Experts Set a Lower Low for Cholesterol Levels

July 13, 2004

> Tue, 13 Jul 2004 15:42:52 +0200

>

> " Sepp (Josef) Hasslberger " <sepp

> Fwd: Re: Experts Set a Lower Low for

> Cholesterol Levels

>

> For information - big drive to lower cholesterol

> levels ...

>

> Kind regards

> Sepp

>

> Interesting indeed,

>

> thank you for sending the copy of this article on

> new cholesterol goals.

>

> This is fraudulent advertising by the drug makers at

> its best. We are

> talking about billions in profits and lots of

> casualties from side

> effects which they are continuing to sweep under the

> carpet.

>

> Cholesterol, by the way, is needed for the body to

> be able to

> routinely detoxify. That is why we see high

> cholesterol in many

> people: They are either eating crap (white flower,

> white sugar and

> similar) or they are being actively poisoned by

> something in their

> environment.

>

> Turning off the detoxifying mechanism by lowering

> cholesterol is

> about as dim as we can get - unless we are making a

> lot of money off

> these drugs of course.

>

> The next step is cancer or other serious trouble

> from accumulating poisons.

>

> And by the way, overall mortality from heart disease

> has NOT been

> shown to be lowered in those taking cholesterol

> lowering drugs.

>

> Kind regards

> Sepp

>

> p.s. Cholesterol and statins are one of my preferred

> subjects

>

(<http://www.newmediaexplorer.org/cgi-bin/mt-search.cgi?Template=Health%2520Supr\

eme & IncludeBlogs=2 & search=cholesterol>see

>

> this page)...

>

> At 9:35 +0100 13-07-2004, P.Taylor wrote:

> Interesting article from today's New York Times, in

> which new

> recommendations in the US call for drug treatment

> for millions of Americans

> who had thought their cholesterol levels were fine.

> Notice too that Dr.

> Scott M. Grundy of the University of Texas

> Southwestern Medical School at

> Dallas describes niacin as a 'drug' that can lower

> cholesterol. See

>

http://www.nytimes.com/2004/07/13/health/13heart.html?th

>

> ------------

> New York Times

>

> Experts Set a Lower Low for Cholesterol Levels

>

> By GINA KOLATA

>

> Published: July 13, 2004

>

> Federal health officials yesterday sharply reduced

> the desired levels

> of harmful cholesterol for Americans who are at

> moderate to high risk

> for heart disease.

>

> The new recommendations call for treatment with

> cholesterol-lowering

> drugs for millions of Americans who had thought

> their cholesterol

> levels were fine. Already more than 10 million

> people take the drugs.

> But now, more should start, the recommendations say.

> For people at

> the highest risk, they suggest that the target level

> of L.D.L., the

> type of cholesterol that increases the likelihood of

> heart disease,

> should be less than 100. That is 30 points lower

> than previously

> recommended.

>

> For people at moderately high risk, lowering L.D.L.

> to below 100 with

> medication should be seriously considered, the

> report said. The

> advice for people at low risk remains unchanged.

>

> The recommendations were published today in the

> journal Circulation

> and endorsed by the National Heart, Lung and Blood

> Institute; the

> American Heart Association; and the American College

> of Cardiology.

> The authors said the change was prompted by data

> from five recent

> clinical trials indicating that the current

> cholesterol goals were

> not aggressive enough and that more intense drug

> treatment led to

> better results.

>

> The recommendations, which modify guidelines set by

> the government

> only two and a half years ago, will increase by a

> few million the

> number of Americans who meet the criteria for

> therapy with the

> powerful cholesterol-reducing drugs called statins,

> and many people

> who are already taking the medications will be

> advised to increase

> their doses.

>

> Under the old guidelines, about 36 million people in

> this country

> should be taking statins, said Dr. James Cleeman,

> coordinator of the

> National Cholesterol Education Program. But only

> about half that

> number do.

>

> In the report, the health officials addressed three

> questions: When

> are statins merely a sensible option? When are they

> imperative? And

> how aggressively should patients be treated? The

> recommendations

> focus on the levels of L.D.L., rather than total

> cholesterol levels,

> because L.D.L. is the target of cholesterol-lowering

> therapies.

>

> One change applies to people at moderately high

> risk, defined as

> having risk factors like advancing age, high blood

> pressure or

> smoking that confer a 10 percent to 20 percent

> chance of suffering a

> heart attack in the next decade. Under the new

> recommendations,

> doctors now have the option of prescribing drug

> therapy for such

> patients if their level of L.D.L. cholesterol is 100

> or higher, the

> report says, and a level of below 100 can be set as

> a goal.

>

> Previously, doctors were advised to prescribe

> statins to moderately

> high risk patients only if the patients' L.D.L.

> levels were above

> 130, and the treatment was considered effective if

> L.D.L. levels fell

> below 130.

>

> For example, following the new advice, a 57-year-old

> nonsmoking man

> who has an L.D.L. of 115 and whose blood pressure,

> with medication,

> is 130, could now receive drug treatment. Under the

> old rules, he

> would not have been treated.

>

> The recommendations also call for more aggressive

> treatment of people

> at high risk, that is, with established heart

> disease, diabetes, or

> other conditions that give them a greater than 20

> percent chance of

> having a heart attack in the next decade. In such

> cases, when L.D.L.

> levels are above 100, doctors should always

> recommend drug treatment,

> the report said, and no longer have the option of

> not prescribing the

> medications.

>

> The previous advice said that drug treatment was

> imperative in high

> risk people only when their L.D.L. exceeded 130.

>

> The report did not change the advice for people

> whose cholesterol

> levels are above 130 but who have no other risk

> factors. Statins are

> seldom prescribed in such cases.

>

> A risk calculator is available on the heart, lung

> and blood

> institute's Web site,

>

http://hin.nhlbi.nih.gov/atpiii/calculator.asp?usertype=prof.

>

> Millions of Americans will be affected by the new

> advice, said Dr.

> Christie M. Ballantyne, director of the Center for

> Cardiovascular

> Protection at Baylor College of Medicine. He said

> that among the more

> than 28 million Americans at high risk, at least 8

> million had L.D.L.

> levels of 100 to 129.

>

> The recommendations also call for more intensive

> drug treatment of

> both moderately high and high risk patients, telling

> doctors that the

> goal should be to reduce patients' L.D.L. levels by

> 30 percent to 40

> percent, no matter what the initial levels were.

>

> " There is some evidence that physicians were using

> so-called starter

> doses of statins, and then not upping the dose when

> that did not

> produce enough L.D.L. lowering, " Dr. Cleeman said.

> " We are saying,

> 'Don't just drop their L.D.L. a few percentage

> points. Drop it by 30

> or 40 percent so they will get real benefit.' "

>

> For example, Dr. Cleeman said: " If you have someone

> who starts at an

> L.D.L. level of 115, don't just give a small dose of

> a statin to get

> it to 99. Give a dose for a 30 to 40 percent

> reduction. "

>

> Perhaps the report's most surprising recommendation

> concerns the goal

> that doctors might set for L.D.L. levels in their

> patients at highest

> risk, those with established heart disease plus

> another condition

> like diabetes, smoking, high blood pressure or a

> recent heart attack.

> For those patients, the report said, there is a

> therapeutic option to

> drive the L.D.L. level to a breathtakingly low level

> - below 70.

>

> The term, " therapeutic option, " was used, Dr.

> Cleeman said, because

> while the advice was suggested by recent clinical

> trials, the

> evidence was not quite ironclad.

>

> " The evidence is quite strong,' he said, " but it is

> just short of

> being definitive where you would say, 'Thou shalt.'

> "

>

> But, Dr. Cleeman added, " I think it is reasonable to

> say that it is

> the preferred option to get these people to an

> L.D.L. level of less

> than 70. "

>

> It will not be an easy goal to achieve, heart

> disease experts said.

>

> Dr. Scott M. Grundy of the University of Texas

> Southwestern Medical

> School at Dallas, the lead author of the new report,

> said, " A

> standard dose of statins gets most people close to

> 100.''

>

> " If you are going to get from there down to 70, you

> have to take a

> high dose of statins, " Dr. Grundy said, " which still

> might not get

> you there. "

>

> One possibility, he said, is to add another drug

> like niacin or

> ezetimibe, a drug that reduces the amount of

> cholesterol absorbed

> from the digestive tract.

>

> But even then, said Dr. Daniel Rader, director of

> preventive

> cardiology at the University of Pennsylvania School

> of Medicine, many

> people will not be able to reach an L.D.L. level of

> 70. " There

> definitely are still going to be people who even

> with combination

> therapy can't get their L.D.L. level into that

> range, " Dr. Rader said.

>

> No one doubts that the new recommendations will be

> expensive. But,

> Dr. Cleeman said, statins, which cost about $100 a

> month, are cost

> effective in those who should be taking them,

> because heart disease

> costs " hundreds of billions of dollars. " Statins,

> which can reduce

> the risk of heart disease by 30 percent to 40

> percent, he said,

> " compare very favorably to other standard

> treatments, like treatments

> for hypertension. "

>

> The stock of Pfizer and Merck, two manufacturers of

> statin drugs,

> showed little change yesterday.

>

> Heart disease researchers say they are taken aback

> by the speed at

> which the old rules are being rewritten in response

> to growing

> evidence that lower is better.

>

> " It is really quite extraordinary, " said Dr. Steven

> Nissen, a

> cardiologist at the Cleveland Clinic.

>

> He said, " When I was in medical school, I was taught

> that any

> cholesterol level under 300 was normal. "

>

> He explained that someone with a total cholesterol

> level of 300 will

> have an L.D.L. level over 200.

>

> " Now here we are a few decades later saying that

> patients at high

> risk should take their L.D.L. levels to 70 or less, "

> Dr. Nissen said.

>

> He and others, like Dr. Valentin Fuster, director of

> the

> Cardiovascular Institute at the Mount Sinai School

> of Medicine in New

> York, predict that the optimal levels for L.D.L.

> cholesterol will go

> lower still.

>

> Clinical trials under way are expected to provide

> even stronger

> evidence of the value of intense cholesterol

> lowering, Dr. Fuster and

> others said. Dr. Fuster added that in the future

> even L.D.L. levels

> of 70 would seem too high for those at greatest

> risk.

>

> " I can predict that the guidelines will be modified

> to be more and

> more aggressive, and it will happen in the next

> three years, if not

> earlier, " he said.

>

The individual is supreme and finds its way through

> intuition.

> Sepp (Josef) Hasslberger

>

> Personal home page on physics,energy technology,

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>

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> --

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