Life Extension Magazine September 2010
As We See It
Media Says: No Cure for Heart Disease
By William Faloon
In response to the failure of quadruple-bypass surgery to keep blood flowing to Bill Clinton’s heart, the Associated Press proclaimed that there is no cure for coronary artery disease.1
As we predicted in the November 2004 issue of Life Extension Magazine®, a lot more than statin drugs would be needed to prevent atherosclerotic plaque from re-occluding the former President’s coronary blood flow.
According to his cardiologist, Bill Clinton did everything right since his 2004 bypass, including eating well, exercising, and keeping his blood pressure and cholesterol in check. Despite this, the bypass graft re-occluded at the beginning of this year, necessitating the insertion of two stents to prop the vessel open.
Mainstream cardiologists were quoted in the media stating that those undergoing coronary artery procedures often have to return every four to five years for tune-ups, i.e., to reopen newly blocked coronary arteries. One cardiac surgeon bragged that he had performed 10 or 15 different stent procedures on the same patient over a period of time.
Bill Clinton’s cardiologist stated that we don’t have a cure for this condition, but we have excellent treatments.
These blatant admissions document the inability of conventional doctors to prevent and reverse atherosclerosis.
Life Extension® Members Know Otherwise
In response to Bill Clinton’s heart attack and subsequent need for bypass surgery in 2004, Life Extension reminded its members that atherosclerosis arises from a chronic condition known as endothelial dysfunction.
We listed the risk factors that cause endothelial dysfunction and described how members could protect against each and every one of them.
The fact that mainstream cardiologists have ‘thrown in the towel’ when it comes to eradicating coronary artery disease reveals how little they pay attention to the published scientific literature.
Life Extension® members long ago were made aware of 17 independent causes of atherosclerotic disease. The diagram on page 16 of this issue outlines each of these correctable cardiac risk factors.
Coronary Artery Disease Can Be Reversed
Contrary to what mainstream cardiologists say, it is possible to reverse the blockage of blood flow through the coronary arteries. One way is to follow the aggressive lifestyle modification program Dean Ornish, MD has prescribed for decades.
Dr. Ornish and colleagues showed that a regimen that emphasized a very low fat diet, regular exercise, meditation, and avoidance of certain risk factors not only stopped the progression of coronary artery disease, but could reverse it.
This result was demonstrated in a randomized controlled trial, known as the Lifestyle Heart Trial, with data published in The Lancet in 1990. In this study, test subjects were recruited with pre-existing coronary artery disease.2 The patients assigned to Dr. Ornish’s regimen had fewer cardiac events than those who followed standard medical advice.3 What’s more, their coronary atherosclerosis was somewhat reversed, as evidenced by decreased narrowing of the coronary arteries after only one year of treatment. Most patients in the control group, on the other hand, had worsening of their coronary artery blockage at the end of the trial compared to when they started. These favorable results have been replicated by doctors using similar methods (for example, Caldwell B Esselstyn, Jr., MD4 and K. Lance Gould, MD).5
The drawback to Dean Ornish’s program is that it is very restrictive. Participants must avoid all meat and dairy products except egg whites, nonfat milk, and nonfat yogurt; as well as all vegetable oils, nuts, seeds, and avocados. Participants following the Ornish program must supplement with calcium, iron, vitamin B12, and essential fatty acids or deficiencies will develop.
As you’ll read soon, there are other documented ways to maintain healthy coronary artery blood flow that are ignored by most practicing cardiologists.
Dick Cheney Does Opposite of What Dr. Ornish Recommends
Perhaps no living political figure exemplifies poor lifestyle choices and ensuing chronic heart disease better than former Vice President Dick Cheney.
Cheney was known for eating outrageous quantities of artery-clogging foods and smoked heavily for 20 years. He almost certainly suffers today from cardiac risk factors that extend beyond his early-life unhealthy habits.
Shortly after Bill Clinton’s coronary stents were inserted this year, Dick Cheney suffered his fifth heart attack. The first occurred in 1978, when he was only 37. He suffered his second in 1984 and a third in 1988 before undergoing quadruple bypass surgery to unblock his arteries. His fourth heart attack occurred in 2000. At that time, doctors inserted a stent to open a re-occluded coronary artery.
In 2001, doctors implanted a device to track and control Cheney’s heart rhythm. In 2008, he underwent a procedure to restore his heart to a normal rhythm after doctors found that he was experiencing a recurrence of atrial fibrillation. Despite all this, Cheney suffered his fifth heart attack in February 2010.
Dick Cheney has reportedly taken statin drugs for nearly two decades. In June 2001, his LDL was an excellent 72 mg/dL, indicating he was taking a high-dose statin drug. This did not, however, prevent him from suffering another heart attack.
The former Vice President has had access to the best that conventional cardiology can offer, yet his chronic heart ailments have not abated.6 Cheney’s multi-decade case history presented the media with another opportunity to declare there is no cure for coronary heart disease, something that Dr. Dean Ornish and many others involved in natural healing vehemently disagree with.
Crestor® Approved by FDA to Reduce C-Reactive Protein
The FDA has given pharmaceutical giant AstraZeneca a gift worth tens of billions of dollars by allowing their statin drug Crestor® to be the only medication approved to reduce the risk of heart attack in aging men and women with LDL-cholesterol less than or equal to 130 mg/dL, elevated C-reactive protein greater than or equal to 2 mg/L, and at least one other traditional cardiac risk factor (e.g. hypertension, smoking, or family history).
Life Extension members were warned long ago about the dangers of excess C-reactive protein in the blood. C-reactive protein is a marker of inflammation. Chronic inflammation, as evidenced by high C-reactive protein blood levels, is one cause of atherosclerosis.7-9 Published studies indicate that elevated C-reactive protein may be a greater risk factor than high cholesterol in predicting heart attack and especially stroke risk.10-14
While generic statin drugs and natural therapies have also been shown to reduce C-reactive protein, the FDA has anointed Crestor® as the only approved drug to treat patients with elevated C-reactive protein who also fit certain age and traditional risk factor criteria. This means that Medicare, Medicaid, and private insurance companies have to pay over $125 for 30 20-mg tablets of Crestor® as opposed to as little as $7.30 for 30 40-mg tablets of generic simvastatin (brand name Zocor®).
Crestor® is the most potent statin drug, so some people may require 40 mg of simvastatin to achieve the same results as 20 mg of Crestor®. Both of these doses are higher than what is usually needed to lower LDL (low-density lipoprotein). Statin drug side effects are amplified as the dose escalates, so one can expect that those prescribed high-dose Crestor® (to reduce C-reactive protein) will suffer more liver-muscle damage.
An increased risk of type 2 diabetes was recently suggested in statin drug users, which further emphasizes the need to use the lowest effective dose if one chooses to use this class of drug.15 There are other options.
The Phony Health Care Cost Crisis
The FDA’s gift to AstraZeneca means that only high-cost Crestor® can be advertised and health insurance-reimbursed for the purpose of reducing cardiac risk in patients with a combination of elevated C-reactive protein, “normal” LDL cholesterol, advancing age, and at least one traditional cardiac risk factor like high blood pressure, smoking, and family history. While AstraZeneca enjoys gargantuan profits, taxpayers will be forking over 17 times more than what a generic of probable equal efficacy would cost.
Remember, there is no real health care cost crisis. It is governmental over-regulation of our disease-care system that causes medical prices to be hyper-inflated. Our 500-page book FDA Failure, Deceit and Abuse thoroughly documents this tragedy that politicians still cannot grasp.16
Life Extension has long advocated that those who need statin drugs should use the lowest possible dose. For many people with excess C-reactive protein, the lifestyle modifications you will soon read about (and/or low dose 5-10 mg/day simvastatin) can bring elevated C-reactive protein down to safer ranges.
Too Many Statin Drug Users Suffer Heart Attacks
Pharmaceutical companies have promoted statin drugs as a virtual universal remedy to prevent heart attack. According to conventional guidelines, statin drugs are to be prescribed when LDL blood levels exceed 130 mg/dL and lifestyle modifications like stopping smoking and losing weight fail to bring LDL cholesterol to an optimal level.
Life Extension has long argued that LDL levels should be kept below 100 mg/dL in healthy people to optimally protect against atherosclerosis. In certain high-risk cardiac patients, LDL levels need to be suppressed below 70 mg/dL.
The high dose used in the Crestor® study pushed median LDL level down 50% to a low of 55 mg/dL from a median of 108 mg/dL at baseline and it reduced C-reactive protein by 37%. Despite these impressive reductions in two proven cardiac risk factors, a significant number of subjects taking Crestor® still suffered “major cardiovascular events.”17 This further exposes the fallacy of relying only on statin drugs to maintain healthy arterial blood flow. Remember Bill Clinton and Dick Cheney took statin drugs for years, but their coronary arteries re-occluded anyway.
Crestor® will soon be promoted as a panacea for heart attack prevention. What will not be disclosed in drug advertising, however, is that more than half of the major cardiovascular events in the Crestor® study would occur despite the high-dose use of this drug. In statistical terms, while Crestor® reduced the relative risk of the combined endpoint of heart attack, stroke, or death from cardiovascular causes by 47%, the majority (53%) of these cardiovascular endpoints in this high-risk study group would still take place! What this means is that if you have cardiac risk factors and rely solely on a high-dose statin drug, you are still at significant risk of suffering a heart attack.
Why Crestor® Failed to Protect All the Study Subjects
There are at least 17 independent risk factors involved in the development of atherosclerosis and subsequent heart attack and stroke. Statin drugs do not come close to correcting all of these risk factors. Based on the findings from the Crestor® study, it is obvious that even when LDL (and total cholesterol) is reduced to extremely low levels, too many people still suffer a major cardiovascular event.
This study will nonetheless be the basis of a national advertising campaign to tout Crestor®. An analysis of the study findings, however, documents the critical need to correct all known cardiovascular risk factors (including elevated LDL, total cholesterol, and C-reactive protein).
We are not vilifying the proper use of statin drugs. For many people with stubbornly high LDL and C-reactive protein levels, they represent an important weapon against arterial disease. Our emphasis is that statin drugs are not the only way to lower LDL and C-reactive protein, and they should not be relied on as the only approach to protect against atherosclerosis.
Reducing C-Reactive Protein Requires a Multimodal Approach
Life Extension has reviewed thousands of C-reactive protein blood test results over the years. Our consistent observation is that overweight and obese individuals have stubbornly elevated C-reactive protein levels.18 Our findings were confirmed in a recent study that showed overweight and obese individuals are far more likely to have elevated C-reactive protein. In fact, obese people are three times more likely to have elevated C-reactive protein levels than normal-weight individuals.19,20
C-reactive protein is a marker of chronic inflammation. A large body of evidence correlates chronic inflammatory reactions with the increased risks of cancer,21-23 stroke,24 heart attack,25-27 and dementia.28 People who accumulate excess body fat suffer sharply higher incidences of all these diseases, further validating the importance of maintaining C-reactive protein at optimal ranges.
In the Crestor® study, median C-reactive protein levels were 4.2 mg/L in the Crestor® group, and 4.3 mg/L in the placebo group at baseline.17 Obese individuals can have C-reactive protein levels that are easily double this.29 The biological challenge in overweight people is to combat the excess C-reactive protein made directly by fat cells (adipocytes) and the C-reactive protein made in the liver in response to excess amounts of interleukin-6 expressed in abdominal fat that is dumped directly into the liver.
Since obese and overweight individuals spew out C-reactive protein from their liver and fat cells, it is often challenging to bring this lethal inflammatory compound (C-reactive protein) into safe ranges.
We are impressed with the data from the Crestor® study showing the reduction in C-reactive protein and major cardiovascular events. Our decade-long evaluation of C-reactive protein blood results, however, prompts us to warn that it will require more than statin drugs to suppress dangerously high C-reactive protein levels prevalent in so many individuals.
The good news is that low-cost nutrients and hormones, along with dietary changes, can work as well as statins in reducing deadly C-reactive protein.