Important Papers in the War Against the War Against Cholesterol

There are a number of reasons why so many doctors believe in statins and the cholesterol hypothesis. One easily appreciable reason is that they simply haven’t been exposed to the huge amount of contrary data.

Doctors are predominantly shown data that has already been put through the pharmaceutical industry’s marketing machine and presented with sufficient twists and turns to create “unequivocal evidence”

During the last ten years I have attempted to show the contrary evidence in published articles, my books and documentary films. It is difficult to summarise all of this in a blog post however, I thought it might be useful to provide a reminder of some of the key scientific publications during the last decade that in particular should have caused our health authorities to sit up and rethink their position.

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These publications individually represent a significant challenge to the cholesterol hypothesis and the widespread use of statins.

It is Important to note that this is certainly not the totality of the evidence against the widespread use of statins - it is just a selection of papers that stand by themselves as a significant challenge. I have also, where possible, tried to select papers that are available free so anyone can have access to them.

Unfortunately, some of these reports have generally gone unnoticed and not received the same level of attention as the pharmaceutical industry’s sponsored information.

I have been working on this list during the last few days and coincidentally, the Guardian published a totally biased article yesterday specifically to attack those doctors who do not believe the dogma that cholesterol causes heart disease. This is not really a surprise since some time ago I met with the deputy editor of the Guardian and presented him with a free copy of Statin Nation. He instantly dismissed the information without even watching the film stating “that’s funny because my neighbour thinks statins are wonderful”. I don’t know who his neighbour is but I would be surprised if they are better qualified than the 18 internationally renowned experts interviewed for the Statin Nation documentaries. It goes without saying that the Guardian piece is completely full of inaccuracies and only serves as a mouthpiece for the pharmaceutical companies. How this article came about would also be intriguing to find out since it doesn’t mention any new studies, just an attack on those who dare question a false hypothesis.

The Ugly Side of Statins

(2013) This paper is written by Professor Sherif Sultan and his colleague Professor Niamh Hynes. Professor Sultan is one of the worlds leading vascular and endovascular surgeons. He is President of International Society Of Vascular Surgeons. This paper forms a concise and powerful systematic critique of the evidence for the widespread use of statins and also discusses statin adverse effects.

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The Cholesterol hypothesis: Time for the obituary?

(2011) This is an editorial written by Professors Tore Schersten, Paul J. Rosch, Karl E. Arfors, and Ralf Sundberg. There is no better summary of this editorial other than its own abstract:

“The cholesterol hypothesis links cholesterol intake and blood levels to cardiovascular disease. It has had enormous impact on health care and society during decades, but has little or no scientific backing that is relevant for the human species. Apparently, the hypothesis is false and should be buried.“

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Nationwide Study in Sweden Finds No Benefit

(2011) Researchers at Linköping University looked at statin usage across all but one municipalities of Sweden and found that statins had not provided any benefit despite a large increase in usage. This study is important because it is one of the few studies that have looked retrospectively at if statins actually work in the real world. Double blind placebo controlled clinical trials are considered the gold standard but what is often overlooked is that the results of a clinical trail are a prediction of how the drug will perform in the real world, not a certainty. In a clinical trial the trial participants are carefully selected and the same results do not necessarily materialise in the real world. In this national study of Sweden the researchers found no benefit in the real world.

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Lipid levels in patients hospitalized with coronary artery disease.

(2009) The American Heart Journal published analysis of 136,905 patients admitted to hospital with heart disease in the United States. They found that people with heart disease have lower levels of LDLs (so called “bad” cholesterol) than the general population. In essence, lower LDLs were associated with a greater risk. Not higher LDLs as we are told.

Link to study

Low admission LDL-cholesterol is associated with increased 3-year all-cause mortality in patients with non ST segment elevation myocardial infarction.

(2009) Researchers at the Henry Ford Heart and Vascular Institute, Detroit, USA found that lower LDL levels were associated with worse 3-year survival after ST segment elevation myocardial infarction, which is the most severe type of heart attack.

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Lipid Paradox in Acute Myocardial Infarction— The Association With 30-Day In-Hospital Mortality

(2015) Researchers at Kaohsiung Medical University in Taiwan looked at the LDL levels of people admitted to hospital after a heart attack. They found that lower LDL levels were associated with a significantly higher 30 day death rate.

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Lack of an association or an inverse association between low-density- lipoprotein cholesterol and mortality in the elderly: a systematic review.

(2016) This is the first systematic review of cohort studies where low-density lipoprotein cholesterol (LDL-C) has been analysed as a risk factor for all-cause and/or cardiovascular mortality in elderly people. The conclusion:

“High LDL-C is inversely associated with mortality in most people over 60 years. This finding is inconsistent with the cholesterol hypothesis (ie, that cholesterol, particularly LDL-C, is inherently atherogenic). Since elderly people with high LDL-C live as long or longer than those with low LDL-C, our analysis provides reason to question the validity of the cholesterol hypothesis. Moreover, our study provides the rationale for a re-evaluation of guidelines recommending pharmacological reduction of LDL-C in the elderly as a component of cardiovascular disease prevention strategies.“

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LDL-C does not cause cardiovascular disease: a comprehensive review of the current literature.

(2018) Almost the same researchers as the study above conducted another review. The researchers concluded that the cholesterol hypothesis is unable to satisfy any of the Bradford Hill criteria for causality and support for the cholesterol hypothesis is often based on misleading statistics, exclusion of unsuccessful trials and ignoring numerous contradictory observations.

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The statin-low cholesterol-cancer conundrum.

(2011) Three giants in the study of cholesterol and statins, Dr. Uffe Ravnskov, Dr. Kilmer McCully and Professor Paul J. Rosch published a paper in 2011 examining, as the title suggests, the link between low cholesterol, statins, and cancer. There is an established connection between low cholesterol and cancer however, whether or not statins cause cancer is more difficult to determine when all the data is considered. The authors take a sophisticated look at this issue.

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Statins and All-Cause Mortality in High-Risk Primary Prevention

(2010) Professor Kausik Ray and colleagues completed a meta-analysis of 11 randomized controlled statin clinical trials Involving 65 229 participants. This paper is significant because it was the first study to more accurately separate out the data for primary and secondary prevention. They found that the use of statins in primary prevention does not extend life expectancy. Interestingly, Professor Ray has since continued to be a strong supporter for the use of statins and cholesterol lowering.

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Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms.

(2015) Professor Okuyama and Professor Hamazaki from Japan, along with Dr. Peter Langsjoen, and others published an important paper detailing the ways that statins actually cause heart disease. They discuss the studies showing statins cause an increase in the amount of calcified plaque in the arteries (these studies should be listed as separate entries in this blog post). Along with the other ways that statins damage the heart through CoQ10, vitamin K2 and selenium depletion.

Link to the study

Towards a Paradigm Shift in Cholesterol Treatment

(2015) Professors Okuyama and Hamazaki publish a supplemental of more than 100 pages discussing cholesterol issues. The focus is more on Japan however the data discussed is relevant to every country. They discuss the huge amount of data confirming a link between low cholesterol and a shorter life expectancy, and low cholesterol and an increased incidence of various cancers and other serious diseases.

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