The Great Cholesterol Debate

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By Christopher Leet, MD, FACC Emeritus

Among “New Agers” and conspiracy theorists, etc., there is an ongoing debate that elevated cholesterol is not the cause of heart attack153256608 and stroke, and that the increasing use of statin drugs (Lipitor®,Crestor® andothers) is a conspiracy among doctors and big Pharma to make money.

As with all conspiracies, there is a grain of truth, but the rest has been blown way out of proportion. Nobody has the answer to the cause of heart attack or stroke, because the cause is a multifactorial problem. There is no conspiracy here.

High cholesterol is not the cause of heart disease, but it is a cause. Other factors include obesity, family history, smoking, diabetes, stress and high blood pressure. Physicians properly consider all of these in assessing an individual’s risk. Treatment is then focused on eliminating as many risk factors as possible.

If high cholesterol is an issue, and diet is unsuccessful in lowering it, then statin drugs are very effective. Recent studies in The New England Journal of Medicine indicate that the average cholesterol of the population is on the decline, in spite of the obesity epidemic. The decrease has been attributed to a widespread use of these drugs.

Objections to the drugs are based on cost and side effects. While there is no drug that is free of side effects, statins are generally well tolerated, except by a few patients who develop muscle pain. There is also a possibility of undefined memory problems.

For those who prefer natural substances to help reduce cholesterol, many recommend Chinese red yeast rice. This will lower cholesterol, mainly because the active ingredient is a statin (lovastatin, brand name Mevacor®).

Indeed, all statins were actually derived from the same fungus used to make red yeast rice, and so they are natural substances to a degree. However, they are much more refined, without the contaminants present in unregulated dietary supplements.

Manassas resident Dr. Christopher Leet, now retired, practiced medicine for nearly 40 years, specializing in cardiology and internal medicine.


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