Are the new statin guidelines based on wrong data?
What led to the new statin guidelines and what should patients know before taking the drugs?
New statin guidelines recently published are still the subject of much debate and may be based on incorrect data.
We asked Dr. Barry Sears of the "Zone Diet" what he thought about about the new statin guidelines that are expected to mean more people will be prescribed the medications that are not without side effects that can make them intolerable.
Aside from the new heart disease and stroke risk calculator that has been highly touted as flawed, Dr. Sears says, "Besides using the wrong data which over-calculates the potential risk, there is no mention of inflammation as a risk factor."
In support of inflammation and its role in heart disease, many experts have recommended testing a patient's blood for inflammatory biomarkers that are associated with heart attack risk.
I also asked Dr. Sears for a comment about plaque stabilization that doesn't necessarily come from just taking statins.
"It was demonstrated in the British Medical Journal many years ago that fish oil stabilized soft vulnerable plaques and dramatically reduced the inflammation in those plaques, decreasing their likelihood to rupture. This explains why the CHD mortality rates in Japanese are 70% lower than in Americans because their levels of inflammation as measured by the AA/EPA are lower 75% lower than Americans although their LDL cholesterol levels are essentially the same in both groups," Dr. Sears said in an e-mail interview.
Eating fish and other anti-inflammatory foods is suggested as part of a healthy lifestyle that can prevent a variety of diseases. Statin drugs also stabilize plaque in the arteries that can rupture to cause heart attack, but for some people at the risk of intolerable and serious side effects that include muscle and liver damage.
What else might be behind the new cholesterol guidelines?
Dr. Sears said one of the reasons the guidelines have been revamped may be the result of an effort from the medical community to reinforce beliefs about heart disease to the general public, despite a lack of explanation of "why CHD mortality rates started to drop 20 years before the introduction of statins."
Dr. Sears who is an expert in anti-inflammatory nutrition wrote in 2011: "One of the great marketing successes of the pharmaceutical industry has been the linkage between LDL cholesterol levels and heart disease. In essence, the message, 'if your LDL cholesterol is high, you are going to die,' is powerful. Unfortunately, the data state otherwise."
Now experts says it's okay to have a higher LDL cholesterol that should not be treated unless is it 190 or higher. In fact, studies show it is oxidized LDL that is the culprit for heart attack as opposed to just the fatty substance itself.
The role of saturated fat in heart disease has also recently been questioned, despite what we have been told for years.
Many other experts agree the new statin guidelines could lead to overtreatment. Another problem is that patients at risk for heart disease based on the new algorithm should be put on the highest dose possible, which is also the most toxic dose.
The new guidelines would double the number of people taking statins and may grossly overestimate the number of people at risk for heart attack.
There may be more to the new cholesterol guidelines than need close scrutiny.
For now, the best thing to do if your doctor recommends a statin drug is to have an open conversation about the risks, benefits and real data behind what causes heart disease and heart attack. It's also important to understand that exercise and eating a heart healthy anti-inflammatory diet are known tools for keeping heart disease and stroke at bay and for preventing recurrence that your doctor should also be prescribing.