.
But when they ask, remember this thought
provoking fact: The average LDL cholesterol
level has dropped significantly over the past
decade, primarily due to the fact that almost
everyone is taking statin drugs. However, the
number of heart attacks in this country has
NOT dropped during this same time period.
This fact leads us to two critical questions. First, is
there a conflict of interest in these research
studies? Second, has our battle against heart
disease been too narrowly focused on
cholesterol?
A careful examination of the evidence gives a
resounding answer of “Yes” to both questions.
A Conflict of Interest?
The new guidelines were based on the results of
5 drug studies conducted since 2001. In addition
to the authors, about 80 experts reviewed and
endorsed them. It is important to realize that
almost all of these studies were actually
conducted and financed by the
pharmaceutical companies who are trying to
sell the drugs. Merrill Goozner of the Center for
Science in the Public Interest said “The people
who are giving you this advice have their research
funded by a party (the pharmaceutical companies)
who has a self interest in the outcome of that
research.”
Many of the authors of these studies have
received direct financial gain from the
pharmaceutical companies. Dr. Sidney Wolfe,
co-founder of Public Citizen’s Health and
Research Group, stated very boldly that people
who are receiving significant payment of money
from pharmaceutical companies should be
disqualified from being the principal authors of
studies that carry the stamp of approval from our
government. The conflict of interest is obvious.
What is even more concerning is that many of the
drug studies are never even published if they
don’t come to a conclusion that the study is
beneficial to the pharmaceutical company that is
conducting the research. They are just filed away
and never released to the public. The American
Medical Association has urged the creation of a
comprehensive, government-run registry for all
drug study results to prevent unfavorable ones
from being buried.
A Focus that is too Narrow?
If you have read two of my latest books, What
Your Doctor Doesn’t Know about Nutritional
Medicine may be Killing You or Death by
Prescription, or if you have heard any of my
lectures in the last few years, you now know that
heart disease is NOT a disease of cholesterol
(Over half of the patients who suffer a heart attack
actually have normal cholesterol levels!). Heart
disease is caused by inflammation of the fine
lining of your arteries. It not only causes plaque
build up, but also causes plaque instability and
plaque rupture, which is the initiating event for the
most heart attacks.
LDL cholesterol is not “bad.” It only becomes
“bad” once it has been modified or oxidized by
excessive free radicals. Oxidized LDL cholesterol
is a risk factor for heart disease because it causes
inflammation. Lowering your LDL cholesterol will
lower the relative amount of oxidized LDL
cholesterol. Studies are now showing that the
major benefit of most statin drugs is that they help
decrease inflammation in our arteries, and
decreasing inflammation lowers the risk of heart
disease.
However, oxidized LDL cholesterol is only one of
several culprits that cause irritation to this fine
lining of your arteries. According to a major
study reported in the New England Journal of
Medicine (January 14, 1999), the main causes
of inflammation of your arteries are excessive
free radicals.
Free radicals are caused by:
1. High blood pressure.
2. Diabetes.
3. Cigarette smoking.
4. Central obesity—abdominal fat cells
release inflammatory products.
5. Elevated homocysteine levels.
6. A fatty meal.
7. A high-glycemic or high sugar meal.
8. Elevated insulin levels—especially in
individuals who have insulin resistance.
9. Excessive emotional stress.
10. Oxidized LDL cholesterol.
Many of these causes of inflammation have also
been found to be independent risk factors for
heart disease because they lead to a vicious cycle
that causes a build up of plaque in our arteries. In
fact, physicians are also now beginning to realize
that when markers for inflammation (highly
sensitive C-Reactive Proteins—hs CRP) are
increased, the risk of having a heart attack is
greatly increased. Testing for hs-CRP is a better
indicator of future risk of heart disease than is
checking your cholesterol levels.
An Issue of Life and Death.
Since World War II, heart disease or coronary
artery disease has become the number one cause
of death in the US, Canada, Australia, and the
western world. In the US alone, there are over
750,000 deaths each and every year due to
heart attacks. Over one-third of these deaths are
in individuals who are under the age of 65. One
third of the time, the first sign of heart disease is
sudden death, killing before the patient can even
get to a hospital.
But before you begin taking drugs as the cure, the
risks of these drugs must also be weighed. Statin
drugs are not risk free, especially when you
realize the fact that you would have to remain
on these drugs for the rest of your life. Some
of the main side effects are liver damage, muscle
weakness, muscle damage (rhabdomyolysis), and
death. Statin drugs work by blocking the
production of cholesterol, but they also block the
production of an important antioxidant and
nutrient called Coenzyme Q10. Long-term use
leads to deficiencies in our body’s CoQ10 levels.
Some studies are now linking CoQ10 deficiencies
to an increased risk of all cancers, which is now
being documented in patients that have been on
statin drugs for more than 8 years.
The Healthy Lifestyle Alternative
Cholesterol is still a concern and cannot be
ignored. There are hundreds of studies that show
that the higher your cholesterol levels the greater
your risk of heart disease. But the first step for
anyone who has an increased risk of heart
disease is to try to decrease or eliminate ALL
of the causes of inflammation caused by free
radicals, not just cholesterol. Three positive
adjustments in your life can make this happen:
1.) Eat a healthy diet that contains the good
fats, good proteins, and good carbohydrates
(those that do not spike your blood sugar).
2.) Have a consistent, modest exercise
program.
3.) Take complete and balanced nutritional
supplements at optimal levels.
It’s simple and it works. A plan for a healthy
lifestyle is detailed for all members of my web
pages, complete with specific
recommendations and a system to track your
progress. When you combine all three of these
elements, you can either eliminate or significantly
decrease ALL of the causes of inflammation.
Every patient deserves a trial of these healthy
lifestyle changes before beginning a lifetime
regimen on statin drugs. After a 4 month trial,
have your cholesterol levels rechecked.
Remember, drugs should be used as a last
resort—not a first choice. If you must take statin
drugs you should also take CoQ10 supplements
(200 mg of powder form CoQ10 or 60 mg of gel
form CoQ10) and you should still engage in a
healthy lifestyle.
Try to get your LDL cholesterol below 130. If you
already know you have heart disease, get your
LDL cholesterol below 100. This is achievable in
the overwhelming majority of patients who eat
right, exercise regularly and take appropriate
nutritional supplements. Yes, oxidized LDL
cholesterol is a culprit but only one of many
causes of inflammation.
Adopting a healthy lifestyle will decrease your
LDL cholesterol levels and decrease all the other
causes of inflammation that lead to heart disease.
It’s the natural, drug-free way to a more
vibrant and healthy life.
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