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November 18, 2002


Cholesterol And Heart Disease Revisited As The Issue Heats Up

By Nicholas Regush - Readflagsweekly.com

Spring may be far off, but a good cleaning may be in order when it comes to the well-entrenched claim that cholesterol is the major villain in heart disease.
Recent attention - and a lot of it - has been focused on the role chronic inflammation plays in atherosclerosis. Though it has taken more than a decade to make this area of science respectable, it is now becoming more obvious that inflammation is involved in all stages of this disease. Plaque in arteries can become dangerous should it be weakened by inflammation. A piece of plaque can break off and form a clot. Once that happens, the blood flow could be stopped, causing a heart attack.
The implications are considerable. What? No more sole preoccupation with heart disease being essentially a plumbing problem caused by cholesterol-laden arteries? Obviously, it is not that simple - and it never was. The cholesterol hypothesis gang will likely stonewall as much as it can, even in the face of very strong basic and experimental science that implicitly challenges the importance of the cholesterol theory. No one is going to give up medicine's standard theory of heart disease without a huge fight. Unless, of course, they can figure out a way to make a quick buck. And doctors are terrific at saying, Show me the money.

This is not to say that the inflammation crowd moving in will have all the answers either. Let's not get too carried away and think that the downfall of one theory means another is true. Not on your life, it doesn't. What the inflammation model does is get more people rethinking the whole concept of heart disease that science and the public have been force-fed for many years.
If you haven't heard already, you will hear a lot shortly about a cheap test that anyone can take to determine levels of a chemical called C-reactive protein. It is one of numerous chemicals that become elevated when inflammation sets in. Evidence is building that this test may be of some value in helping doctors to assess risk of atherosclerosis and potential damage to the body.
Can it really be that inflammation will turn out to be more important than cholesterol in triggering heart attacks? It now looks that way. Your cholesterol level may be low, but the test for inflammation may turn out to be a much better indicator of whether you are at an increased risk of having a heart attack or a stroke.
Naturally, you may be wondering what all this means for the cholesterol-lowering drugs known as statins that basically top the drug market, to the tune of almost $20 billion per year. We're talking about drugs such as Zocor, Pravachol, Lipitor, and Mevacor.
Here is what you will likely hear or read about: Cholesterol is still very important and therefore statins, which also seem to protect against inflammation, are now more desirable than ever. You do not need a crystal ball to predict this next market ploy .
However, look for something else in the pipes: a growing challenge to the idea that statins really do address cholesterol in an important way. It may well be that whatever they do to help protect against heart disease may actually be related to inflammation - not both inflammation and cholesterol. This one is a battle-royale in the works, but be patient.
And considering that statins can cause nerve and muscle damage, deplete the body of valuable CoEnzyme Q10, which helps power cells, and possibly even contribute to cancer, the shifting tide may eventually include a reconsideration of their overall value in heart disease.
For a detailed view of inflammation and disease, including neurodegenerative illnesses, such as Alzheimer's and Parkinson's, one of the hottest topics in medicine today.

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