Have just started reading his book The Great Cholesterol Con.
Dr Malcolm Kendrick: Have just started... - Cholesterol Support
Dr Malcolm Kendrick
Written by
deeanne14
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35 Replies
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Very informative read. There's lots of other stuff on the Web and YouTube too
Heart UK is a cholesterol charity. HUK supports lowering cholesterol by information given on the web site!!!!
This seems flawed "Heart UK - The Cholesterol Charity" as if something else were found to be the root cause of coronary vascular disease then this charity has no raison d'être. It is likely that High cholesterol may be a symptom that something is wrong, perhaps life style or your genetics are not the best.
I cannot however see a step decrease of CVD since the introduction of Cholesterol lowering drugs. (reference ONS). I have read recent articles that portray that statins may have other effects for instance decreasing inflammation, this I can understand.
Don't get me wrong I am on statins and have been on them for 16 years as I have CVD, but I am not sure that lowering my cholesterol is the reason I am taking them, although it is why I started taking them and my cholesterol came down initially.
My guess is that those taking statins and other medication to treat their condition are benefiting from the overall treatment, have lowered their blood pressure, exercise more, and eat more wisely i.e. they have changed their lifestyle, so the overall package works.
I would be interested to know what the levels of cholesterol limits have been over the years, for someone with CVD.
I ran a health screening unit in the 1970s when not many people had heard of cholesterol. The normal level then was 3.6-7.2 mmol/l. Gradually over the years the upper level of normal has been reduced. When I was diagnosed circa 1975 my cholesterol was between 10 & 12 mmol/l. I have taken statins since they became available, without problem, and for years have been on rosuvastatin (Crestor) 40 mg. daily.
in reply to Floozie
"The normal level then was 3.6-7.2 mmol/l. Gradually over the years the upper level of normal has been reduced. "
Which means that a lot of us with 'normal' cholesterol are being given the possible FH label and a lot people are being labelled or worried unneccesarily.
This is the thing that I object to most. If you are already worried about the risk of heart disease and seek help from a doctor then that's one thing. But I was basically targeted by a doctor when I hadn't sought advice on heart disease risk and caused endless anxiety as a result.
Who benefits from this? I don't, and the NHS doesn't either because it has ended up costing them more money e.g having expensive investigations and A&E admissions for chest pains caused by a combination of anxiety and indigestion.
BAUS in reply to
I hear you ... My anxiety is sky high because of these test figures ... I brought my cholesterol down from 7.4 to 7.1 in 7 weeks but my hdl has also decreased from 1.0 to 0.95 so I've decided to take fish oil and eat salmon three times a week and reduce grains and carbs ... Also adding walnuts ...
Test figures help you understand your body functions. Put it a side and concentrate on healthy life style till you next blood test!
you can do a xl file for all blood test results for easy understanding and all in one place. Later on a graph can help you to get better understanding.
I should add that I have never changed my lifestyle, always being slim & eating what I fancied (potatoes, cheese, cream, chocolate, butter, white bread, etc.) I have never been to a gym & don't exercise, except for walking my dogs & for 10 years I looked after my daughter's ponies, so I suppose this did count as exercise, but that was 25 years ago. My cholesterol is somewhere between 4 & 5 mmol/l now, with the addition of Ezetrol 10 mg. daily & a Benecol drink, which I found to work for me. My parents both died quite suddenly at age 63 from cardiovascular incidents and, in the absence of genetic testing, I was diagnosed with heterozygous FH. Today I am 70 & believe statins have helped me achieve this age.
in reply to Floozie
you may well be right that statins have helped you achieve that age, I'm not disputing for one moment that statins lower heart disease risk, and if you feel your risk is high, then apart from diet and exercise, they are about the only intervention that will work to prevent heart disease. In your position I would probably have considered a statin too.
The point is you were very probably at high risk just from your family history. My own family history is a lot less alarming - both my parents lived until 72 when the average life expectancy was 76 despite having smoked and not had particularly easy lives or the benefit of modern lifestyle advice on diet and exercise. No one who does not smoke in my family has ever had heart disease or a stroke so far, though two of my cousins have died of cancer. My oldest sibling is 70 and does not take statins.
And yet the health service is telling me to take a statin on the basis of my supposedly high cholesterol risk , yet when I ask for their evidence base refuses to give it to me.
I have raised various academically respectable studies with consultants who have agreed they are academically respectable and then point blank refused to discuss them.
The evidence shows that risk varies hugely even in confirmed FH.
kasibarndoor in reply to
Thank you Floozie and Idontbelieveit for your comments, My father and his father died at 63 and my paternal grandmother died at 53 all from heart disease, I had a stent at age 44 due to Angina and a double CABG at 60 (12 weeks ago), in the past 16 years my cholesterol has been 5 or below and I have taken the highest dose of statins I can tolerate.
I am not advocating don't take statins but that Cholesterol MAY be an innocent bystander, the problem is that a lot of research and Thesis have been written which investigate aspects of CHD with people taking statins and blood pressure treatment and shown a benefit.
We do not know for certain what part of the jigsaw is the solution but since 1980 there has been an almost straight line reduction in age adjusted morbidity in the UK due to cardiovascular disease, during this period there has been a decrease in the smokers amongst the population. I have also read that oestrogen has been used in studies, and found to lower the incidence of mortality in men, but was unpopular due to the side effects. The birth control pill has also been reported as being present in our water supplies.
in reply to kasibarndoor
oestrogen as a drug lowers circulating COQ10 and there's not really any evidence that HRT lowers risk of heart disease - some trials have found it does, some have found it increases the risk.
What this indicates to me yet again is what a morass the whole issue of preventive medicine is. Our bodies are very complicated organisms, and everyone has a different physiology, so you can't say a drug will do everyone good or predict the result of taking it in an individual.
So why prescribe drugs to healthy people? It really doesn't make sense, yet this is the road the NHS seems to want to increasingly go down.
Floozie in reply to
Thank you for responding to my post. I do agree with you & the points you make about your family history. I don't have any siblings to compare with, but my son & daughter have been tested & are within normal limits so my grandchildren will not be affected. A male first cousin of my mother had 2 sons who both died of heart attacks at the ages of 38 & 40 & he, himself, and his sister both died in their fifties from heart problems, so there is obviously a rogue gene here. My mother dropped dead at a football match the day before her 64th birthday, which was a shock as she had been completely asymptomatic, but then in 1969 there was no screening. I don't know whether you are male or female or how old you are, but in your shoes I would have made the same decision about statins. I have recently been offered NHS gene testing, but, although I have agreed, I don't feel I need to know about this now as I don't see the point.
in reply to Floozie
It is worth you having gene testing if you are worried about your family as it can tell you more about risk.
Please see my post below about prothombin G20201A. This is not a gene that causes FH, but it can co occur with FH. I think it would be worth your while finding out if you can be tested for this gene mutation, as it is an independent cause of heart disease.
in reply to Floozie
another point the consultants ignore that is unlike you, who has always been slim, I am well into the 'obese' category, which I think is the main cause of my high cholesterol. I am trying to lose weight and am quite confident that even if I get below A BMI of 30 my total cholesterol will drop to less than 7 - probably about 6.5.
I may well have slightly higher than average cholesterol, but that's just natural variations. I'll only believe I have FH when they prove it via a genetic test.
sandybrown in reply to
What about weight height ratio?
in reply to sandybrown
thats basically what BMI is.
Floozie have you avoided intentionally or unintentionally Animal fats or Man made fats (margarine)?
I have ignored following any advised diet (probably unwisely) because I don't like & didn't need any what I would term "slimming foods" and have just carried on eating what I fancied. I like French cuisine, which includes lots of rich sauces etc. and white toast dripping with butter. I can't stand steamed veg. or cooking without salt & I have a sweet tooth which I indulge.
I have no doubt though that had I had a weight problem when I was younger I would not have had this mindset as I was very concerned about my appearance (not so now I am old). Nowadays I just want to live long enough to see my grandchildren grow into adulthood & to be there for them. I have a husband with Alzheimer's which dictates my life now to some degree.
in reply to sandybrown
It's strange how, in spite of all the evidence which shows that cholesterol is not a villian, people are so brainwashed that they still think they must lower it!
Out of interest (I haven't got the book, must invest in a copy) does Kendrick explain where the theory that cholesterol causes heart disease first came from?
And here's an interesting analysis of that.
The coronary primary prevention trial did show that those whose cholesterol was lowered had a lower risk of heart disease. However other trials on cholesterol lowering have shown the direct opposite.
And even if cholesterol is lowered, that doesn't mean all cause mortality is lowered. Niacin was commonly used to lower cholesterol but has now been found to increase mortality and serious illness.
Reading is good Deanne - and question everything.
We are still learning, the human body can have 60,000 dysfunctions - that we currently know about. Our bodies are so complex with sensitive, complex and interactive systems which we really do not understand.
'Facts' have a limited shelf life and what was once accepted wisdom will become obsolete in the light of 'new' knowledge.
It is clear there is a link between cholesterol and heart disease - but it is not proven that high cholesterol is the direct cause of heart disease. Statistically it can be shown that lowering cholesterol reduces heart disease - AND they act as an anti-inflammatory so is it the inflammation or the cholesterol which triggers disease? And shouldn't it be called vascular disease rather than heart disease? Blocked vessels may cause a heart attack but the heart itself may actually be perfectly healthy so it is illogical for Heart UK to be 'the cholesterol charity' - to me at least.
A very wise doctor once told me that all disease was the result of a dysfunctional immune system - autoimmune diseases the result of an overactive immune system - everything else, including cancer, the result of the immune system being unable to recognize and fight off the invader or cells behaving inappropriately.
And please remember that all research needs to be funded - so always look at who pays for the research.
Everything is connected to everything else, literally. I think we need to be really cautious about assuming anything about any large charity, however seemingly benign, and question everything. And I say that having worked for a few!
If the answers to our questions stack up for our way of thinking then we will be supporters, if not we will look elsewhere for a different way of thinking. My Professor used to say - 'Look for the Mavericks, they may not have the answer today but they will lead the way to the answers tomorrow'. So I have read all sides and come to my own judgement which is - cholesterol - case not yet proven, but evidence links it to disease AND cholesterol is produced by the body to heal inflammation so why aren't we looking more closely at the role of the inflammations? And why not more emphasis on the role of nutrition and healthy lifestyle? Why does it have to be all about the drugs? And having heard the 'advice' from a so called cardiac nurse who was morbidly obese lecture me about diet allegedly directly from the Heart UK who advised me to cut back on fats and presented a 'plate' which was high in carbs - I just burst out laughing and left the building!
My experience of 3 autoimmune diseases has made me look very closely at diet and lifestyle and the role of sugar, gluten and carbohydrates in particular. We are so controlled by marketing from all sides - yet we sleep walk through our lives seemingly completely unaware of the effect of the Madmen.
It is human nature to disagree and argument - in the old sense of the word, to present an argument - is healthy - I have learned so much from the presented arguments on this site - so thanks to all who contribute.
My View is that it is disrespectful to dismiss the views of others, so I retain the right to disagree with you Bala on this occasion and would defend the right of others to disagree with me and you.
I am glad of the discussion. Accept your disagreement!
Have a learned a lot over the last four years.
Where is the evidence that statins lower inflammation?
sandybrown in reply to
OK, where can we find this?
in reply to
Hi petalline.
Dr Kendrick agrees they lower inflammation. I tend to trust him, but there's a paper here.
ncbi.nlm.nih.gov/pmc/articl...
in reply to
Hi idontbelieveit
All the research on statins lowering inflammation is based on C-reactive protein (CRP) levels. That's fair enough as it's an easily measured marker of inflammation. However, we don't really know conclusively that lowering them in all conditions is always beneficial - but it may be. However, ignoring this latter comment for the moment, even if statins do lower inflammation beneficially, why would anyone choose to take them for this purpose, considering the huge question mark over their safety? There are (provably) loads of things that will lower one's CRP - low dose aspirin, Vitamin C, krill oil, fish oil, vit D etc etc. I think Pharma is getting worried that cholesterol is now being shown not to be a villian so want to be able to say, "You might not need them to lower your lipids but, hey, they're anti-inflammatory so you need them after all."
in reply to
I'd also add that there are plenty of foods that lower inflammation, and also foods that cause inflammation, that you can avoid in your diet.
in reply to
Hi idontbelieveit
Just saw your second comment on foods, which mirrors my above spiel. So we are in agreement, leave the statins alone.
Penel in reply to
The site PubMed is usually a useful place to go if you are looking for scientific answers.
Hi Penel
Thank you. I have now read through that paper. It does suggest strongly anti-inflammatory vascular effects of statins but, taken as a whole, it far from shows that statins are a good treatment for coronary heart disease. In fact, it points out the dangers of lowering cholesterol in patients with advanced heart failure, who do very badly with low levels. It also points out the dangers of rebound effects when stopping the statins, particularly in very ill patients. In all, the evidence for using statins to mitigate inflammation was shown to be very equivocal - it seems to mitigate in some cases and not in others. That is my take on it anyway but I am anti-statin. Others may interpret it differently, although the researchers did themselves point out the unreliability and dangers of using statins for this purpose.
in reply to
I think all the statin sceptics, even Drs Kendrick and Briffa admit there are some benefits to statins - they're also anti coagulant.
What they aren't is either a miracle drug, or one that can't do anything for most people that lifestyle change couldn't do just as well. Kendrick and Briffa agree that they may help men who have heart disease, but that's it.
if you have FH and a very high family risk of heart disease, it's often due to mutations on the prothrombrin gene which makes your blood more likely to clot - I posted a study about this elsewhere but here it is again
atvb.ahajournals.org/conten...
Now I am just an unqualified person and I can find that information through google. Yet again - when I tried to discuss this with a consultant he refused.
Anticoagulants certainly can help those with high heart disease risk, that's why warfarin is often prescribed, or aspirin. There are also, again, many foods with anti coagulant effects, but if you need drugs there are a number to choose from.
I wouldn't say to anyone don't take statins, if you have had heart disease and can't/don't want to change your lifestyle, or you are very high risk, they may be appropriate for you.
My complaint is about the wholesale NHS scaremongering that I've experienced. It isn't backed up by the evidence and even though I'm a fairly strong minded sceptic, it has been a horrible experience to go through.
I'd really like the consultants and specialists to listen to this and take it on board, but I know they won't listen. Our only hopes are the Aseem Malhotras and Malcolm Kendricks of the medical profession who fortunately seem to be gaining ground. But the lipid specialists seem entrenched and defensive. Probably because if they reviewed their position they'd be forced to admit how much they've got wrong, but they are harming as well as helping in my view by exaggerating the risks for lower risk patients.
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