Cholesterol is not the cause of heart disease

[Guest guest]

http://www.mercola.com/2005/may/28/cholesterol_heart.htm

 

 

Cholesterol is NOT the Cause of Heart Disease

 

 

Ron Rosedale, MD

 

By Ron Rosedale, MD

 

Cholesterol is not the major culprit in heart disease

or any disease. If it becomes oxidized it can

irritate/inflame tissues in which it is lodged in,

such as the endothelium (lining of the arteries). This

would be one of numerous causes of chronic

inflammation that can injure the lining of arteries.

However, many good fats are easily oxidized such as

omega-3 fatty acids, but it does not mean that you

should avoid it at all costs.

 

Common sense would indicate that we should avoid the

oxidation (rancidity) of cholesterol and fatty acids

and not get rid of important life-giving molecules.

Using the same conventional medical thinking that is

being used for cholesterol would lead one to believe

that doctors should reduce the risk of Alzheimer's

disease by taking out everybody's brain.

 

In fact, cholesterol is being transported to tissues

as part of an inflammatory response that is there to

repair damage.

 

The fixation on cholesterol as a major cause of heart

disease defies the last 15 years of science and

deflects from real causes such as the damage (via

glycation) that sugars such as glucose and fructose

inflict on tissues, including the lining of arteries,

causing chronic inflammation and resultant plaque.

 

Insulin & Leptin Resistance

 

Hundreds of excellent scientific articles have linked

insulin resistance and more recently leptin resistance

to cardiovascular disease much more strongly than

cholesterol, and they are in fact at least partially

responsible for cholesterol abnormalities. For

instance, insulin and leptin resistance result in

" small dense " LDL particles and a greater number of

particles.

 

This is much more important than the total cholesterol

number. Because of particle size shift to small and

dense, the total LDL cholesterol could still be low

even though the number of particles and the density of

the particles is greater. Small, dense LDL particles

can squeeze between the cells lining the inside of the

arteries, the " gap junction " of the endothelium, where

they can get struck and potentially oxidize, turn

rancid, and cause inflammation of the lining of the

arteries and plaque formation.

 

Importantly, many solid scientific studies have shown

a mechanistic, causal effect of elevated insulin and

leptin on heart and vascular disease, whereas almost

all studies with cholesterol misleadingly only show an

association. Association does not imply cause. For

instance, something else may be causing lipid

abnormalities such as elevated cholesterol and

triglycerides, and also causing heart disease.

 

This " something else " is improper insulin and leptin

signaling. Similarly, sugar does not cause diabetes;

sugar is just listening to orders. Improper insulin

and leptin signaling is the cause of diabetes.

Likewise, cholesterol does not cause heart disease,

but improper metabolic signals including improper

signals to cholesterol (causing it to oxidize) and

perhaps to the liver that manufactures the

cholesterol, will cause heart and vascular disease and

hypertension.

 

Removing cholesterol will do nothing to improve the

underlying problems, the real roots of chronic

disease, which will always have to do with improper

communication, and the generals of metabolic

communication are insulin and leptin. They are really

what must be treated to reverse heart disease,

diabetes, osteoporosis, obesity, and to some extent

aging itself.

 

Cholesterol; Wrongly Accused?

 

Before we can begin to talk about the real cause and

effective treatment for heart and blood vessel

disease, we must first look at what is known, or I

should say what we think we know. The first thing that

comes to mind when one hears about heart disease is

almost always cholesterol. Cholesterol and heart

disease has been almost synonymous for the last

half-century. Cholesterol has been portrayed as the

Darth Vader to our arteries and our heart.

 

The latest recommendation given by a so-called panel

of " experts " recommends that a person's cholesterol be

as low as possible, in fact to a level so low they say

it cannot be achieved by diet, exercise, or any known

lifestyle modification. Therefore, they say

cholesterol-lowering drugs; particularly the so-called

" statins " need to be given to anyone at high risk of

heart disease. Since heart disease is the number one

killer in this country that would include most adults

and even many children. The fact that this might add

to the $26 billion in sales of statin drugs last year

I'm sure played no role in their recommendations.

 

Or did it?

 

Expert Conflict of Interests

 

Major consumer groups think so. They found out that

eight of the nine " experts " that made the

recommendations were on the payroll of pharmaceutical

companies that manufacture those drugs. Major

scientific organizations have chastised medical

journals for allowing the pharmaceutical industry to

publish misleading results and half-truths. There is a

major push under way to force the pharmaceutical

industry (and others) to publish results of all of

their studies, and not just the ones that appear

positive. The studies that showed negative results

would be forced to be published also.

 

It could be that lowering cholesterol might not be as

healthy as we are being told. More and more studies

are coming out showing just how unhealthy lowering

cholesterol might be, particularly by the use of

statin drugs. In particular, statin drugs have been

shown to be harmful to muscles causing considerable

damage. A common symptom of this damage is muscular

aches and pains that many patients experience on

cholesterol-lowering drugs, however most do not

realize that these drugs are to blame.

 

Hmm...isn't the heart a muscle?

 

Statin Drugs Actually Increase Heart Disease

 

Indeed, low cholesterol levels have been shown to

worsen patients with congestive heart failure, a

life-threatening condition where the heart becomes too

weak to effectively pump blood. Statin drugs have been

shown to also cause nerve damage and to greatly impair

memory. One reason that statin drugs have these

various serious side effects is that they work by

inhibiting a vital enzyme that manufactures

cholesterol in the liver. However, the same enzyme is

used to manufacture coenzyme Q10, which is a

biochemical needed to transfer energy from food to our

cells to be used for the work of staying alive and

healthy.

 

Statin drugs are known to inhibit our very important

production of coenzyme Q10. Importantly, while many

cardiologists insist that lowering cholesterol is

correlated with a reduction in the risk of heart

attacks; few can say that there is a reduction in the

risk of mortality (death). That has been much harder

to show. In other words it has never been conclusively

shown that lowering cholesterol saves lives. In fact,

several large studies have shown that lowering

cholesterol into the range currently recommended is

correlated with an increased risk of dying, especially

of cancer.

 

No Such Thing as Good and Bad Cholesterol

 

Because the correlation of total cholesterol with

heart disease is so weak, many years ago a stronger

correlation was sought. It was found that there is

so-called " good cholesterol " called HDL, and that the

so-called " bad cholesterol " was LDL. HDL stands for

high-density lipoprotein, and LDL stands for

low-density lipoprotein. Notice please that LDL and

HDL are lipoproteins -- fats combined with proteins.

There is only one cholesterol. There is no such thing

as a good or a bad cholesterol. Cholesterol is just

cholesterol. It combines with other fats and proteins

to be carried through the bloodstream, since fat and

our watery blood do not mix very well.

 

Fatty substances therefore must be shuttled to and

from our tissues and cells using proteins. LDL and HDL

are forms of proteins and are far from being just

cholesterol. In fact we now know there are many types

of these fat and protein particles. LDL particles come

in many sizes and large LDL particles are not a

problem. Only the so-called small dense LDL particles

can potentially be a problem, because they can squeeze

through the lining of the arteries and if they

oxidize, otherwise known as turning rancid, they can

cause damage and inflammation. Thus, you might say

that there is " good LDL " and " bad LDL. " Also, some HDL

particles are better than others. Knowing just your

total cholesterol tells you very little. Even knowing

your LDL and HDL levels do not tell you very much.

 

A mistake that is rarely made in the hard-core

sciences such as physics seems to be frequently made

in medicine. This is confusing correlation with cause.

There may be a weak correlation of elevated

cholesterol with heart attacks, however this does not

mean it is the cholesterol that caused the heart

attack. Certainly gray hair is correlated with getting

older; however one could hardly say that the gray hair

caused one to get old. Using hair dye to reduce the

gray hair would not really make you any younger.

Neither it appears would just lowering your

cholesterol.

 

Perhaps something else is causing both the gray hair

and aging. Even if elevated cholesterol were

significant and heart disease (which I question)

perhaps something else is causing the elevated

cholesterol and also causing the heart disease.

 

Let's look little more at cholesterol or, as Paul

Harvey was fond of saying, " the rest of the story. "

First and foremost, cholesterol is a vital component

of every cell membrane on Earth. In other words, there

is no life on Earth they can live without cholesterol.

That will automatically tell you that, in of itself,

it cannot be evil. In fact it is one of our best

friends. We would not be here without it. No wonder

lowering cholesterol too much increases one's risk of

dying. Cholesterol also is a precursor to all of the

steroid hormones. You cannot make estrogen,

testosterone, cortisone, and a host of other vital

hormones without cholesterol.

 

Cholesterol Is The Hero, Not The Villain.

 

It was determined many years ago that the majority of

cholesterol in your bloodstream comes from what your

liver is manufacturing and distributing. The amount of

cholesterol that one eats plays little role in

determining your cholesterol levels. It is also known

that HDL shuttles cholesterol away from tissues, and

away from your arteries, back to your liver. That is

why HDL is called the " good cholesterol; " because it

is supposedly taking cholesterol away from your

arteries. But let's think about that.

 

* Why does your liver make sure that you have

plenty of cholesterol?

* Why is HDL taking cholesterol back to your

liver?

* Why not take it right to your kidneys, or your

intestines to get rid of it?

 

It is taking it back to your liver so that your liver

can recycle it; put it back into other particles to be

taken to tissues and cells that need it. Your body is

trying to make and conserve the cholesterol for the

precise reason that it is so important, indeed vital,

for health.

 

One function of cholesterol is to keep your cell

membranes from falling apart. As such, you might

consider cholesterol your cells " superglue. " It is a

necessary ingredient in any sort of cellular repair.

The coronary disease associated with heart attacks is

now known to be caused from damage to the lining of

those arteries. That damage causes inflammation. The

coronary disease that causes heart attacks is now

considered to be caused mostly from chronic

inflammation.

 

What Is Inflammation?

 

Think of what happens if you were to cut your hand.

Within a fraction of a second, chemicals are released

by the damaged tissue to initiate the process known as

inflammation. Inflammation will allow that little cut

to heal, and indeed to keep you from dying. The cut

blood vessels constrict to keep you from bleeding too

much. Blood becomes " thicker " so that it can clot.

Cells and chemicals from the immune system are alerted

to come to the area to keep intruders such as viruses

and bacteria from invading the cut. Other cells are

told to multiply to repair the damage so that you can

heal. When the repair is completed, you have lived to

be careless another day, though you may have a small

scar to show for your troubles.

 

We now know that similar events take place within the

lining of our arteries. When damage occurs to the

lining of our arteries (or even elsewhere) chemicals

are released to initiate the process of inflammation.

Arteries constrict, blood becomes more prone to clot,

white blood cells are called to the area to gobble up

damaged debris, and cells adjacent to those damaged

are told to multiply. Ultimately, scars form, however

inside our arteries we call it plaque. And the

constriction of our arteries and the " thickening " of

our blood further predisposes us to high blood

pressure and heart attacks.

 

So Where Might Cholesterol Fit Into All Of This?

 

When damage is occurring and inflammation is being

initiated, chemicals are being released so that that

damage can be repaired. One could speculate that to

replace damaged, old and worn-out cells the liver

needs to be notified to either recycle or manufacture

cholesterol since no cell, human or otherwise, can be

made without it. In this case, cholesterol is being

manufactured and distributed in your bloodstream to

help you repair damaged tissue and in fact to keep you

alive.

 

If excessive damage is occurring such that it is

necessary to distribute extra cholesterol through the

bloodstream, it would not seem very wise to merely

lower the cholesterol and forget about why it is there

in the first place. It would seem much smarter to

reduce the extra need for the cholesterol -- the

excessive damage that is occurring, the reason for the

chronic inflammation.

 

So Why Take Cholesterol-Lowering Drugs?

 

The pharmaceutical companies thought that you might

think that. They went back to the drawing board. They

did more " research " and found (coincidentally) that

statin drugs had anti-inflammatory effects. Therefore

we're currently being told to stay on our

cholesterol-lowering drugs because now they work by

reducing inflammation and perhaps not even by reducing

cholesterol, and in fact perhaps in spite of it.

Aspirin reduces inflammation for a lot less money. So

does vitamin E, and fish oil, and dietary changes

without the dangers of drugs and having many other

benefits instead.

 

What About Triglycerides?

 

Triglycerides are just medical terminology for fat. A

person with high triglycerides has a lot of fat in the

bloodstream. Triglycerides are generally measured when

a person has fasted overnight. High fasting

triglycerides are either from manufacturing too much,

or using (burning) too little. In other words, what

high triglycerides are telling you is that you are

making too much fat and you are unable to burn it.

This indeed is a major problem. The inability to burn

fat underlies virtually all of the chronic diseases of

aging, and in fact may contribute to the rate of aging

itself.

 

As such, one might think that the control all fat

burning and storage might be very important in heart

disease, and the other diseases of aging such as

diabetes, obesity, osteoporosis, and even cancer.

Indeed, this appears to very much be the case. The two

hormones that to a major extent control our ability to

burn and store fat, insulin and leptin, appear to play

a major role in all of the chronic diseases of aging.

I would call them the most important hormones, indeed

chemicals in the entire body. But that is a story for

next time.