The Skinny on Heart Disease, Cholesterol

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In the United States, about $19 billion are spent on statins yearly. That's more than is spent on all the supplements out there. So are we getting our money's worth for all those drugs lowering our cholesterol?

Lowering Cholesterol

The best-known statin drug, Lipitor, is the most prescribed drug ever in the world. That's because it lowers cholesterol.

Click play to hear Pat Robertson's comments following CBN News Reporter Gailon Totheroh's report.

And for the past seventy years, high levels of cholesterol have been thought to damage the blood vessels. That damage appears as bad spots inside the vessel walls called plaques.

In medical lingo, the collective name for all those plaques is atherosclerosis. That used to be called hardening of the arteries.

In fact, because of high cholesterol, President Dwight Eisenhower was put on a low cholesterol diet following his heart attack way back in 1955.

In Ike's situation as well as the recent case of journalist Tim Russert, plaques broke open and triggered blood clots. The clots went to their hearts blocking blood flow. That killed Russert, but only weakened Eisenhower. But in 1957 one of those clots went to President Eisenhower's brain and caused a stroke.

High Cholesterol, Heart Disease -- a Link?

In the late 1950s, researcher Ancel Keys began looking at the link between high cholesterol and heart disease around the world. Cardiologist Stephen Sinatra comments, "He showed in seven countries high cholesterol predisposed people to heart disease, but when you extend it to 22 countries the cholesterol hypothesis fell apart."

Sinatra says there was much research contrary to Keys' proposition. The "blame cholesterol" interpretation still won the day and led to the widely accepted idea that high cholesterol causes heart and circulatory disease.

That opened the door for the introduction of statins 20 years ago as the means to lower that cholesterol. They were hailed as a breakthrough in heart attack and stroke prevention.

Cardiologist Arthur Agatston likes the statins and prescribes them to his patients. He follows research showing they reduce the number of heart attacks, "Statins are wonderful medications. They're much safer than much of the popular press indicates. They decrease heart attacks by about 30%."

And when statins first came on the market, Sinatra also thought they were great until some of his patients with low cholesterol began having heart attacks.

He started noticing a trend, "I did thousands of cardiac catheterizations and took care of thousands of heart attacks. But wait a minute, I'm seeing people come in with heart attacks with cholesterol levels of 150. It didn't make sense."

Today, Sinatra believes the theory making high cholesterol responsible for heart disease is wrong. He says cholesterol doesn't predict who will have a heart attack.

And he contends the reason statin drugs reduce heart attacks is not because they lower cholesterol but because they reduce inflammation in the body.

"Inflammation is the root cause of heart disease -- unfortunately this cholesterol story, you know, is stealing the stage as the number one factor in heart disease," he says, "but I believe nothing is farther from the truth."

Yet Sinatra does prescribe statins for their anti-inflammatory benefit. He prescribes small doses, usually ten milligrams, primarily in those few patients with serious heart conditions.

Especially because of concerns about the safety of statins, he limits their use. Debilitating muscle pains and serious memory loss are reported.

Risks of Taking Statins

Harm to the immune system may leave the young and the old susceptible to dangerous infections. And statins may also increase the risk of several cancers, Sinatra says, "Who cares if your cholesterol is 250? You want to take a drug that could give you breast cancer when we've got to re-think this whole cholesterol hypothesis and heart disease? That's a tragedy."

Why the side effects? Probably because statins inhibit the liver from producing coenzyme Q10, a substance that powers the body's cells. So Sinatra says if you're taking Zocor, Crestor, Pravachol or any of the statins, you should definitely take a coenzyme Q10 supplement to overcome the deficit.

He says start with CoQ10, as it's often called, and add antioxidants like vitamins C and E which also fight the damaging results of inflammation.

Magnesium, L-carnitine, and D-Ribose are other supplements that strengthen the body against inflammation and may also help offset drug side effects. Sinatra has written a book explaining how those energizing substances work, Metabolic Cardiology.

Both Sinatra and Agatston recommend that people take fish oil, which can help prevent the tragedy that struck Tim Russert. The omega-3 fats in fish oil reduce inflammation and can help keep those plaques from breaking open.

The Importance of Your Diet

The cardiologists also agree that diet is central to fighting inflammation and heart disease. Agatston offers sobering news about the U.S., "While we're overfed, we're literally undernourished. We're not getting the nutrients from the variety of fruits and vegetables and whole grains we should be."

He adds the insight that statins are not a substitute for a healthy lifestyle. That's why he's emphasized proper eating in his latest book, The South Beach Diet Supercharged.

And Sinatra says there are many inflammation-fighting foods in the aisles of your grocery store. Start with lots of vegetable, organic if possible, and use healthy spices, "Ginger does the same thing aspirin does, it thins the blood, it's also a potent anti-inflammatory."

But there's one category to avoid for heart health. That group is highly inflammatory, Sinatra insists, "Sugar is the worst thing for causing heart disease. It's not cholesterol, it's sugar. I'm anti-sugar whether it's high fructose corn syrup or regular sugar or synthetic sugars."

Sinatra believes going the natural route can actually reduce plaques in the vessels. That concept led to his writing Reverse Heart Disease Now.

In the rush of talking about cholesterol theory and statins, the goal of good health can be missed. That crucial focus means finding ways to protect and restore the heart and blood vessels.

*Originally aired on July 30, 2008.

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Gailon Totheroh

Gailon Totheroh

CBN Science & Medical Reporter

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