Friday, March 28, 2008
Something to think about?
This is one article that makes me go "hmmm....". It's sometimes confusing to find the balance between trusting modern drugs and traditional or natural cures.
Have You Seen Those Misleading Lipitor Ads?
by Jonny Bowden, PhD, CNS
I'm sure you've seen the ads. Dr. Robert Jarvik, best known for the artificial heart he pioneered more than 25 years ago, is rowing a one-man racing shell across a mountain lake, looking like the picture of health. "When diet and exercise aren't enough", Dr. Jarvik says solemnly, "adding Lipitor significantly lowers cholesterol".
The implication is clear. This stuff's got to be good. Here's one of the big guns in the area of heart medicine - he invented the artificial heart for goodness sake - endorsing it. He uses it himself and he's rowing away like an athlete half his age. It's got to be good, right?
Shades of those old late night infomercials for hair replacement - "I would not lie to you! I'm the president of the company!"
Well, it turns out that Jarvik doesn't actually row. And he isn't actually a cardiologist and currently isn't even licensed to practice medicine. "He's about as much an outdoorsman as Woody Allen" said his longtime collaborator, Dr. O. H. Frazier of the Texas Heart Institute.
OK, so they used a stunt double to sell the pill. Is that so bad?
Not by itself. But taken together with some other troubling information that was revealed recently, it might cause us to take a new look at the whole mania for lowering cholesterol.
Most people only care about lowering their cholesterol for one reason: they believe that doing so is going to make them live longer and reduce the risk for a heart attack. Otherwise why bother, right? So the recent trials on Vytorin - a new cholesterol medication - have something interesting to tell us.
Vytorin (which became famous for commercials which showed people who look similar to foods like banana cream pie and tacos) actually combines two drugs: Zocor, a top-selling statin (cholesterol lowering med) and Zetia, a drug that limits cholesterol's absorption. The hope was that the combo med would be a blockbuster because it lowers cholesterol even more than either medication taken alone.
And it does.
Problem is, that's all it does. The recent study that got headline attention showed that the new drug didn't do a darn thing to slow the growth of arterial plaque. The decline in cholesterol level didn't translate into any appreciable benefit if by benefit you mean living longer or avoiding heart disease.
Which might make you wonder.
Maybe, just maybe, we've been concentrating on the wrong thing. Maybe lowering cholesterol isn't the be-all and end-all of a heart healthy lifestyle.
Remember, fully half of people with heart attacks have normal cholesterol. And half of the people with "elevated" cholesterol have perfectly fine tickers.
Emperor's new clothes, anyone?
Trying to lower death rates and heart disease just by lowering cholesterol is like trying to reduce auto fatalities just by making stronger air bags. The air bag industry likes it; but it doesn't touch the major risk factors for highway deaths, like drunk driving.
For a long time I've been part of the "International Network of Cholesterol Skeptics" who believe our collective emphasis on this one measurement is wrong-headed and not even based in good science. I've seen people with absolutely not a heart disease risk factor in sight be given Lipitor or Zocor because their total cholesterol was a measly 210. That is utterly ridiculous.
And by the way, there is not a shred, and I mean not a shred, of evidence that lowering LDL cholesterol does a thing for women. The only population it seems to help is middle aged men who have already had a heart attack.
We would be so much better off looking at blood measures like triglycerides, homocysteine, CRP (a measure of inflammation) and the ratio of triglycerides to HDL cholesterol, a ratio which, in a published article in the journal Circulation, was found to predict heart disease 16 times better than cholesterol. To find your ratio take your triglycerides and divide by your HDL cholesterol. For example if you've got triglycerides of 100 and HDL cholesterol of 50, your ratio is 2, which is a vanishingly low level of risk. Five, on the other hand is high risk. You can lower your ratio simply by bringing down your triglycerides, something relatively easy to do with a lower carb, no-sugar diet!
And while I'm ranting, let me say one more thing about statin drugs, which, by the way, are inching close to being a 20 billion dollar a year industry, and that's just for the two top selling cholesterol-lowering drugs.
Statin drugs probably do some good but not because they lower cholesterol.
Statin drugs lower inflammation, and that is something we should be concerned about. But saying they prevent heart attacks by lowering cholesterol is like saying aspirin prevents clotting because it gets rid of headaches.
And by the way, in case you're interested, cholesterol is the parent molecule for your sex hormones, not to mention for vitamin D. And there are multiple dangers to lowering it too much, despite what the drug manufacturers would like you to believe.
Let's start looking at the other risk factors for heart disease, like smoking, not exercising, not eating fish or fish oil, being overweight and stress. Remember, in the Nurses Health Study they got an 83% reduction in risk for heart disease just by following five simple lifestyle modifications: a healthy diet (with fish), a healthy weight, no smoking, moderate alcohol and daily exercise.
Eighty three percent!
There's not a drug on earth that can give you those results.
And by the way, Pfizer has pulled those ads with Dr. Jarvik.
About the author
Dr. Jonny Bowden (www.jonnybowden.com) is a board certified nutritionist, and nationally known speaker who has appeared on Fox News, CNN, MSNBC, ABC, NBC and CBS as a nutrition expert. His latest book is "The Most Effective Natural Cures on Earth"((http://www.amazon.com/Most-Effective-Na...). For more information, free audio courses and newsletter please visit (www.jonnybowden.com) .