1. Pharma companies will make a mint on cholesterol drugs, now that 25% of Americans are supposed to be on them, up from 12%.
Au contraire, and trick question. Nearly all statins are generic, and generics are not where pharma has placed its future bets: only Crestor is not generic, and it sold $5.1B in the U.S. in 2012, making it the 3rd biggest drug.
From 2000 to 2010, however, the cost of prescription cholesterol medicines (nearly all of which are statins, as niacin is very cheap, and Zetia and Vytorin have not gained real traction) rose from $10B to $38B.
So the money has been made. However, pharma is well-positioned to profit as statins are now suggested to prevent not just heart attack but stroke. This reinforces the culture of prescriptions, and the prescriptive industrial complex that rules medical education and thus practice.
Have we thrown in the towel on nutrition, fitness, sleep and stress relief? I hope not.
2. Saturated fat raises cholesterol and therefore heart disease risk.
Saturated fat does raise LDL (lousy) and HDL (healthy) cholesterol, unlike trans fat which raises LDL and lowers HDL (the WSJ did a good piece on the FDA trans fat step-in-the-right-direction: I’m quoted). But saturated fat probably doesn’t cause heart disease, which is an inflammatory condition. Highly refined starches and sugars, however, make heart disease risk worse because they effect inflammation.
3. As long as I take my statins, I can eat whatever I like, because my numbers are good.
If you really think this (and before one memorable eating trip to Oaxaca with the staff of Topolobampo, at least 2 of my travelmates stocked up on Lipitor), then you need to realize BS means Bad Science.
For example, there’s the new tossing out of the numerical targets (LDL 70, LDL 100, HDL 50), which both the ACC and AHA found there was *no basis for*. So, this is a way of saying: your numbers don’t really matter.
But back to eating whatever you like: statins might actually reduce dementia risk while raising diabetes risk, but they work by stopping the production of cholesterol in the liver–not by lining the arteries with a protective coat.
You can’t prophylax against atherosclerosis (although you can and should chew an aspirin if you are having angina, and eat 8 walnut halves before a fatty meal: consult your physician for more detailed advice).
4. Older people are responsible for the big run up in my health care costs, including the $200 per month I pay for Crestor.
Uh, no. People under 65 with chronic illness account for 65%+ of health care costs. Chronic illness overall: 84% of costs.
The prices (which the patient and physician almost never see) of procedures, hospital care and yes, pharmaceuticals like Crestor are why health care spending is so out of control. That will get worse in our culture of prescription.
In other words, it’s the charges for drugs, devices and duration of stay. And the epidemic of obesity causing so much hypertension, diabetes, back pain…but that needs (at least for men and the women who are interested in them) a new way out: Refuel.
5. Keeping my cholesterol low will be good for me sexually.
Probably not. If you’re a man, you need the cholesterol your liver makes so your testes can manufacture testosterone. if you’re a woman, you need cholesterol to make estrogen, progesterone and testosterone.
Testosterone is important for sex drive, and the good news here is that your liver makes what you need: you don’t need entire lobsters or deep fried egg yolks or a prime rib to get yours up and going. Actually, your arteries may spasm with those foods all at once, which will not help blood flow to the parts that need it.
But the take home is that men on low fat diets have lower testosterone levels, which usually makes men feel tired, energy less, and unhappy. Not good for sex.
6. If my cholesterol is low because I’m on a statin, I am largely protected from heart disease and stroke.
Sadly, half the people who have heart attacks have them with normal cholesterol levels (leaving aside the difference between small and beady and evil LDL, and light and fluffy and less harmful HDL, both of which are lumped together into one reading).
Get yours checked at home. I recommend it.)
To know your actual 10 year risk for heart disease, use the calculator found here: your doctor is going to be asked to do so, so you might as well be ahead!
7. The diet and lifestyle measures for lowering cholesterol and heart disease risk are hard to do and follow.
This is not truly BS: most writers, nutritionists and doctors make it too hard, and ask you to rely on motivation and self-discipline. That doesn’t work.
What does work: make it super easy for yourself to eat more plants; do interval training to drop extra fat and build stamina; sleep better (use a sleep tracker if you’re at all techie: they help); and re-adjust your mindset without overdrinking or overeating or smoking. Your heart disease risk will plummet, as will your cholesterol and blood pressure. My patients have done it and you can too.
You might not even need statins.