Cholesterol: The Rest of the Story


Everyone has heard the commercials that repeat “when diet and exercise aren’t enough, take Zocor or Lipitor (or another statin drug). What the commercials don’t say is that for the vast majority of individuals with elevated cholesterol levels diet and exercise ARE enough according to the medical studies. Unless a person has a condition called Familial hypercholesterolemia, an autosomal dominant genetic disease affecting either 1 in 500 for the heterozygous form (caused by a single abnormal copy of the gene) or the homozygous form (caused by two abnormal copies of the gene) affecting 1 in one million Americans, the routine or garden variety elevations of cholesterol in everyone else are predominantly due to dietary and lifestyle factors.

What is also not mentioned in the TV commercials is something called the number needed to treat or NNT. This means that 50 men at risk for a heart attack would have to take a statin drug for 5 years to prevent one heart attack or stroke. In other words, 98 of 100 men treated for 5 years would receive no benefit from the drug.

Here are some other Cholesterol findings from recent medical studies:

• If you lower bad cholesterol (LDL) but have a low HDL (good cholesterol) there is no benefit to statins.

• If you lower bad cholesterol (LDL) but don’t reduce inflammation (marked by a test called C-reactive protein), there is no benefit to statins.

• If you are a healthy woman with high cholesterol, there is no proof that taking statins reduces your risk of heart attack or death.

• If you are a man or a woman over 69 years old with high cholesterol, there is no proof that taking statins reduces your risk of heart attack or death.

• Aggressive cholesterol treatment with two medications (Zocor and Zetia) lowered cholesterol much more than one drug alone, but led to more plaque build up in the arties and no fewer heart attacks.

• 75% of people who have heart attacks have normal cholesterol.

• Older patients with lower cholesterol have higher risks of death than those with higher cholesterol.

• Countries with higher average cholesterol than Americans such as the Swiss or Spanish have less heart disease.

• Recent evidence shows that it is likely statins’ ability to lower inflammation it what accounts for the benefits of statins, not their ability to lower cholesterol.

So who should take statins? Men who have already have had at least one heart attack to prevent future attacks and death. Middle aged men may receive some benefits that have other risk factors like obesity, diabetes and high blood pressure (all considered to be lifestyle diseases).

Our FirstLine Therapy lifestyle program demonstrates the diet and lifestyle ARE enough for most cholesterol problems through a Mediterranean Diet and specialized medical foods with plant sterols proven to lower cholesterol.