Why Cholesterol Meds Alone Are Not Always the Answer
"Can't I just take a pill to get my cholesterol down?"
Not long ago, one of my patients said this to me in the office. He was a middle aged man with known heart disease, previous angioplasty, and a high cholesterol. I had suggested to him that his cholestrol was too high. His bad cholesterol, LDL, was elevated over 120 and his belly was quite large. The man had been eating ice cream 3-4 days a week and wanted to know if there was a pill that he could take that would allow him to lower his cholesterol and still eat ice cream.
Normally as cardiologists we try to reduce the LDL cholesterol to well below 100mg/dl. Ideal is somewhere between 50-70. Studies show that people in cultures that have very little or no heart disease, the LDL cholesterol is exceedingly low. Just as it is in all newborns. It can be as low as 35-50mg/dl.
Eating saturated fat from animal products has been show to be a key reason that people have high LDL cholesterol levels. Many other things play a part in getting heart disease but improper eating is very crucial.
A large belly has been shown to cause elevated insulin levels that can help lead to heart disease.
So I wondered what to say to a man who:
1. Has had a heart attack
2. Has a high LDL
3. Is already on medications
4. Wants to take a pill rather than giving up his ice cream.
Would someone ask such a silly question about their car? We all know that if you have a car that runs on regular gasoline and we've been putting kerosine in it and it stops working the way it should. We all know we can't do this.
Everyone understands that an automobile has to have the proper oil, care, and fuel to make it run properly.
So why don't people understand this about their bodies?
Heart disease is 90% preventable- 90% of all CAD, Coronary Artery Disease, can be prevented with proper diet, exercise, and relaxation techniques.
A health care crisis is upon us. Yet, very few people are interested in taking the steps needed to prevent illness. Andrew Weil, M.D. a guru of integrative medicine in a recent interview, suggests that we need to really examine the medical system to get away from a disease management system and really embrace prevention (http://www.mydigitalpublication.com/publication/?i=29055)
I would agree. Consider the costs of just knee replacement therapy. Each year over 50 billion of dollars are spent on orthopedic surgeries related to Osteoarthritis, frequently caused by obesity (http://www.ajmc.com/supplement/endocrinology/2009/A235_09sep_Osteoarthritis/A235_09sep_Bitton_S230toS235). Knee replacement surgery is a big part of this cost. Obesity is one of the key causes of knee injury.
Obesity is preventable. Yet, it means that people have to take responsibility for their health care.
Last year, in my cardiology practice in Michigan, I highly recommended a yoga class to 50 of my patients who suffered from obesity. I spent nearly 10 minutes talking to each and every patient. I gave them literature and a phone number to call.
Did you know that not 1 patient even called the phone number?
Sad but true. I also suggested a relaxation CD to over 100 people suffering with emotional upset, that I am sure was aggravating or causing their heart disease.
The number of people who were willing to spend $15 on a relaxation CD was none. Not one single person was willing to buy a CD on relaxation. Yet, I would venture that most of those people were willing to spend $15 eating out.
Perhaps we can create a pill that will make people want to exercise and eat a heart healthy diet. This would be a good prescription to write.
I would then have a pill that could lead to prevention of heart disease. I would welcome comments on this topic