Recently I admitted a patient to the rehab hospital where I work. This is an interesting but unfortunate story. It was a 79 year old man who has been very active and still working. It started with a heart attack. Because it happened in a public venue, EMS quickly responded and took him to the ER. The routine workup in the ER included an x-ray of the chest. They found a 5 cm. mass in the lung. Sadly, it was inoperable and a tumor type that responds poorly to chemo therapy. He did get some XRT or radiation therapy which relieved some of the pain in the ribs and back where the tumor was invading, but the ultimate outcome was understood by doctors and family to be grave. The oncologist told the family that he had a few months only.
It is a federal requirement that if a patient is in a hospital and has a cardiac or stroke diagnosis, he or she must be discharged on a STATIN drug to lower cholesterol. He was. Incredible as it seems, this federal mandate is almost never ignored by doctors who are under pressure from hospitals to follow these “core measures”. The patient did not do well and the family moved him to Hospice within 7 days.
But here’s the point, actually 2 points. First, cholesterol is not the cause of heart disease, heart attacks and strokes. It is INFLAMMATION!! That is what triggers the liver to make proteins, homocysteine and C-Reactive Protein among other products which perpetuate inflammation. When the liver is inflamed, it makes cholesterol. The body uses the cholesterol to “plaster over” the irritated areas in the arteries caused by the inflammation eventually plugging up the pipes. There are also other cascades of reactions which contribute to the problem such as oxidation. Dr. Roby Mitchell uses the term “OXIMATION” which I think is appropriate.
A recent paper from doctors at Southwestern Medical School in Dallas (where I earned my PhD, in fact working with the preeminent cardiology group there) recommends no longer using “cholesterol” as a measure of cardiovascular risk. The recommend instead 5 tests: a CT scan of the chest to evaluate calcium content of the vessels (which I started using in 2003), a HIGH SENSITIVITY C-REACTIVE PROTEIN LEVEL (which I’ve also used since 2003), A HIGH SENSITIVITY TROPONIN LEVEL, NT-proBNP hormone level, and an EKG. Dr. James deLemos published in April 2017 issue of Circulation his results that showed superiority of this method of predicting who will get heart disease than the traditional “blood pressure, cholesterol, diabetes and smoking history” method.
I find this VERY refreshing that FINALLY some real science is worming its way into this STATIN-CHOLESTEROL mindset.
My second point is a question which the reader can answer himself. “Why is the government passing such core measure mandates that doctors and hospitals must follow when there is no longer scientific support?
My friend, Nadir Ali, a highly respected cardiologist gave this lecture last week. Watch it on YouTube. It will help you answer the question I posed above.
https://youtu.be/7pTXuXk-4b0. Please watch this!!