Most heart attack patients’ cholesterol levels did not indicate cardiac risk
How does that headline grab you? When I saw it, it was one of those “duh” moments, but to most people, that has to be more than a little disconcerting. The average patient goes to the doctor’s office and has their blood lipids checked. When the results come back, if the total cholesterol results are over 200, then the patient is advised to take medication. Some decide to take the statin drug and some do not. The assumption is that those who opt not to take the pills will have a heart attack. But what about the people whose results do not show a total cholesterol of 200 or better? The assumption is that they are not at risk. Well, this headline claims otherwise:
“A new national study has shown that nearly 75 percent of patients hospitalized for a heart attack had cholesterol levels that would indicate they were not at high risk for a cardiovascular event, based on current national cholesterol guidelines.
Specifically, these patients had low-density lipoprotein (LDL) cholesterol levels that met current guidelines, and close to half had LDL levels classified in guidelines as optimal (less than 100 mg/dL).”
These unfortunate individuals left their doctors’ offices feeling pretty good about their chance for cardiac risk, yet they suffered cardiac events. That tells us two things: First, that cholesterol levels don’t accurately determine cardiac risk, and Second, that something else causes heart attacks that the experts either haven’t told us, or we did not properly understand.
While the risk of cardiovascular events increases substantially with LDL levels above 40–60 mg/dL, current national cholesterol guidelines consider LDL levels less than 100–130 mg/dL acceptable for many individuals. The guidelines are thus not effectively identifying the majority of individuals who will develop fatal and non-fatal cardiovascular events, according to the study’s authors.
Researchers also found that more than half of patients hospitalized for a heart attack had high-density lipoprotein (HDL) cholesterol levels characterized as poor by the national guidelines.
Now this is more of what I would expect. The standard high-carbohydrate diet consumed by modern Western nations would produce low HDL and varying LDL levels. It’s impossible to tell the LDL level by looking at a lipid profile. A more thorough exam is needed to identify the type of particles present on the LDL. They would be either small and dense, or large and fluffy. But then again, if the particles were large and fluffy, the HDL number would most likely be over 40. So what type of diet provides a high HDL and large and fluffy LDL particles? A diet restricted in carbohydrate intake.
Of course, our experts won’t recommend that because they believe that you, dear reader, are unable to stick to such a common-sense approach. Therefore, they say:
Published in the January issue of the American Heart Journal, the study suggests that lowering guideline targets for LDL cholesterol for those at risk for cardiovascular disease, as well as developing better treatments to raise HDL cholesterol, may help reduce the number of patients hospitalized for heart attack in the future.
Now, knowing what you know about cholesterol (after reading this blog) then it should surprise you that this is their recommendation. If anything, they should go about the business of finding out why cardiac events take place. Obviously, there is something seriously wrong with the conventional wisdom to eat a “cholesterol-lowering” diet and that high cholesterol “causes” heart attacks. Obviously it doesn’t. Something happens long before people get to the “risk” factor. I’ve made this point on the blog before. Risk factors are just educated guesses based on the characteristics of those who don’t happen to have heart disease at the time. Relying on risk factors can be fool’s gold because the recommended interventions do not transform a sick person into a healthy person. A low-fat, cholesterol-lowering diet is not a healthy one.
The study also showed that HDL cholesterol, or “good cholesterol,” levels have dropped in patients hospitalized for heart attack over the past few years, possibly due to increasing rates of obesity, insulin resistance and diabetes.
Researchers found that 54.6 percent of patients had HDL levels below 40 mg/dL. Developing more effective treatments to boost HDL levels may help reduce the number of patients hospitalized for heart attacks, according to the authors.
What is an effective treatment for HDL? That would be a high-fat diet, restricted in carbohydrates. Saturated fat will raise HDL. Will it raise LDL? Yes it will but as you can see from the study, the higher LDL is nothing to worry about. Most heart attacks happen at a low LOL, not a high one. The high one may be just fine if the particles on the LDL are large and fluffy. These are protective against heart disease.
So why would these experts recommend a drug rather than a natural solution such as a high-fat, restricted carbohydrate diet?
The study was sponsored by the Get with the Guidelines program, which is supported by the American Heart Association in part through an unrestricted education grant from the Merck Schering Plough Partnership.
Fonarow has conducted research for GlaxoSmithKline and Pfizer and serves a consultant and has received honorarium from Abbott, AstraZeneca, GlaxoSmithKline, Merck, Pfizer and Schering Plough companies. He is also chair of the Get with the Guidelines steering committee.
They are funded by the drug companies. Therefore, they want the guidelines lowered so they can get more people on medication. This only benefits their bottom line.
If you want to prevent cardiac events, then you need to get your blood sugar stabilized, your HDL elevated, and your triglycerides lower. How can you do that? By consuming a high-fat, carbohydrate-restricted diet.
In: Cholesterol, Diet, Heart Disease, Obesity
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on November 10, 2009 at 9:15 pm
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