Cholesterol and Statins

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Cholesterol and Statins

• The Truth about Cardiovascular Disease and Health

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C-V Disease or Coronary Disease

• Leading killer of men and women in U.S.
• Across all ethnic and racial groups
• Almost 1 million die of CVD each year which adds
  up to 42 of all deaths
• One must include those suffering from CVD which
  is 8 million world wide
• This is 18X the mortality of breast cancer

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The costs.

• CVD costs the nation 274 billion each year
  including health expenditures and productivity
  loss
• The burden continues to grow as the U.S. ages
• There is no federal mandate directed towards the
  states to target CVD

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CIRCULATION Journal.

• The effectiveness of conventional medicine as
  far as early detection and treatment in actually
  preventing heart attacks is questionable.

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The Allopathic Approach..

• Medication and Surgery - Angiograms, PTCA, CABG
  are a big business
• Over one million heart angiograms are performed
  annually for a total annual cost of ten billion
  dollars
• But based upon extensive analysis, it appears
  that most of this money is wasted
• Surgery is physically invasive and traumatic and
  is 5-10X more deadly than the disease and in many
  cases, unnecessary!

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Center for Disease Control

• Where you live geographically might affect your
  exposure to factors causing heart disease (ie.
  Environmental pollution, daily stress, lifestyle
  behaviors)
• A number of health-related behaviors practiced by
  people every day contribute markedly to C-V
  disease

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These include..

• Stress (elevated stress hormones) Mental stress
  is a higher indicator more so than smoking,
  diabetes, high cholesterol or even being a man
• For those suffering from heart disease already,
  this factor is responsible for more MIs, and
  cardiac death itself

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Stress

• People whose BP rises as a result of stress are
  six times more likely to have CVD than those who
  remain calm
• This includes anger, chronic worrying and anxiety
• JAMA and Circulation both agree that stress
  blocks blood flow to the heart

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Stress..

• The walls of the blood vessels thicken, narrowing
  the flow of blood to the heart
• This increased pressure causes the heart to work
  harder (stroke volume) and faster (heart rate)
• Results in increased BP while decreasing the
  amount of blood going to and exiting from the
  heart
• All this happening when the heart demands oxygen
  and nutrients

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Diet Poor Nutrition Elevated glucose levels
and obesity

• With almost 40 of the nation being obese, this
  has resulted in hypertension (HTN), high BP, high
  cholesterol and other chronic diseases such as
  diabetes
• Only 27 of women and 19 of men eat the proper
  foods during day
• One would expect that saturated (animal) fat
  consumption would be a major cause

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But.

• The consumption of saturated fat from 1920 to
  2000 has dropped from 83 to 62 as has the
  amount of butter 18 lbs. To 4 lbs. annually
• During the past eighty years, dietary cholesterol
  intake has increased only 1
• Margarine, shortening and refined oils increased
  about 400, while sugar consumption rose almost
  60

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Lowering cholesterol by dietary means does NOT
improve health

• There is little support from trials because there
  is none at all!
• And simply lowering the percentage of energy from
  total fat in the diets is unlikely to improve
  lipid profiles or reduce CVD incidence
• The same applies to treating obesity by diet..no
  good evidence that reducing dietary fat leads to
  weight loss (in this case, it might lead
• to stupidity!!!!)

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Lack of Physical Activity

• People who are sedentary have twice the risk as
  those who are physically active
• One-half of the U.S. population do not exercise
  at recommended levels
• One quarter are completely sedentary
• This may be the key to preventing the
  occurrence and morbidity of CVD

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Tobacco Use

• Smokers have twice the risk of heart attack
• One-fifth of annual deaths directly connected to
  smoking
• 1,000,000 young people smoke in the U.S.

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With all these facts

• Lets look at the myths

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Myth 1 High cholesterol (and LDL) is the number
one cause of heart disease in the U.S.

• High cholesterol is a risk factor but not the
  number one factor
• The most prevalent risk factor is low HDL
• 70 of victims have low HDL while 30 have High
  LDL
• If this is the case why dont we hear more about
  Low HDLs?

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The answer is simple.

• Because treating these is not profitable for drug
  companies!!!!
• But wait!!! When a drug becomes available to
  treat the HDL, you will hear about the epidemic
  in this country which will justify millions being
  spent for a new drug!

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What qualifies as Low HDL?

• 40 mg/dL for men
• 45 mg/dL for women
• HDL is already available in the standard
  cholesterol panels
• Drug Companies focus on the lowering of the LDLs
  while the most important factor goes unchecked

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Myth 2 If I take my statin, I will not get a
heart attack

• This simply is not true
• Lowering cholesterol, even to rock-bottom levels
  reduces but does not eliminate heart attacks
• Other factors must be considered like low HDL,
  homocysteine and high insulin levels
• The 2003 National Health and Nutrition Survey
  show that 47 million U.S. adults have Metabolic
  Syndrome low HDLs High triglycerides, High
  BP and excess abdominal fat which substantially
  heightens the risk of CVD even in the presence of
  of cholesterol levels and statin use.

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Myth 3 I feel fine and my stress test was
normal. My doctor says I do not have heart
disease.

• Lack of symptoms should not be reassuring as most
  heart disease is silent, without symptoms
  undetectable by conventional means such as ECG
  and cholesterol testing.
• Stress testing is a miserable failure for
  screening asymptomatic people most future MI
  occur in people with normal stress tests
• How many times have you heard about your neighbor
  passing a stress test on Tuesday only to drop
  dead on Thursday?

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Cholesterol The Lipid with the bad reputation

• Hyperlipidemia refers to elevated blood levels of
  lipids (fats) including cholesterol and
  triglycerides.
• Most people with hyperlipidemia have no symptoms
• But hyperlipidemia is a contributing factor for
  coronary heart disease (CHD), a thickening or
  hardening of the arteries that supply blood to
  the heart muscle

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Cholesterol The Lipid with the bad reputation

• CHD can in turn result in angina pectoris (chest
  pain), a heart attack or both
• Hyperlipidemia is but one risk factor of many
  concerns and what causes it is also of great
  debate
• It is not as simple as foods that contain
  cholesterol which elevate lipids

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But what has been overlooked..

• The oxidation of LDL cholesterol caused from a
  lack of antioxidant-rich foods, herbs and
  nutrients and/or a large intake of foods and
  chemicals hat contain damaging free radicals.
• When LDL cholesterol oxidizes, it promotes
  atherosclerosis by a process referred to as the
  macrophage foam cell mechanism
• This is especially so in the presence of
  stressors like cortisol and insulin

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Cortisol and Insulin

• Act to inflame the arterial walls which are the
  real underlying causes of chronic disease
  including PVD
• The production of a C-reactive protein is the
  essential part of the inflammatory process deep
  within the body
• Multiple risk markers for atherosclerosis and C-V
  disease act in a synergistic way through
  inflammatory pathways

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The immune, endothelial and smooth muscle cells
are all affected

• What prevents the inflammatory process is the
  presence of flavonoides carotenoids, sterols,
  vitamin C and E Omega 3 and 6 fatty acids (alpha
  linoleic) to circumvent these inflammatories
• A marker of note is that of Nitric Oxide and
  Peryoxynitrate to reduce vascular lesion
  formation and induce vasodilation

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How do we obtain these nutrients?

• Arginine
• Antioxidants Vitamin C and E, lipoic acid,
  selenium, glutathione
• Enzyme co-factors such as B2, B3, B6, B12, folate
  and zinc
• DHA/EPA from fish oil, tocotrienols and quercetin
• All help to elevate nitric oxide levels

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The Range of Cholesterol

• With a broad range from 180-240 mg/dL there is
  little to no evidence that this alone correlates
  with heart disease.
• Below 180 there is risk of hemorrhagic stroke,
  depression and suicide
• Above 240 there is increased risk of C-V disease
  and ischemic stroke.
• Over 70, elevated cholesterol and C-V events do
  not correlate
• All told, total serum cholesterol is a poor
  indicator of C-V disease.
• Half of all MI have normal total cholesterol
  levels

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