The lipid hypothesis
The lipid hypothesis of heart disease is, as Dickens wrote of Scrooge’s partner, Jacob Marley, dead as a doornail, yet, like Marley’s ghost, it continues to haunt us. Why? Because the idea that cholesterol causes heart disease–the lipid hypothesis–has been so frequently repeated for so many years that doctors have forgotten that it is only a hypothesis, not a fact.
In simplistic terms the lipid hypothesis is as follows:
a) cholesterol and/or fat in the diet leads to cholesterol and/or fat in the blood;
b) cholesterol and/or fat in the blood causes plaque formation in the arteries and, consequently, heart disease; and, therefore
c) cholesterol and/or fat in the diet causes heart disease.
Sounds simple enough, but problem is there is no hard science behind it. There is a bit of weak, but not fully convincing science that purports to prove a. Less science yet that proves b. Yet we’re all to believe a leads to b and, therefore, causes c.
One scientifically verified fact disproves the whole lot: only about half the people who have heart attacks have elevated cholesterol levels.
Let’s look at the above statement, which is absolutely true, in view of how we determine the causes of other diseases. We know that the measles virus causes measles–there is no doubt about it. Doctors can find the evidence of measles virus infection in anyone who has measles; and there is no instance that I’m aware of in which an individual is teeming with the measles virus, yet doesn’t ultimately manifest the symptoms of measles.
If half the time that people were diagnosed with measles they were found to have no evidence of the measles virus, and half the time they were swarming with an infection of measles virus yet never developed measles, would we still say that the measles virus caused measles? I don’t think so. Infectious disease specialists starting with Dr. Koch, the German physician who derived the eponymous postulates that define an infective disease back in the nineteenth century, have specific criteria to determine whether a specific bacteria or virus causes a specific disease.
Not so with those wedded to the lipid hypothesis as is apparent from an article from the Science section of last Tuesday’s New York Times.
The gist of the article is thus: a 51 year old male has had cholesterol levels that have hovered at around 300 mg/dl for the past couple of decades. A physician had persuaded this man to take Lipitor (a “statin”? drug) in the past, but he had experienced side effects and stopped it. Since that time all his physicians had been after him to go on some kind of “statin”? drug to get his cholesterol down. In his latest blood test, his cholesterol levels zoomed up to 380 mg/dl, so he finally agreed to go on a “statin”? if his doctor could give him some kind of objective evidence that his “arteries were actually clogging.”? His physician sent him for an Ultrafast CT scan of the heart, an X-ray type of test that can actually see the coronary arteries and determine the degree of calcification in those arteries. The more calcification, the worse the disease. After the radiologist examined the scan he declared the guy free of coronary arteries disease with his arteries clean as a whistle. (You can see pictures of his scan in the article along with pictures of diseases arteries.)
You would think that his clean arteries would have his physicians saying something along the lines of, “Well, you’re one of the lucky ones, so we’ll just watch and maybe re-evaluate a little later on.”?
His doctor said:
“I still want you on a statin. And Burt [the radiologist] agrees. You got lucky. But you still shouldn’t walk around with those numbers.”
Remember, doctors are supposed to treat diseases not numbers. Pharmaceutical companies have succeeded in persuading most physicians that the lipid hypothesis is a fact, and that numbers should be treated. If Lipitor and other “statin”? drugs were innocuous, this zeal to treat numbers would just be an expensive chimera. But these drugs are far from innocuous. Take a look at the book Lipitor, Thief of Memory: Statin Drugs and the Misguided War on Cholesterol by Duane Graveline, M.D.
Not only can Lipitor steal your memory, it can do in your liver and cause a lot of other problems as well. Side effects of drugs are tolerable when the drug in question treats a disease, but elevated numbers are not a disease. Beware.