Cardiovascular Disease, Cholesterol & Statins

 According to the American Heart Association’s (AHA) most recent report on cardiovascular disease (CVD) statistics from 2011, CVD is the leading global cause of death, accounting for over 17 million deaths per year and it is expected to grow to almost 24 million by 2030. Nearly 800,000 people in the U.S. died from heart disease, stroke and other CVD in 2011. CVD claims more lives than all forms of cancer combined. The costs of this problem is even more expensive than diabetes at this time with direct and indirect costs of over $320 billion. Almost half of all African-American adults have some form of CVD (heart attack, sudden cardiac death, stroke, arrhythmia, hypertension, hyperlipidemia, valve disease, etc.). The overall death rate from CVD accounts for over 31% of all deaths, which translates to one in three deaths every year in the United States. It is actually the burden of the risk factors which remains alarmingly high.

 Obesity, Dysmetabolic Syndrome, prediabetes and type 2 diabetes continue to remain as the main risk factors for the development of CVD. Sometimes, an individual finds out they have diabetes when they go to the emergency room with chest pains and a subsequent heart attack. Diabetes and CVD are very closely linked. Despite a genetic background to have insulin resistance, the epidemic of diabetes throughout the world is truly related to the concurrent epidemic of obesity, poor diet and physical inactivity.

According to the AHA, having diabetes is considered a “cardiovascular risk equivalent”. This means that having diabetes is a risk that is equal to having a heart attack history. In the 7 years after a diagnosis of type 2 diabetes, the risk of having a heart attack are as high or higher as those who have already had a heart attack in the same 7 year period. Individuals with type 2 diabetes have twice the risk of CVDs like heart attack and stroke compared to an individual without diabetes. Women with type 2 diabetes are at particularly high risk for increasing cardiovascular disease, especially heart attack. The presence of diabetes was the strongest predictor of having a heart attack, increasing the risk for women 45 years old and younger by 6 times that of other women in the same age group.  

The Paleo diet has been studied extensively in populations at risk for cardiovascular disease and diabetes. It has also been studied in populations that already have been diagnosed. It  is an excellent resource for these people. However it cannot be taught to patients unless the health care provider understands the benefits of this lifestyle change. Many medical providers simply prescribe pharmaceutical drugs to deal with the ravages of cardiovascular disease and diabetes. One of the most popular drugs today are statins. They are prescribed to “lower total and LDL cholesterol”, which, based on some of the newest research, is not strongly associated with the risk of CVD.

Since the development of Lovastain, the first statin medication by Merck in 1980, millions of Americans have been under the misconception that they have a disease called high cholesterol and that this requires treatment. High serum total and LDL cholesterol is NOT a disease, but simply a symptom of a poor diet and lack of exercise. All the statins in the world won’t fix that. Based on one study, nearly 75% of people with a first heart attack had serum cholesterol levels that the current guidelines would consider to be in the normal range. Many people believe that taking a statin every day is harmless and can only do them good. Nothing could be further from the truth. Current research into the dangers of statins are finding some very interesting drawbacks to using these medications.

The use of statin medications are recently being linked to the development of diabetes, memory loss and cataract development. A study of postmenopausal women in the Women’s Health Initiative found that statin use in this population was associated with an increased risk for diabetes. Another study of Canadians in Ontario were found to have an increased incidence of diabetes with most all statins; with higher risk found with higher dose. Diabetes is also a risk factor for cataracts and many people with diabetes also use statin medications. Those with diabetes using statins were substantially more likely to have cataracts requiring surgery than those with diabetes but not using statins in a study of over 6300 participants.

Chris Masterjohn, PhD lipidologist, has written extensively on his research of cholesterol and statins. He states that it is not the amount or number of serum cholesterol or LDL’s but whether or not the molecules are oxidizing - which cause cardiovascular disease. Cholesterol molecules oxidize in response to inflammation which is mediated by poor diet, smoking, sedentary lifestyles and excessive blood sugar. When it comes to cholesterol, size matters. If you have LDL’s that are small and dense (like golf balls), they are more “atherogenic” (causing plaque in the arteries) than if they were large and fluffy (like beach balls). If I were to throw a golf ball at you with all my might, I would probably hurt you, however if I throw a beach ball at you, it would bounce off you with no damage. The same can be said of the LDL’s in your arteries.  And taking a statin to lower your cholesterol has side effects that may not be worth the effort. Statin use is associated with myopathy (muscle pain), liver damage, cataracts, kidney failure, cognitive impairment, impotence and diabetes.

So what is a better marker of CVD? Low HDL levels are far more predictive of who will develop CVD than high LDL levels. But how do you raise HDLs? Exercise and the Paleo diet!!!

Your Paleo Practitioner