A sudden flash of truth

 

 ‘Men occasionally stumble over the truth, but most of them pick themselves up and hurry off as if nothing had happened.’ Winston Churchill

Anyone reading this blog will know that I do not believe a raised LDL/Cholesterol causes heart disease. I am not going to bore you with my reasoning here. Suffice to say that it is a completely non-scientific theory that rapidly dissolves on contact with critical thought, or the evidence.

I recognise that this flies in the face of conventional thinking. Indeed, almost every day there is a new headline about the wonders of cholesterol lowering using statins. Recently Professor Sir Rory Collins re-iterated his wish that all adults over the age of the fifty should take statins. http://www.dailymail.co.uk/health/article-2194892/All-50s-statins-regardless-health-history-says-Oxford-professor.html

Just around about exactly the same time someone sent me a link to an article about the effect of statins on coronary artery calcification in diabetics. For those who don’t know, calcification of the arteries is a very powerful indicator that you have serious atherosclerosis in the arteries in your heart. The basic underlying cause of coronary heart disease.

To quote from WebMD on an article in the Journal of the American Medical Association (JAMA):

“A test that measures calcium deposits in the walls of the blood vessels supplying the heart is better than other tests for identifying patients at risk for heart attack and stroke. Coronary artery calcium score (CAC) was found to be the most accurate predictor of whether people would suffer one of these events, in a study published today in the Journal of the American Medical Association.

The test is increasingly used by heart doctors to identify heart disease, says cardiologist Gordon Tomaselli, MD, of Johns Hopkins University Medical Center. He was not involved with the study. “Someone who has calcium in their coronary arteries is no longer at risk for developing heart disease — they have heart disease,” he tells WebMD. “That is why more and more cardiologists are using this test.” (WebMD Health NewsAug. 21, 2012)

So you would expect, would you not, that statins would reduce the amount of coronary artery calcification. Or at least the progression of calcification. Furthermore, you would expect that this effect would be especially pronounced in people with diabetes as their risk of heart disease is around three to five times as great as in the rest of population.

Much my great lack of surprise, the study I was sent found the following (just read the conclusion if you like):

ABSTRACT:

Objective: to determine the effect of statin use on progression of vascular calcification in type 2 diabetes (T2DM).

Research and Design methods: Progression of coronary artery calcification (CAC) and abdominal aortic artery calcification (AAC) was assessed according to the frequency of statin use in 197 participants with T2DM.

Results: After adjustment for baseline CAC and other confounders, progression of CAC was significantly higher in more frequent statin users than in less frequent users (mean ± SE, 8.2 ± 0.5 mm(3) vs. 4.2 ± 1.1 mm(3); P < 0.01). AAC progression was in general not significantly increased with more frequent statin use; in a subgroup of participants initially not receiving statins, however, progression of both CAC and AAC was significantly increased in frequent statin users.

Conclusions: More frequent statin use is associated with accelerated coronary artery calcification in T2DM patients with advanced atherosclerosis.

[Saremi A, Bahn G, Reaven PD:  ‘Progression of Vascular Calcification Is Increased with statin Use in the Veterans Affairs Diabetes Trial (VADT)’ .Diabetes 2012 Aug 8.  [Epub ahead of print]]

So, there you go. Statins, which protect against heart disease (a bit), accelerate coronary artery calcification. Explain that one.

My explanation is simple. Statins do not work by lowering cholesterol levels. In fact, lower cholesterol levels lead to more rapid development of atherosclerosis. Any beneficial effect of statins is due to anti-coagulant effect – amongst other non-lipid effects.

Would a supporter of the cholesterol hypothesis care to come up with another explanation that fits the facts?

Anyway, here was a sudden flash of truth. Like supernova they light up the sky for a bit, then fade. Then the world will carry on believing in the cholesterol hypothesis, pretty much as before. Facts cannot destroy belief.

To quote Daniel Kahneman, Nobel prize winner in economics, on the irrationality of the financial system, and how people come to believe in things. He makes many interesting points. For example:

The way scientists try to convince people is hopeless because they present evidence, figures, tables, arguments, and so on. But that’s not how to convince people. People aren’t convinced by arguments, they don’t believe conclusions because they believe in the arguments that they read in favour of them. They’re convinced because they read or hear the conclusions from people they trust. You trust someone and you believe what they say. That’s how ideas are communicated. The arguments come later.’

 

6 thoughts on “A sudden flash of truth

  1. Tony Collingwood

    Hello Dr Kendrick

    I read the Daily Mail article about Prof Collins’s work and noted the statement “Healthier people who were given statins also had lower overall death rates than those who were given a placebo”.

    Do you know whether that is supposed to refer to death rates from all causes or just from heart disease/strokes? I suspect the latter, in which case the statement is misleading.

    Incidentally I wrote to Prof Collins a few months ago since he seemed to have an interest in relation to the side effects of statins and the SLCO1B1 gene. I told him that my wife had taken statins for about 4 years (until 2009) but decided to suspend taking them for a while as she thought they were interfering with her ability to lose weight. Literally within days, a number of health problems she had been having resolved (muscle pains which had reduced her to “crawling out” of bed in the mornings, insomnia and reflux). I pointed out to Prof Collins that my wife had never related any of these health issues to statins. It could have been coincidence of course but she immediately resolved never to take statins again and the problems have not recurred (but the weight problem unfortunately persisted!). Prof Collins has not shown any sign of interest in my wife’s case – not even the courtesy of an acknowledgement. Probably because it doesn’t align with the propaganda he’s pushing.

    Keep up the good work!

    TC

    Reply
    1. Dr. Malcolm Kendrick Post author

      Prof Collins is a black belt dan seven in writing things that appear to mean one thing, but don’t. Firstly, he seems to know which statin studies contained ‘healthy’ people. What does he mean by healthy? Tricky one that. Moving on, did he he mean an overall lower death rate from all cause mortality. Not likely, as no study has shown this effect with statins – other than JUPITER (the most distorted study of all time). Professor De Logeril had much to say on this study:

      Meanwhile, de Lorgeril et al spend much of their paper arguing that the lack of significant effect on cardiovascular deaths in JUPITER does not fit with the strong effect on nonfatal complications and total mortality, which in turn are inconsistent with other data from primary-prevention trials. They write that although an “unequivocal reduction in cardiovascular mortality was announced in March 2008 as the main justification for the premature trial termination, the absence of cardiovascular mortality data in the published article is striking.

      “If readers calculate the rate of cardiovascular mortality from the data in the paper, it’s clear that the CV mortality in JUPITER is actually ‘unexpectedly low’ compared with total mortality—between 5% and 18%, depending on the means of calculation—whereas the expected rate would have been close to 40% in a non-Japanese and non-Mediterranean population,” they write. “These mortality data are not epidemiologically consistent, and the early termination of the JUPITER trial likely was, at least partly, responsible for that lack of consistency.”

      Basically, there is a very powerful coterie of researchers: Collins, Ridker, Topol, Baigent, Nissan, Law, Wald, Reckless etc. who have pushed mass statination to infinity and beyond. They have all become exceedingly powerful, influential, famous and rich from so doing. At times the truth has been subjected to the Procrustean bed, and we know what happens to anything subjected to that particular instrument of torture.

      Reply
  2. Radames Soto

    Dr. Kendrick, I am here in NYC. My cholesterol is 229 and the Dr. suggested statins. I have been avoiding stains by my cholesterol levels continue to go even though I live a very healthy life style- I have tried the Red Yeast but nothing seems to work, what Should I do?
    thanks

    Reply
  3. Christopher Palmer

    I love the fairly open declaration of intent and agenda that slipped into that Daily Mail report. A quote in this instance from Peter Weissberg of the BHF.

    Professor Peter Weissberg, medical director of the British Heart Foundation, said: ‘The issue is where do you set the threshold between low, normal and high risk.
    ‘The current arbitrary threshold was decided by cost but now statins are off patent (and much cheaper) it may be appropriate to see if there are benefits for more people – the threshold is a bit too high,’ he added.

    He could be more transparent and say something along these lines …

    .. .. Now that would be borrowers have ceased borrowing in the numbers and amounts they once did, and now that would be mortgage lenders require higher percent deposits there has been a huge contraction in lending. The huge contraction in lending means that there is also an equivalent and immutable contraction in the supply of the new money that would otherwise represent the additional value needed to sustain the capital gains or profits that everyone holding an investment or asset is seeking. While people expect and try to sustain capital gains and profits in keeping with their expectations bit in the face of greatly reduced money supply then money becomes decidedly scarce in some parts of the economy.

    .. .. I used to be confident the income streams that sustain the BHF and its excellent work would continue, and then in turn that my remuneration via my association would continue to butter my parsnips for many a year. But the Banking crisis, the austerity measures and the regulators insistence (rightful) that the banks re-establish fractional reserves (liquidity ratios) of 3% (Just how low did these liquidity ratios fall if they are to be restored to 3%?) has put the brakes on the supply of new money and I can no longer remain so confident about the continued generosity of my paymasters. .. .. Hell boys, times are hard and they get worse! Contemporaneously and at the same time) those highly lucrative pills that sustained the gold-rush are now off patent. Those former high prices cannot be sustained post-patent and now nor can the profits. Revenues have declined and profits are in free-fall.

    .. .. Those that ride the BHF gravy-train, myself included, fear for our future and our future security. We have mortgages, school fees, and children insistent we buy expensive sterol enriched spreads, stock the fridge with cholesterol lowering yoghurt drinks, pots of friendly bacteria, and other functional foods. The returns on our savings have been poor and our investments are stagnating. We have no choice but to act. From our point of view it makes the most perfect sense to take the former niche market for statins and convert it into a mass market. And it needn’t cost the NHS any more because with the fall in price they can treat more people for the same money. It’s a win – win situation.

    Mind you, such a statement would pass over many peoples heads as very few people are clear in their minds that the pyramid of wealth requires a persistent relationship with a pyramid of debt, and with an equivalence ratio of 1:1; as matters stand. Growth in the former requires an extension of the latter. Recognition could be the one advance that could actually lead to the building of a Brave New World.

    Reply
  4. vicarage

    While this could be considered to be a” work in progress. Yo-yo dieting jokes has also been found to be associated with increased risks of diabetes, heart disease, diabetes and cancer. Some folks have this misconception that they must stop eating to be able to shave 100 calories from your meal.

    Reply

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