So I started the month of February off with this question, “do cholesterol numbers matter?” and I’ve done two articles on heart health and the true cause of heart disease. This is my final article of the month and we will take a look at statins, do we need them and what testing we really want to determine our risk of heart disease.
The Deep Dive…
This is a “deep dive” so hang in there with me!! If you missed the last two articles you can catch yourself up to speed HERE.
Since their introduction in the 1980s, statin drugs have been almost universally hailed as “wonder drugs” by medical authorities around the world. The global market for statins was $16 billion in 2016, and approximately 40 million Americans (that’s one in every five adults!) takes a statin.
Cardiovascular disease (CVD) is still the leading cause of death in the United States, claiming 350,000 lives annually. Medical authorities and doctors claim that statins reduce the risk of CVD and vascular deaths by lowering levels of total cholesterol and proclaimed “bad” low-density lipoprotein (LDL)-cholesterol. There’s no denying that statins are effective at lowering blood cholesterol levels. Depending on the dose and circumstance, LDL-cholesterol (LDL-C) can be lowered by 30 to 60 percent.
As I discussed in the previous articles, cholesterol is the “ambulance” that shows up on the scene of the accident to do its job, so we can’t blame it 100% for the cardiovascular deaths each year. I believe taking statins can give you a false sense that “all is ok” when in reality, there could be a whole lot of damage going on without you being aware.
There is little information regarding the long-term effects of this class of drugs. We do know the extensive list of side effects including diabetes, digestive disorders, cataracts, memory loss, muscle damage, liver damage and low testosterone to name a few.
How To Understand the Clinical Trial Numbers
“Statins reduce deaths from coronary heart disease by 28 percent in men.” This is a headline from 2017 reporting the results from a long-term study on cholesterol-lowering statins. Sounds pretty impressive, doesn’t it?
An important thing to understand about drug clinical trials and medical claims is the difference between relative risk and absolute risk. For example, imagine that your risk of developing Condition A is one-half of 1 percent—0.5 percent. That’s your absolute risk, and it’s quite low. Now, imagine that Drug B reduces your chance of developing Condition A down from one-half of 1 percent to one-quarter of 1 percent.
We could report this reduction in one of two ways:
- Your relative risk of developing Condition A was reduced by a whopping 50 percent, from 0.5 percent to 0.25 percent, from Drug B.
- Your absolute risk was reduced by a mere one-quarter of 1 percent, or 0.25 percent, for an already low-risk event.
Many statin studies and claims perfectly exemplify this phenomenon of reporting relative risk without acknowledging absolute risk. If you want to read one such study in Lancet Go here and you’ll see that an absolute risk reduction of a mere 0.2 percent!! Even if it was 1.5%, 63 people would need to take the drug for 5 years in order to prevent 1 person from having a cardiovascular event.
Did you know you can have “low” cholesterol and still be at risk for heart disease? Did you know you can have “high” cholesterol and not be at risk for heart disease? How do you know???
You need to know your “particle numbers”. We are going through this right now with my husbands cardiologist. They want to just do a standard HDL/LDL cholesterol lab. We requested an additional panel, LDL-P, small particle LDL numbers (still waiting to hear if they will). In my previous article I touched briefly on the small particle LDL being the one that gets into the endothelial barrier in your arteries and causes damage which in turn causes “repair” which builds plaque. You can have “low” LDL and have “high” LDL-P and be at a higher risk. You can have “high” LDL with very little LDL-P and be at low risk.
For those of you who want a deep dive, you can get the Boston Heart Health Panel. We had to “ask” for this from our cardiologist and it turns out he had a requisition form in his office and Medicare-covered it! This is a deep dive, very thorough and gives you so much great information on what is going on inside your body.
The bottom line, if you really want to know your heart health risk, ask for more than your standard HDL/LDL, ask for at least the small particle LDL. Ask for inflammation markers such as CRP, IL1b, and IL-6. Ask for Homocysteine, Thyroid panels and Vitamin D. All of these are as important as your cholesterol numbers.
Heart disease is a complex, multifactorial process. So many factors play a role, genetics, diets, lifestyle, and toxic exposure. Last week’s article gave you a whole list of ideas for lifestyle and diet that can help lower inflammation, oxidative stress and help prevent the cholesterol train from showing up on the seen to create plaque. Let’s look at some specifics for heart health. This is not even an exhaustive list but my “top picks”!
- Green Powders – you want to support your detoxification pathways and chlorella and spirulina are two detoxifiers that you will usually find in a “green” powder. Along with detoxifying blood, they have Vitamin A, B, C, E, and Inositol. A 2013 study found they decreased inflammation and oxidation of LDL. My favorite is “Green Vibrance” because it not only is loaded with wonderful greens but tastes good! You can find it on Amazon in either 30 or 60 serving size. I throw it in my smoothies!
- Omega 3’s – these have hundreds of clinical trials that demonstrate benefits for lowering inflammation. This polyunsaturated fat is critical for the brain, heart and every cell in your body. Many people try and use flaxseed for their Omega 3’s but it does not convert well to the DHA and EPA that you need for the benefits. Make sure you are buying an Omega 3 that has been tested for heavy metals and is “species-specific” for the type of fish.
- Vitamin K & D – you need vitamin K and D in order for calcium to store in your bones and teeth. Without it, calcium deposits everywhere, including blood vessels and coronary plaque.
- Vitamin E – this is a powerful antioxidant and protects against free radicals. It improves vascular endothelial function, protects cells from free-radical damage and contains anti-clotting properties. Make sure and buy an E that is “complete”, containing tocopherols and tocotrienols.
- Vitamin C – vitamin C is a winner in so many ways including lowering blood pressure, boosting immune function, as an antioxidant, improving endothelial function, decreases LDL oxidative damage, decreases clotting, lowers the risk of atrial fibrillation and supports collagen production.
- Berberine – studies show improvement in lipid control, heart failure, lowered inflammation and the side benefit it has been shown to be as effective as Metformin in lowering blood sugars. Remember, high blood sugars equal to high inflammation.
- Magnesium – lowers blood pressure, raises HDL, lowers triglycerides, lowers CRP (a measure of inflammation) and improves blood sugar control.
- Red Yeast Rice – If you have stubborn cholesterol numbers (after changing your diet), red yeast rice may be appropriate. It is a form of statin that has been used in Asia for centuries. It is derived from fermented rice that creates a yeast. The original statin formula came from red yeast rice! Lowers LDL, lowers CRP, appears to be safe for people who do not tolerate statins. You must take a CoQ10 just as if you were on a statin.
- CoQ10 – this is found in the body as ubiquinone and ubiquinol. Ubiquinone is better for those younger than forty and ubiquinol for those over forty. This is an excellent antioxidant, protecting LDL from oxidation. Statins reduce the CoQ10 levels by 40%!
Whew! We made it! February has been Heart Health month and I hope with these three articles you have learned a lot about what causes heart disease and what you can do to prevent it. Thanks for hanging in there with me!
P.S. Mark your calendar for April 13th, our next 10 Day Detox!