Why You Don’t Need Lipitor

Posted 10/28/2008

You could see smoke pouring from the ears of some doctors, myself included, at information released earlier this year. A combination of junk science, the drug industry, FDA, and American Heart Association (AHA) had convinced us that lowering cholesterol actually prevented heart disease.

It turns out we’d all been conned. And it’s interesting how these revelations are surfacing a few months before Lipitor becomes generic and drug giant Pfizer loses its cash cow.

I’ll keep this succinct by using bullet points:
• Cholesterol, even the so-called bad LDL cholesterol, is not the villain after all. Analyzing worldwide data, epidemiologists have shown that cultures with high LDL have low heart attack risks and vice versa. Other factors, especially inflammation, are much more important than cholesterol levels.

• According to the newly released data, taking a statin drug such as Lipitor, Zocor, or Crestor to lower cholesterol will not–repeat, will NOT–prevent you from having a heart attack unless you have already had a heart attack (these drugs prevent a recurrence) or you are diabetic. I’m not suggesting that you quit your statin tomorrow and do nothing else. You’ve got to replace it with healthful eating, exercise, monitoring your blood pressure to ensure it’s normal, stress reduction, and a daily aspirin. In addition, ask your doctor to confirm that you’re not borderline diabetic.

• In cases when the statin drugs do prevent heart attacks, such as among diabetics and in those who’ve had previous heart attacks, they do so by reducing inflammation in the arteries. However, you can reduce inflammation for pennies a day by taking aspirin, fish oil, and/or the spice turmeric.

• If you’re someone who has never had a heart attack and yet you’ve taken a statin drug for years, you can give it some credit for doing something: it’s acted like a mild anti-inflammatory. One recent study showed exactly that. Heart disease was prevented by lowering levels of C-reactive protein (CRP), a measurable marker of your body’s inflammation. Although no study has pitted a statin drug head-to-head against aspirin when it comes to heart disease prevention, most cardiologists think the two have about the same effectiveness. Eating fish and using turmeric in your cooking are bonus anti-inflammatories.

• The AHA has been under fire recently for its financial partnerships with Big Pharma and endlessly endorsing medications to lower cholesterol even in the face of evidence that cholesterol (or high fat diets) are not the villains of heart disease.

• Every time you see an AHA logo on a product, understand that the AHA receives a substantial royalty check. Do you really think brand-name Cheerios are “heart safe” while generic Cheerios are not? And do you really think Cheerios themselves are a better heart protector than a bowl of oatmeal? Like pharmaceuticals, cereal is big business. Go to the dry bins at your local co-op or Whole Foods, scoop out some organic whole oats, cook up a big batch, and enjoy a bowl every day. No logo needed and guaranteed “heart safe.”

• Statin drugs are potentially quite dangerous. Painful muscle cramps, liver enzyme abnormalities, gastrointestinal upsets, and even mental confusion are fairly common side effects. Even as some doctors are actually encouraging prescribing statins for children, no one really knows the effect on the body of taking these medicines for decades.

• One of my major concerns is how I’ve watched the taking of statin drugs lull many patients into the false complacency of continuing an unhealthful lifestyle. “I don’t have time to exercise but at least my doctor thinks my cholesterol is terrific.” How many people will have gravestones that read “At least his cholesterol was normal”?

• For more on the fascinating story of how drug companies teamed up with the FDA and others to con us all on cholesterol, click here.

• The best eating for heart disease prevention is a low-inflammation diet, essentially a Mediterranean diet. Dr. Andrew Weil has a nice piece on it here.

Be well,
David Edelberg, MD