The Great Cholesterol Con: the Truth About What Really Causes Heart Disease and How to Avoid It

289 Pages·2008·1.904 MB·English

by  Kendrick, Malcolm

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THE TRUTH ABOUT WHAT REALLY CAUSES HEART
DISEASE AND HOW TO AVOID IT
DR MALCOLM KENDRICK
••HB Master Imprint page.qxd 23/5/11 15:42 Page 1
Published by John Blake Publishing Ltd,
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First published in paperback in 2007
ISBN: 978 1 84454 6107
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CONTENTS
Introduction vii
1 What is heart disease,anyway? 1
2 What is cholesterol,anyway? (And what's a fat?) 11
3 You cannot have a cholesterol level 25
4 What are statins and how do they work? 39
5 The rise and rise of the cholesterol hypothesis 45
6 Eat whatever you like (Diet has nothing to
do with heart disease) 57
7 A raised cholesterol/LDL level does not
cause heart disease 79
8 Statins and heart disease 155
9 What causes heart disease? 203
10 The stress hypothesis - does it fit the facts? 237
11 Other forms of stress 253
12 Glossary 267
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INTRODUCTION
All humans must die… astatinate,astatinate!1
A Dalek
W
e are bombarded with so much confusing nonsense about
heart disease that it is difficult to know where to start.Each day
that dawns,it seems,heralds a new study that flatly contradicts the last.
Omega 3 fish oils are good for you;Omega 3 fish oils are not good for
you.Alcohol protects against heart disease;alcohol does not protect
against heart disease.Coffee is good for you;coffee is bad for you.Or
maybe it was excess milk in the diet,or green-leaf tea,or… To quote my
lovely daughter,‘yeah,whatever’.
It has reached the point where I feel like shouting,‘Listen guys, I
know you need to ‘publish or perish’,and the more publicity you can
achieve the bigger the next research budget,but you’re scaring people
half to death.No one knows what to do or what to believe any more.
And by the way, your study was RUBBISH! Now go away, grow your
beard, and do some proper boring research that no one can
understand.’
But they won’t. For it’s so much more fun to appear on a news
programme, talking earnestly about your discovery of the latest
possible cause of heart attacks – a danger that the public absolutely,
positively, must be warned about. Afterwards, you will probably be
invited to lucrative speaking engagements at international cardiology
1 Adapted from Dr Who and the Daleks(1965).Screenplay by Milton Subotsky.Based on the BBC Television serial
by Terry Nation.Produced by Milton Subotsky and Max J Rosenberg.
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THE GREAT CHOLESTEROL CON
conferences. Does a professorship beckon? ‘Who, me? I really don’t
deserve it,but if you must…’
Somehow,in this ever-changing,ever-confusing world,one idea has
stood the test of time.And it is this:
The Diet-Heart Hypothesis
(aka The Cholesterol Hypothesis)
If you eat too much food containing cholesterol and/or
saturated fat,the level of cholesterol in your blood will rise.
The excess cholesterol will be deposited in artery walls,
causing them to thicken and narrow. In time this will block
blood supply to the heart (and other organs) causing a heart
attack,or stroke.
Whichever name you use for it,this hypothesis has the advantage of
being extra-super straightforward – suitable for children from the age
of five upwards,no parental guidance required.But be careful.Perhaps
the single greatest prejudice in scientific research – the researcher’s
holy grail,if you like – is the belief that,in the end,the simplest solutions
are correct. Occam’s razor, E=MC2, the perfect four base sequence of
DNA.But it is as well to remember a warning from history:
For every complicated problem there is a solution that is simple,
direct,understandable and wrong.
HL Mencken
And boy,is the cholesterol hypothesis wrong.To adapt a quote from
Blackadder, ‘It is wronger than a very wrong thing.’ Yet it has
mesmerised scientists, doctors and the general public for years,
exuding a siren song that none can resist,dragging us all to our doom
on the sharp rocks of illogicality.
OK,when you look at the eye-watering profits being generated,it
hasn’t exactly dragged pharmaceutical companies to their doom – yet.
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DR MALCOLM KENDRICK
Indeed,once everyone believed that a high cholesterol level was the
most important single cause of heart disease,the gold rush was on to
discover drugs that could lower cholesterol levels.A highly successful
gold rush led by big pharmaceutical companies.
Admittedly,at first things didn’t go too well.Various substances were
discovered in the 1960s and 1970s that, to widespread rejoicing,
lowered cholesterol levels. However, when the clinical trials were
carried out it was found that more people died when they took the
drugs than when they took the placebo.In some cases the cholesterol-
lowering agents very nearly doubled the overall mortality rate.Which
did put rather a dampener on proceedings.
In 1970,a study by the WHO (the World Health Organization,not the
rock group) on clofibrate (a big drug at the time,but now defunct for
reasons that will shortly become apparent), measured blood
cholesterol in 30,000 healthy,middle-aged men in Edinburgh,Prague
and Budapest. The 10,000 men with the highest blood cholesterol
levels were selected for the trial – half to receive clofibrate, half
placebo.After five years there had been a total of 128 deaths in the
clofibrate group and 87 in the placebo group.Oops.And there were
more fatal heart attacks in the clofibrate group too.
It was decreed,however,that this problem had nothing whatsoever
to do with the cholesterol-lowering ability of clofibrate.Perish the very
thought. The drug obviously had some other, nasty, heart-disease-
causing effects – not that anyone was quite sure what these effects
were.But because everyone already ‘knew’that a high cholesterol level
caused heart disease,no one dared suggest that these results might –
just might – contradict the cholesterol hypothesis.Hey ho,let not the
facts spoil a good story.
The 1960s, 1970s and 1980s represented a period that could be
known as the BSera;the time Before Statins began.(In a nutshell,statins
are drugs that lower cholesterol and so,in the eyes of the mainstream
medical community,are believed to reduce the risk of heart disease.
More on this subject – much more – to follow.)
In this period new drugs were found;they lowered cholesterol,but
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