Scientists appear reluctant to admit that a serious blow has been dealt to the cholesterol hypothesis
Last Friday saw the publication of an intriguing study which assessed the relationship between cholesterol levels and ‘vascular’ mortality – namely deaths due to heart disease and stroke. This review appeared in the Lancet medical journal, and assessed data from 61 studies. In short, this piece of research found that higher levels of cholesterol were associated with an increased risk of death due to ‘ischaemic heart disease’, but this was not the case with stroke. This finding is, to my mind, highly significant, and here’s why.
Conventional medical thinking is that high levels of cholesterol in the blood stream cause ‘atherosclerosis’ – a furring up of the arteries through the build of fatty deposits there. Atherosclerosis is believed to be the underlying process in pretty much all heart attacks, and about 85 per cent of strokes (15 per cent of strokes are caused by bleeding rather than vessel blockage). Logic would dictate that the if cholesterol causes atherosclerosis, then higher levels of cholesterol should increase the risk of both heart disease and stroke deaths.
The fact that this appears not to be the case appears to have left the researchers who unearthed this data a little nonplussed. The authors, collectively referred to as the ‘Prospective Studies Collaboration’ say that their findings are ‘unexplained’ and ‘invite further research’. They are also in their paper keen, it seems, to remind everyone that cholesterol reducing drugs (statins) reduce the risk of stroke (and heart disease).
So, what’s going on here? Well, just applying a simple deduction for a moment, if strokes are not caused by raised cholesterol, but statin drugs (which reduce cholesterol) reduce risk, is it not possible that statins reduce stroke risk through a mechanism other than cholesterol reduction. Before anyone starts nominating me for a Nobel prize, can I just point out that is well established that statins have a number of effects in the body, which include a blood-thinning effect. Just this effect alone would be expected to reduce the risk of stroke.
What is puzzling about the Lancet paper is that the effects of statin drugs other than cholesterol reduction are not even mentioned. The Prospective Studies Collaboration, by the way, is made up more than 100 doctors and scientists, all of whom had the opportunity to contribute to the interpretation of the results. It is almost beyond comprehension, to me anyway, that none of them thought of suggesting that the paradoxical findings regarding stroke could be explained by the fact that statins are perhaps working though mechanisms other than cholesterol reduction.
To do that, of course, would ask serious questions about the whole cholesterol hypothesis. And one might imagine that drugs companies who make money though the promotion of this concept as well through the sale of ‘solutions’ to the cholesterol ‘problem’ would be none too keen about this.
So, is it possible that drug company money might have exerted some influence here? The Lancet paper was written by a ‘writing committee’, comprised of 9 individuals, all but one of whom are members of what is known as the ‘Clinical Trial Service Unit’ (CTSU). In the ‘Conflict of interest statement’ at the bottom of the paper it is revealed that the CTSU is involved in clinical trials of cholesterol lowering medication and is funded, at least in part, by manufacturers of that medication including Merck, Schering and Solvay. Oh, and the one member of the writing committee who not a member of the CTSU has shares in GlaxoSmithKline (another manufacturer of cholesterol lowering medication).
None of this proves anything of course. However, bearing in mind that the CTSU is involved in research into statin drugs, does it not seem a little odd that its members seem to be unaware of the effects that these drugs can have in the body other than cholesterol-reduction? It does to me.
References:
1. Prospective Studies Collaboration. Blood cholesterol and vascular mortality by age, sex, and blood pressure: a meta-analysis of individual data from 61 prospective studies with 33000 vascular deaths. Lancet 2007;370:1829-1839.
Published December 3, 2007 . Filed under: Cholesterol and Statins, Food and Medical Politics
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Definition from Professor John Brignell at
http://www.numberwatch.co.uk/vocabulary.htm
Paradox = A politically incorrect result of observation
December 3, 2007 @ 1:58 pm
After reading about this for a couple of years now, including studies and other’s interpretation of studies, I’ve come to the conclusion that the “positive” effects of statins are far overblown and more likely random due to inequalities in the groups. (I also feel strongly that you can “tweak” statistics to say whatever you want, so I’m very cautious when I see that numbers are “adjusted for” smoking, or whatever).
I think that it’s not the cholesterol lowering but the inflamatation lowering that statins cause. But, at the same time, that doesn’t make sense either, as other drugs that lower inflammation seem to increase rather than decrease the deaths from heart disease?
My personal belief is that the best thing we can do is lifestyle changes. Dramatically reduce the amount of processed food you eat, exercise, sleep well and relax frequently. It’s not easy in today world, but it’s what’s going to save us, not some expensive drug that has all kinds of side effects.
The medical community and the media must stop pandering to the drug companies. We should all be encouraged to get back to natural wherever we can, not take a pill to cover up symptoms. Drugs used properly are lifesavers, no doubt. But the way so many are used today is dangerous and a waste….and statins are up at the top of the list.
December 4, 2007 @ 12:04 am
[...] Briffa posted an article on his blog today titled Scientists appear reluctant to admit that a serious blow has been dealt to the cholesterol hypothesi… regarding this [...]
December 4, 2007 @ 2:29 pm
I have been looking into this for a few months. Somewhere, and I can’t remember where, I saw it suggested that statins have an anti-inflammatory effect. As it is not cholesterol but inflammation in the arteries that causes cardiovascular problems, could this be a possible explanation for the apparent effectiveness of statins? Whatever the answer, the best course of action would be to prevent inflammation in the first place with a proper diet, avoiding the really bad fats, ie the trans fats, and including sufficient nutrients to prevent the build up of one of the real culprits for heart disease, homocysteine. And, of course, herbs are much better anti-inflammatories than drugs. Drugs cannot heal the body and statins, like most drugs, have damaging side-effects.
December 7, 2007 @ 5:41 pm
Doesn’t taking aspirin regularly significantly reduce your chances of ischaemic heart disease & stoke? It’s cheap, easy to obtain & as I understand it, a fairly natural product.
December 8, 2007 @ 2:51 pm
[...] 11 Dec ‘07 update: “Scientists appear reluctant to admit that a serious blow has been dealt to the cholesterol hy…. [...]
December 11, 2007 @ 1:36 am
That’s some “real” science going on there. Anyone can come up with a hypothesis. If it sells more drugs and you profit from those drugs, could it be biased? Remember the other real scientific studies? Butter is bad, oh wait, butter is good. Eggs are bad, oh wait, eggs are good. Salt is bad, oh wait, salt is necessary (real salt, not sodium chloride).
Don’t be a sheep, use your noggin people. I take most “scientific” advice with a grain of salt as we all should.
February 23, 2008 @ 12:36 am