The Hidden Truth About Cholesterol-Lowering Drugs
A Review of Hidden Truth About Cholesterol-Lowering Drugs by Shane Ellison, M. Sc.
Health Myths Exposed, LLC, 2005
Review published September 1, 2005 by Chris Masterjohn.
Shane Ellison's Hidden Truth About Cholesterol-Lowering Drugs is yet another weapon fit for your arsenal of intellectual self-defense against the myth that cholesterol causes heart disease and that, to protect your health, you must contribute your fair share to the $26 billion/year empire of cholesterol-lowering statin drugs.
Ellison possesses a Master's degree in organic chemistry. After first-hand experience in drug design, he abandoned what he calls "synthetic medicine" to become an independent researcher, nutritional consultant, developer of product testing certification, and designer of numerous nutritional supplements. He is also a member of The International Network of Cholesterol Skeptics.
The Statin Financial Empire
In Hidden Truth, Ellison identifies the huge profits made from cholesterol-lowering drugs as the driving force behind not only the production of the drugs, but the official government recommendations on cholesterol and statins as well.
The new cholesterol-lowering drugs account for 6.5% of the market share and brought in $12.5 billion in 2002. In 2004, Lipitor became the first drug to bring in $10 billion annually, and statins now rake in $26 billion per year.
Between 2002 and 2004, of course, arrived in 2003 the updated recommendations of the U.S. government's National Cholesterol Education Program (NCEP) that, as discussed in the second issue of our newsletter, aimed to triple the number of U.S. citizens taking statin drugs.
Who is the NCEP? The NCEP is a is a project of the National Heart, Lung, and Blood Institute, itself under the aegis of the National Institutes of Health and the Federal Department of Health and Human Services.
But that's not all. The NCEP is also a panel of industry scientists tying together the financial interests of the major pharmaceuticals and the public power of the Federal government, into what I have called elsewhere the "Public Health-Industrial Complex."
Ellison exposes this connection, citing evidence that among nine members of the NCEP, only one did not have financial links to cholesterol-lowering drug producers. The connections of the other eight were undisclosed at the time the panel's recommendations were released.
The Cholesterol Myth
The myth surrounding statins-- that statins will protect against disease by lowering LDL cholesterol-- rests on the myth that LDL cholesterol plays a causal role in disease.
Ellison cites evidence from the 1930s through the 1960s using post-mortem analysis showing cholesterol levels to be unrelated to the degree of atherosclerosis.
Electron beam tomography now allows medical researchers to analyze plaque levels in live patients. Ellison cites Hecht and Harman of New York's Beth Israel Medical Center, who determined cholesterol-lowering drugs, both alone and in combination with niacin, to have no effect on atherosclerotic plaque, despite lowering LDL cholesterol.
Hecht and Harman report ". . . with respect to LDL cholesterol-lowering, 'lower is better' is not supported by changes in calcified plaque progression."
The Statin Myth
Despite contrary evidence, the statin myth progresses full-force ahead, assuming that LDL cholesterol-lowering will prevent disease, and thus recommending continuous expansion of the number and type of patients who should be prescribed statins.
Cholesterol May Save Your Health
Yet according to Ellison, studies have consistently linked high cholesterol to lower mortality. For example:
Low cholesterol is associated with heart arrhythmia.
The European Heart Journal published a 3-year study of 11,500 patients finding those with low cholesterol to have a risk of all-cause death 2.27 times higher than those with high cholesterol.
The Journal of Cardiac Failure published an analysis of 1134 patients with heart disease and found low cholesterol to be associated with the worst outcomes in heart failure patients and impaired survival, while high cholesterol improved survival rates.
The American Geriatrics Society reported in 2003 that, in patients over the age of 65, even cholesterol levels up to 417 mg/dL were associated with lower mortality compared to levels under 189 mg/dL.
Yet the growth of cholesterol-lowering drugs expands.
Fibrates — the FDA-Approved Carcinogens
An older class of cholesterol-lowering drugs called fibrates were notoriously unsuccessful.
The US General Accounting Office reported in Cholesterol Treatment -- A Review of the Clinical Trials Evidence that fibrates offered no improvement in survival rates to patients with or without known heart disease.
In fact, Ellison cites several studies showing fibrates increased mortality, and are carcinogenic. When the FDA approved fibrates, 6 of 9 advisory board members voted against approval, while the FDA chose to enact the minority recommendation and approve the drugs.
Statins, Statin Cocktails, and More Cancer
The new cholesterol-lowering drugs, statins, also called HMG CoA-reductase inhibitors, or by such names as Lipitor, Zocor, Mevacor, Leschol, Pravachol, etc, share a similar story, according to Ellison.
Ellison cites hysterical proclamations by leading medical authorities about the wide expansion of statin use that should take place, including calls to put statins in the public water supply.
Wald and Law advocate statin "cocktails," be given to all people over the age of 55, consisting of one statin drug, 3 blood pressure-lowering drugs, an angiotensin-converting enzyme inhibitor, folic acid, and aspirin, without any clinical evidence that this is either safe or effective.
Yet there are a few secrets about the effectiveness of statins that are rarely brought to light.
Ellison criticizes the use of relative risk figures, which exaggerate a cardiovascular benefit. For example, if a drug is shown to lower the risk of some disease from 2% to 1%, a doctor may tell her patient that the drug will reduce his risk of disease by 50%. This sounds dramatic to the patient. Yet in absolute terms, there is only a reduction of one percentage point.
The doctor could also have told the patient that he has a 1 in 100 chance of receiving a benefit from the drug!
Ellison also points out the massive gender bias in statin research. From 1990 to 1999, all statin trials were overwhelmingly conducted with men. The trial with the lowest percentage of patients who were men was the 4S trial, in which 81% of patients were men, and the highest was the WOSCOPS trial, in which 100% of the patients were men.
That there was no evidence allowing for sex-specific analysis was ignored for nearly ten years. Walsh and Grady analyzed 13 studies together in a meta-analysis (an analysis that takes data from many studies and combines it into one) that had some data for women patients, and found no evidence of any benefit at all to healthy women.
Ellison also points out that some statin trials found no reduction in mortality with statins. The PROSPER trial, for example, found no reduction in mortality with Lipitor.
Dr. Steven Nissen, the lead investigator of the REVERSAL Pravachol trial, writes:
"Surprisingly, despite attaining a low LDL level on pravastatin, these patients showed highly significant progression for percent atheroma volume and percent obstructive volume . . . When I started this study, I believed that any reduction in progression would just be due to lower LDL levels, but now I'm not so sure."
Finally, Ellison also discusses evidence that the very small benefit of statins in relation to cardiovascular health shown in some trials is not related to their effects on LDL cholesterol, but to other, independent effects of statins.
More Cancer
Like fibrates, there is some evidence that statins cause cancer. The PROSPER trial, according to Ellison, showed statins to increase breast cancer by a factor of 15.
Vascular endothelial growth factor is a compound necessary for angiogenesis, which benefits the heart, but also fuels the growth of cancers by providing cancerous cells with new blood vessels. Statins mimic this compound, which could be related to their apparent carcinogenic potential.
Some natural food medicines claimed to reduce cancer risk, such as green tea, may exert their actions by blocking vascular endothelial growth factor.
What Does Cause Heart Disease
Shane Ellison cuts through the shoddy speculations about correlative data and looks at the actual mechanisms of heart disease. Like Dr. Al Sears in The Doctor's Heart cure , reviewed on this site here, Ellison primarily blames damage to blood vessels, and identifies LDL and immune responses as corrective actions against this damage, rather than the mere presence of LDL as the cause of atherosclerotic plaque.
Ellison also highlights the importance of such factors as insulin resistance and homocysteine.
Hidden Truth recommends various supplements, dietary changes, and lifestyle changes that can help protect blood vessels from the assaults of toxic and abrasive compounds, and thus keep the heart healthy, strong and protected from heart disease.
Make Hidden Truth Part of Your Arsenal of Intellectual Self-Defense
The only caveat I have about Hidden Truths is that it could use more discussion about the effects of statins on those who have established heart disease. Ellison discusses several studies that found no benefit to people without established heart disease, without analyzing the findings for those with established heart disease.
Nevertheless, Ellison's emphasis on the effects of statins on healthy people is necessary, because many medical authorities have recommended the use of statins even for perfectly healthy people.
Ellison also cites many studies showing that high cholesterol is beneficial in cases of heart disease, which would make a discussion of how statins effect those with established heart disease even more interesting, since statins lower cholesterol, while also exerting many other effects.
Ellison occasionally injects some dark sarcasm into the pages of Hidden Truths. Some people might dislike this, while others will enjoy it. Either way, the depth of junk science and financial corruption revealed by Ellison would be considered truly tragicomic by many a reader.
Ellison's Hidden Truth is a welcome addition to a growing minority of perspectives that abandon the simplistic notion that the mere presence of high cholesterol in the blood causes its deposition into plaques, challenges the purveyors of health myths who draw in tens of billions of dollars annually from these myths, and gives practical advice based on cutting edge science about how you can make less expensive, natural changes to protect against heart disease while improving your health, mental function, and stamina rather than compromising it.
Hidden Truth About Cholesterol-Lowering Drugs belongs in your arsenal of intellectual self-defense against the purveyors of the cholesterol myths.
You can buy Hidden Truth here, or download an electronic version for free here.