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Wed, 15 Oct 2003 09:56:53 -0500

HSI - Jenny Thompson

Cresting the Wave

 

Cresting the Wave

 

Health Sciences Institute e-Alert

 

October 15, 2003

 

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Dear Reader,

 

Less than a month ago, international drug giant AstraZeneca

(AZ) launched a new cholesterol-lowering statin drug called

Crestor. AZ reps claim their Crestor is less expensive and

more effective than Lipitor (made by Pfizer), the drug that

dominates the statin market, grossing about $8 billion per

year.

 

But in light of a recent study that reveals conclusions about

LDL levels and arterial plaque that would shock the

mainstream, these are hard times for any statin drug

manufacturer.

 

I'm just kidding, of course. Not about the study. That's

real. But the study received almost no mainstream media

coverage whatsoever. By all appearances, the astronomical

profits of Lipitor and its new competitor, Crestor, are quite

safe.

 

-----------------------------

Voice in the crowd

-----------------------------

 

In what should have been terrible news for any statin drug

manufacturer, a recent study reported in the American Journal

of Cardiology casts serious doubts on the commonly held

mainstream belief that lowering your LDL cholesterol is the

most effective way to reduce arterial plaque.

 

Researchers at Beth Israel Medical Center (BIMC) in New York

City examined the coronary plaque buildup in 182 subjects who

took statin drugs to lower cholesterol levels. One group of

subjects used the drug aggressively (more than 80 mg per

day), while the balance of the subjects took less than 80 mg

per day. Using electron beam tomography, the researchers

measured plaque in all of the subjects before and after a

study period of more than one year.

 

The subjects were generally successful in lowering their

cholesterol, but in the end there was no statistical

difference in the two groups in the progression of arterial

calcified plaque. On average, subjects in both groups showed

a 9.2 percent INCREASE in plaque buildup. The BIMC concluded

that the LDL cholesterol mantra that " lower is better " could

not be supported by their findings.

 

Now, did you hear this news shouted from the rooftops? Of

course not. Did you hear it at all before today? Reuters

Health covered it, but not one major news outlet picked it

up. And while further research is called for to corroborate

the results, this was a significant trial that flies in the

face of the cholesterol message we're bombarded with daily in

commercials and mainstream commentary.

 

It's as if the little boy who cried out, " The emperor has no

clothes! " made his observation during rush hour in Times

Square. What's that, kid? Cholesterol what? Sorry, can't hear

you. Gotta run.

 

-----------------------------

Not one, but two...

-----------------------------

 

The BIMC study is far from the last word on the cholesterol

issue. But it's not the first time research has concluded

that LDL cholesterol is not quite the terrible killer that

drug ads and cereal commercials tell us to fear.

 

Last year the Journal of the American Medical Association

published a study that used data from more than 10,000

participants in the Antihypertensive and Lipid-Lowering

Treatment to Prevent Heart Attack Trial; better known as

ALLHAT. Following the subjects over a period of four years,

researchers compared the use of a statin drug to " usual care "

(maintaining proper body weight, no smoking, regular

exercise, etc.) in treating subjects with moderately high

levels of LDL cholesterol.

 

Of the 5170 subjects in the group that received statin drugs,

28% lowered their LDL cholesterol significantly. And of the

5185 usual-care subjects, about 11% had a similar drop in

LDL. More importantly, however, both groups showed the same

rates of death, heart attack and heart disease.

 

So the statin group lowered its LDL more than twice as

effectively as the usual-care group, but didn't experience

any fewer heart attacks than the usual-care group; not

exactly a ringing endorsement for risking the side effects of

statin drugs.

 

-----------------------------

The right track

-----------------------------

 

One report I read estimates that AstraZeneca is planning to

spend as much as $1 billion to promote Crestor in the U.S

this year. With drug companies willing to devote that kind of

money to convince us that cholesterol should be our number

one health fear, I'm afraid it's going to be a long time

before the general public gets the message that lowering LDL

cholesterol is not the urgent end-all and be-all of heart

health.

 

Next week I'll take a closer look at the fascinating

marketing battle that's already underway between

AstraZeneca's Crestor and Pfizer's Lipitor. In the meantime,

we'll continue to focus on this reality: Reducing

homocysteine, triglyceride, and C-reactive protein levels is

much more important to heart health than worrying about your

cholesterol. And the best way to reduce all of those levels

is to exercise, maintain a proper body weight, don't smoke,

limit alcohol consumption, increase your intake of omega-3

fatty acids, cut out the junk foods in favor of the soluble

fiber in fruits and vegetables, and take supplements that are

known to protect the heart.

 

Easy as popping a pill? No. Effective? Yes. And worlds safer

than prescription drugs.

 

**************************************************************

To start receiving your own copy of the HSI e-Alert, visit:

http://www.hsibaltimore.com/ealert/freecopy.html

Or forward this e-mail to a friend so they can sign-up to

receive their own copy of the HSI e-Alert.

 

**************************************************************

 

... and another thing

 

" Keep it simple, " was the advice (in so many words) from an

HSI member named Gary who sent an e-mail in response to " This

Week in the HSI e-Alert " (10/3/03), in which members

discussed the best way to address pain associated with a

herniated disc. Among the many suggestions, the number-one

recommendation was to consult a chiropractor.

 

A member named Dee finished up by asking how to go about

finding a chiropractor, and I suggested she start by checking

the web site for the National Center for Complementary and

Alternative Medicine, and then search for a chiropractor by

zip code at the American Chiropractor Association web site.

 

But Gary has other ideas. He writes:

 

" As a chiropractor, I was thrilled to read your report on the

herniated disc thread. A couple of things FYI: I went to the

NCCAM site and found nothing useful about chiropractic. And

the American Chiropractors Association represents only a very

small percentage of chiropractors. Your readers would do

better to search 'chiropractor' and 'their city' in their

favorite search engine or get a recommendation from a friend

who loves their chiropractor. "

 

I agree with Gary; personal recommendations are an excellent

way to start looking for this sort of help. I also tried out

Gary's first suggestion. In Google I entered " chiropractor,

Baltimore " and the first item on the results list was a web

page with a long list of Baltimore area chiropractors, along

with addresses and phone numbers.

 

Good suggestions from a chiropractic insider.

 

To Your Good Health,

 

Jenny Thompson

Health Sciences Institute

 

**************************************************************

 

Sources:

" Relation of Aggressiveness of Lipid-Lowering Treatment to

Changes in Calcified Plaque Burden by Electron Beam

Tomography " American Journal of Cardiology, 2003 Aug 1;92

(3):334-6, ncbi.nlm.nih.gov

" Aggressive Lipid Lowering does not Slow Atherosclerosis "

Reuters Health, 8/4/03, reuters.com

" Major Outcomes in Moderately Hypercholesterolemic,

Hypertensive Patients Randomized to Pravastatin vs Usual

Care " Journal of the American Medical Association, Vol. 288,

No. 23, 2998-3007, 12/18/02, jama.ama-assn.org

" The New Statin " Nicholas Regush, Red Flags Weekly, 10/6/03,

redflagsweekly.com

" AstraZeneca's Crestor " Jeff Hwang, The Motley Fool, 10/2/03,

fool.com

 

Copyright ©1997-2003 by www.hsibaltimore.com, L.L.C.

The e-Alert may not be posted on commercial sites without

written permission.

 

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