Should You Fly Over That Big Gaping Hole?

BFP Magazine

Cardio-vascular Health

Cholesterol-Lowering Drugs, CLDs

Should You Fly Over That Big Gaping Hole?

By Dr. W. Gifford Jones

October 26, 2003

A picture is often worth a thousand words. One recently caught my eye. The picture shows a small plane circling a huge active volcano. A passenger says, "Let's take a closer look at the volcanic crater". The pilot replies, "We can't, it's not worth the risk". And a recent report similarly questions whether the mass consumption of cholesterol-lowering drugs (CLDs) is worth the risk.

Dr. Jim Wright is Director of The Therapeutic Initiative. It's a British Columbia organization that aids doctors in evaluating drugs. It concluded that cholesterol-lowering drugs may be doing more harm than good in the attempt o prevent heart attack.

After studying five clinical trials of CLDs, Wright writes that they only decreased the risk of heart attack and stroke by a mere 1.4 per cent over a three-to-five year period.

He adds that "If I were a physician I would have to treat 71 people with CLDs for one to benefit". Moreover, he expressed concern that cholesterol-lowering drugs may have increased other health problems such as cancer and psychiatric troubles.

This is not the first time researchers have questioned the use of cholesterol-lowering drugs. In 1990 the British Medical Journal published a study involving 25,000 men. Half of these men had lowered their blood cholesterol primarily with drugs.

The result? The men using drug therapy had 28 fewer heart attacks than the other group without this medication. But the benefit was offset by 29 additional violent deaths such as accidents, suicides and homicides.

Later that year the National Heart, Lung and Blood Institute reviewed all the data on cholesterol blood levels and mortality rates. They reported their findings in the Journal Circulation, (A publication of the American Medical Association), after analyzing 19 studies.

Their findings showed that high blood cholesterol levels were associated with an increased risk of heart disease, at least in men. But low blood cholesterol levels in both men and women showed a 40 per cent greater risk of death from non-cardiac causes such as violent death, lung disease and some cancers.

In an editorial accompanying this report Dr. Stephen Hulley, of the University of California at San Francisco, strongly recommended that CLDs should not be used except in patients who already showed signs of heart disease.

Then in July 1992, the Archives of Internal Medicine reported on a study involving 351,000 men. This showed that low cholesterol levels were associated with increased risk of hemorrhagic stroke, liver disease, pancreatic cancer, digestive disease, cirrhosis of the liver and alcoholism.

For years I have questioned the widespread use of cholesterol-lowering drugs. There is no doubt that the general consensus among doctors is that CLDs drugs save lives. So my doubts are not shared by many others.

So why am I so reluctant to climb aboard this bandwagon that touts the cardiovascular benefits of CLDs? For one thing I don't believe you can totally ignore the studies that show adverse side-effects. After all, it's well known CLDs can damage liver and kidneys and that patients have died from their use. That's a big price to pay.

I'm also a great believer in the use of common sense . Today some authorities claim it's important to push blood cholesterols even lower using CLDs. In effect, they say, if low cholesterol is good for you an even lower one is better. This reasoning worries me as cholesterol is an essential nutrient for repairing cell membranes that manufacture vitamin D and produce hormones such as estrogen and testosterone.

The economics of CLDs also concerns me. Money drives many things and it's had a huge impact on CLDs. Massive amounts of money are spent on their promotion because great profit is made from the sale of CLDs. Moreover, much of the research has been paid by the pharmaceutical industry and he who pays the piper often calls the tune.

All this has created a nation of cholesterol phobiacs. People talk about the reduction of cholesterol numbers as if they were searching for the holy grail.

Since I'm not related to the Almighty I may be terribly wrong. But I believe history will show that the level of blood cholesterol is not the huge culprit it's made out to be.

W. Gifford-Jones M.D is the pen name of Dr. Ken Walker graduate of The Harvard Medical School. He's been a ship's surgeon, hotel physician and family doctor and later trained in surgery at McGill in Montreal, University of Rochester N.Y. and Harvard. His medical column is published by 60 Canadian newspapers and several in the U.S. He is the author of seven books. Dr. Walker has a medical practice in Toronto. His Web site is: He can be reached at

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