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“Cholesterol-Lowering” Has Ripped Its Guts Out But Will Not Sink by Malcolm Kendrick, MD
Thursday, January 14, 2010 1:33 pm Email this article
The Zocor Debacle - I Told You So! But The Great Ship “Cholesterol-Lowering” Has Ripped Its Guts Out On The Harsh Rocks Of Evidence, But Still It Does Not Sink.
Oh, the joy. Just how annoying can I be now? After the PROVE-IT and REVERSE trials comes the A to Z trial, looking at aggressive high-dose Simvastatin treatment vs. low-dose. And I have just been proved right.
‘Munich, Germany - The Z phase of the Aggrastat to Zocor (A to Z) study has shown disappointing results...Treatment with high-dose simvastatin (Zocor®, Merck) failed to show a significant reduction in the primary composite end point of cardiovascular death, MI, readmission for ACS , or stroke. In addition, the high-dose statin regimen was associated with a higher rate of myopathy and rhabdomyolysis.’
(This article was written by Malcolm Kendrick, MD, author of the wonderful, eye-opening, paradigm-shifting book The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It .)
I think I made the point some time ago that, if you wanted to prove that the more you lowered cholesterol, the greater the protection against heart disease would be, then a basic requirement would be to use the same drug at different doses - unlike PROVE-IT and REVERSE, which used different drugs at different doses, thus introducing two variables into the equation.
To quote myself from a previous column in Red Flags, ‘ Prove-IT Proved What?’
‘I suppose the most basic problem with the (PROVE-IT) study is the old ‘two variables’ conundrum. It is true that those with the greatest LDL lowering were protected against death. However, as you may have noticed, those who were protected not only had a greater degree of LDL lowering, THEY WERE ALSO ON A DIFFERENT DRUG!..... which is rather important, yet seems to have been swept aside on a wave of hype.
In reality, if you really want to prove that the more you lower the LDL level, the greater the protection, then you must use the same drug. This achieves an absolutely critical requirement of any scientific experiment, which is to remove all possible uncontrolled variables.’
Degree of LDL-lowering has no impact on Coronary Heart Disease
Now, the experiment has been done. Someone did use the same drug at different doses, achieving different degrees of cholesterol lowering and, hey presto, no difference in CHD [ Coronary Heart Disease ] rates. Which proves two things:
Firstly: The degree of LDL lowering has no impact on CHD [ Coronary Heart Disease ].
Secondly: Atorvastatin [ Lipitor ] has direct anti-CHD [ Coronary Heart Disease ] effects that are better than pravastatin [ Pravachol ].
I feel the urge to climb up a local hill nearby with a loudspeaker in hand and bellow to all and sundry, ‘I told you so.’ Unfortunately, the local sheep population is unlikely to be impressed. And I may find myself arrested by the local constabulary.
The LDL-Lowering Hypothesis Continues
The LDL-lowering hypothesis continues even though it was proven wrong
More frustrating, however, is the fact that this trial will have absolutely, and I mean absolutely, no impact on the prevailing orthodoxy. Already, the powers that be have decreed the following:
‘Despite these surprising findings, experts say these results should not detract from previous studies showing a strong benefit with early and aggressive statin therapy. They continue to recommend early aggressive lipid-lowering therapy to reduce the risk of future cardiovascular events but expressed caution over the 80-mg dose of simvastatin.’
Here was the (close to) perfect study designed to demonstrate that the more you lower cholesterol the more you will protect against CHD. It completely and utterly contradicted the hypothesis. Yet, experts will continue to recommend early aggressive lipid-lowering therapy – based on the hopelessly flawed trials. Ye Gods.
I am overcome by a sense of impotent rage. ‘I told you so,’ has already turned into the bitter ashes of defeat. The great ship, ‘Cholesterol-Lowering,’ has ripped its guts out on the harsh rocks of evidence, but still it does not sink. I am beginning to believe that it is unsinkable.
Article Previous Published on THINCS.org
This article was previously published on THINCS.org
This article was previously published on THINCS.org (The International Network of Cholesterol Skeptics).
I republished the article here with Dr. Kendrick’s permission.
Malcolm Kendrick’s Contact Info
Malcolm Kendrick, MD is the author of the wonderful, eye-opening, paradigm-shifting book book The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It .)
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