A frequent conversation point among my patients, as well as participants in the www.cureality.com program, is "Are cholesterol medications really necessary?"

No, they are not. What IS necessary is to correct all manifest and hidden causes of coronary plaque. Among these causes, in my view, is LDL cholesterol of 60 mg/dl or greater. There are many other causes of coronary plaque--e.g., small LDL particles, unrecognized hypertension, Lp(a), hidden diabetic patterns, etc.--but reducing LDL to 60 mg is still an important part of a plaque-reversing effort.

Insofar as we wish to get LDL to this goal, the statin cholesterol drugs like Lipitor, Zocor, Crestor, etc. may play a role. However, they should only be considered after a full effort dietary program is pursued. Don't follow the American Heart Association's diet unless you want to fail. It's nonsense.

For a more detailed discussion of how to use nutrition and nutritional supplements to reduce LDL cholesterol, go to www.lef.org, the website for the Life Extension Foundation. I wrote an article for their magazine called "Cholesterol and Statin Drugs: Separating Hype from Reality". You'll find the article at http://search.lef.org/cgi-src-bin/MsmGo.exe?grab_id=0&page_id=1295&query=davis%20cholesterol%20natural&hiword=CHOLESTEROLA%20CHOLESTEROLS%20DAVI%20DAVID%20DAVIE%20DAVIES%20DAVIN%20DAVIO%20DAVISON%20DAVISS%20DAVIT%20NATURALBASED%20NATURALES%20NATURALIZED%20NATURALLY%20NATURALS%20NATURE%20NATURES%20cholesterol%20davis%20natural%20.)

Can your plaque-reversal efforts succeed without statin drugs? It depends on your causes. For instance, someone with small LDL and Lp(a) only may do great on our basic program and then add niacin. Unfortunately, another person with a starting LDL cholesterol of 240 mg/dl--sky high--will have more success with these drugs.

Believe me, I am no blind supporter of drug companies and their flagrantly profit-seeking practices which, in my view, are cut-throat, shoving anyone and anything out of their way to increase profits and market share. I share many of Dr. Dave Warnarowski's views on how vicious their tactics can be; see his recent Blog post at http://www.drdavesbest.com/blog/ called "I smell a rat".

Nonetheless, the deep and well-funded research of the pharmaceutical industry does yield some useful tools. You don't have to love the insect exterminator, but if your house is being eaten by termites, his services can be useful. Same thing with these drugs. Useful--not the complete answer, not even close, but nonetheless useful in the right situations. Sometimes antibiotics are necessary, even life saving. That's how cholesterol drugs are, too.

Take it all in the proper perspective. Your goal is not cholesterol reduction, per se, but plaque control, preferably reversal.

Ever hear of "polypharmacy"? That's when someone takes too many medicines. People will have lists of 15-20 prescription medicines, for instance, with crazy interactions and oodles of side-effects.

Well, how about "poly-supplments"? That's when someone takes a large number of nutritional supplements.

Let me tell you about a 45 year old man I met.

In an effort to rid himself of risk for heart disease that he felt was likely shared with his family (brother and father diagnosed with heart attacks in their late 40s), Steve followed a program of nutritional supplementation. You name it, he took it: hawthorne, anti-oxidant mixtures, vitamins C, E, B-complex, saw palmetto, 7-keto DHEA, velvet deer antler, gingko biloba, policosanol, chronium picolinate, green tea, pine bark extract, St. John's Wort, CoEnzyme Q10, papain and other digestive enzymes...He became a distributor for a nutritional supplement company to allow him to afford his own extraordinary program.

To satisfy himself that he had indeed "cured" himself of heart disease, he got himself a CT heart scan. His score: 470, in th 99th percentile. Steve's heart attack risk based on this score was around 10% per year. High risk, no question.

For weeks after his scan, Steve admitted walking around in a daze, not knowing what to do. Years of telling himself that he had effectively dealt with his heart disease risk, now all down the drain.

When we met, I persuaded him that to think that this collection of supplements would reverse heart disease was magical thinking. We trimmed his list down to the essentials and got him on the right track.

Heart disease is controllable and reversible, but not this way. Don't fool yourself into thinking that some collection of supplements will be enough to stamp out your heart disease risk. Just like taking an antibiotic when you don't have an infection achieves nothing, so does taking the wrong supplements.

CT heart scans can mean different things to different people.

What does a heart scan mean to you? There are several possibilities:

1) A way of reducing uncertainty in your future.

2) A tool to crystallize your commitment to health.

3) A device to help you track how successful your heart disease prevention program is.

4) A trick to get you in the hospital.

5) A moneymaking tool for unscrupulous physicians hoping to profit from "downstream" testing, particularly heart catheterizations.

Like anything, heart scans can be used for both good and evil. How can you be sure that your heart scan is put to proper use--for your benefit and not someone else's profit?

Simple: Get educated. Understand the issues, be armed with informed questions.

If, for instance, you're a 55-year old female with a heart scan score of 90, active without symptoms, and you're told to have a heart catheterization right off the bat---run the other way. This is bad advice. A heart procedure like catheterization at this score in an asymptomatic woman is very rarely necessary. That decision can only be made after a step-by-step series of decisions are made by a truly interested, unbiased party. (A stress test is almost always required in this situation before the decision can be made to proceed with a catheterization.)

Unfortunately, in 2006, getting unbiased advice from your doctor is still a struggle. That's why we started Track Your Plaque---unbiased information, uncolored by drug or device company support, with an interest in the truth.

I had an interesting conversation with a device representative this morning. He was a sales representative for a major medical manufacturer of stents, defibrillators, and other such devices for heart disease.

Since I'm still involved with hospital heart care and cardiac catheterization laboratories, this representative asked me if I was interested in getting involved with some of the new cardiac devices making it to market over the next year or two. "The coronary market is drying up, what with coated stents and such. We've got to find new profit sources."

Well, doesn't that sum it up? If you haven't already had this epiphany, here it is:

HEART DISEASE IS A PROFITABLE BUSINESS!

Why else can hospitals afford billboards, $10 million dollar annual ad campaigns, etc.? They do it for PROFIT. Likewise, device and drug manufacturers see the tremendous profit in heart disease.

The representative's comments about the market "drying up" simply means that the use of coated stents has cut back on the need for repeat procedures. It does NOT mean that coronary disease is on the way out. On the contrary, for the people and institutions who stand to profit from heart care, there's lots of opportunity.

Track Your Plaque is trying to battle this trend. Heart disease should NOT be profitable. For the vast majority of us, it is a preventable process, much like house fires and dental cavities.

With the booming popularity of "64-slice CT scans", there's a lot of mis-information about what these tests provide.

These tests are essentially heart scans with added x-ray dye injected to see the insides of the arteries. However, to accomplish this, a large quantity of radiation is required. In addition, the test is not quantitative, that is, it is not a precise measure that can be repeated year after year.

It is okay to have a 64-slice CT coronary angiogram. It is NOT okay to have one every year. That's too much radiation. However, a heart scan can be repeated every year, if necessary, to track progression or regression. Once stabilization (zero change) or reduction is achieved, then you're done (unless your life takes a major change, like a 20 lb weight gain).

The tried-and-true CT heart scan is the gold standard--easy, inexpensive, precise, and repeatable. Not true for 64-slice angiograms.

What if you went to your doctor for a problem and he/she promptly placed leeches on your body?

Yeccchhhh! Would you go back? I'd bet that you'd run the other way as fast as your bleeding legs could take you. Outdated health practices like "bleeding" are outdated for good reason.

Then why would you allow your doctor to approach your heart disease prevention program by checking cholesterol and then waiting for symptoms to appear? That miserable approach leads to tragedy and death all too often--ask Bill Clinton! He might as well have had leeches!

Don't allow your doctor's ignorance or disinterest impede your prevention program. Get your coronary plaque measured, then attack it from all sides by knowing all causes, hidden and obvious. That's why Track Your Plaque is such an effective program.

I often wonder why more doctors aren't using this unbelievably powerful approach to deal with heart disease. But when I see colleagues implanting stents, defibrillators, and the like for many thousands of dollars per patient, the answers are obvious. Given a choice of a rational, effective program of prevention that pays the doctor a few hundred dollars for his time, versus $2000 to $10,000 for a procedure, you can see that the temptation is irresistible for many physicians.

What should you do if a close relative of yours is diagnosed with coronary disease?
This question came up recently with a patient of mine. The patient--a strapping, 47 year old businessman who looked the absolute picture of health--was undergoing bypass surgery. Although I'd met him for the purposes of plaque reversal, he was already having symptoms and his stress test was flagrantly abnormal, all discovered after a heart scan score of 765. On the day after the patient's bypass, the patient's brother came to me. Understandably concerned about his own health, he asked what he should do. The answer: get a heart scan.
Measure the disease with the easiest test available. If his heart scan score is zero, great--he's at exceptionally low (near zero) risk for heart attack. A modest program of long-term prevention is all that's necessary. What if his score is like his brother, should he get in line for his bypass? No, absolutely not! But he will need two things: 1) a stress test to ascertain whether or not he's safe (60% likelihood a stress test would be normal), and 2) an effort to determine how the heck he got so much plaque. (We favor lipoprotein testing, of course, for greatest diagnostic certainty.)
Message: Learn from the lessons your own family provides. Don't let this valuable information go to waste.

Heart Scan Blog reader, Mike, shared his story with me. He was kind enough to allow me to reprint it here (edited slightly for brevity).

Dr. Davis,

I was much intrigued to stumble onto your blog. Heart disease, nutrition, and wellness are critically important to me, because I’m a type 2 diabetic. I’m 53 and was diagnosed as diabetic about 5 years ago, though I suspect I was either diabetic or pre-diabetic 5 years before that. Even in a metropolitan area it's next-to-impossible to find doctors sympathetic to any approach beyond the standard get-the-A1c-below 6.5, get LDL <100, get your weight and blood pressure normal, and take metformin and statins.

I’m about 5’10-and-a-half and when I was young I had to stuff myself to keep weight on; it was an effort to get to 150 pounds, and as a young man, 165 was the holy grail for me. I always felt I’d look better with an extra 10-15 pounds.
I ate whatever I wanted, mostly junk, I guess, in my younger years.

When I hit about age 35, I put on 30 pounds seemingly overnight. As I moved toward middle age I became concerned with the issue of heart health, and around that time Dr. Ornish came out with his stuff. I was impressed that he’d done a
study that supposedly showed measurable decrease in atherosclerotic plaque, and had published the results of his research in peer-reviewed journals. It looked to me as though he had the evidence; who could argue with that? I tried his plan on and off, but as so many people note, an almost-vegan diet is really tough. It was for me, and I could never do it for any length of time. But given that the “evidence” said that I should, I kept trying, and kept beating up on myself when I failed. And I kept gaining weight. I got to almost 200 pounds by the time I was 40 and have a strong suspicion that that’s what caused my blood sugar to go awry, but my doctor at the time never checked my blood sugar, and as a relatively young and healthy man, I never went in very often.

I’ve had bouts of PSVT [paroxysmal supraventricular tachycardia, a rapid heart rhythm] every now and again since I was 12 or so. I used to convert the rhythm with Valsalva, but as I moved into my forties, occasionally my blood pressure would be elevated and it made me nervous to do the procedure because it was my understanding that it spikes your blood pressure when you do it. So I began going to the ER to have the rhythm converted, which they do quite easily with adenosine. On one of my infrequent runs to the ER to get a bout of PSVT converted, they discovered my blood glucose was 500 mg/dL, and I’d never experienced any symptoms! They put me in the hospital and gave me a shot of insulin, got it town to 80 mg/dL easily,
diagnosed me as diabetic, and put me on 500 mg. metformin a day.

I was able to get my A1c down to 7, then down to 6.6, and about that time I read a number of Dr. Agatston’s books, and began following the diet, and pretty quickly got my A1c down to 6.2, and my weight down, easily, to 158. That was fine with my doctor; he acted as though I was in good shape with those numbers. Soon I ran into Dr. Bernstein’s material, and came face to face with a body of research that suggested I needed to get the A1c down to below 5! That was both discouraging and inspiring, and frankly it’s been difficult for me to eat as lo-carb as I appear to need to, so I swing back and forth between 6.2 and 6.6. I know I need to work harder, be more diligent in my carb control, and I see with my meter that if I eat low-carb I have great postprandial and fasting blood sugars, but since I don’t particularly get any support or encouragement from
either my doctor or my wife for being so “radical,” it’s hard to pass the carbs by.

One thing that always confused me was that though I saw on my meter that BG [blood glucose] readings were better with a lo-carb diet, and though I saw the preliminary research suggesting that lo-carb could be beneficial in controlling CVD, I didn’t understand why Ornish had peer-reviewed research demonstrating reversal of atherosclerosis on a very-lowfat diet. How could two opposing approaches both help? I wondered if it were possible that one diet is good for diabetes, and the
other good for heart health. That would mean diabetics are screwed, because they always seem to end up with heart disease.

From time to time I’d look for material that explained this seeming contradiction. I was determined to try to stay lo-carb, simply because I saw how much better my blood sugars are when I eat lo-carb; but it’s hard in the face of this or that website that tells you about all the dangers of a lo-carb diet and that touts the lo-fat approach. That tends to be the conventional wisdom anyway.

Finally in one of those searches I came across your material, and saw you offer what was at last an explanation of what Ornish had discovered--it wasn’t a reversal of atherosclerotic plaques he was seeing; it was that his diet was improving endothelial dysfunction in people who had had high fat intakes.

Odd as it may seem to you, that little factlet has been enough to allow me to discard entirely the lingering ghost of a suspicion that I ought to be eating very-lowfat. In fact, I was very excited to see your claim that your approach can reverse atherosclerotic plaque.

It would be nice to find a doctor who’d be supportive of your approach. My doctor isn’t much interested in diet or
nutrition. He just wants my weight in the acceptable range, my blood pressure good, and my LDL 100 or below (which I know isn’t low enough). He’s not particularly interested in getting a detailed lipid report. I hope I can talk him into ordering one so that it’s more likely I can get it covered by my insurance.

I very much appreciated the links you gave to Jenny’s diabetes websites, and I’ve resolved to get even better control of my BG by being more diligent with my diet. I’m planning on joining your site, reading your book, and following your advice. I just have this sort of deflating feeling that it would have been better if I’d stumbled upon this before I had diabetes. Still, it’s nice to have a site that offers to laypeople the best knowledge available concerning how to take care of their heart.

Mike is yet another "victim" of the "eat healthy whole grains" national insanity, the Post-Traumatic Grain Disorder, or PTGD. The low-fat dietary mistake has left many victims in its wake, having to deal with the aftermath of corrupt high-carbohydrate diets: diabetes, heart disease, and obesity.

We should all hope and pray that "low-fat, eat healthy whole grains" goes the way of Detroit gas guzzlers and sub-prime mortgages.

Gretchen
6/20/2009 2:03:19 PM |

I don't think Ornish has ever shown that his diet results in plaque regression. What he showed was that his total program, including diet, exercise, stress reduction, giving up smoking, and lots of peer support reduced plaque. Then everyone ascribes the results to the diet alone.

This is analogous to the studies that lump red meat into a diet group that includes cold cuts, sausages (including chicken sausage) and a lot of other things and then blame the red meat for the poorer results.

You never see headlines saying "Chicken (sausage) is bad for you."

Peter
6/20/2009 3:05:10 PM |

I appreciate that letter, because I also try to keep on current research and it's hard to know which research to believe, since there's a fair amount of research that supports whole grains and a fair amount that supports a low carbohydrate diet. I'm not a true believer type, so I'm looking forward to better research. I notice that in Gary Taubes's book he says there has been no trustworthy research comparing the low carb and the whole food/whole grain diets, and I'm looking forward to it when it comes out.

Tom
6/20/2009 5:44:16 PM |

Yes, my guess is that *stress reduction* is key to the Ornish plan. The other components are really just contributors to this overall result, with the exception of the vegetable diet, which probably doesn't help.

I don't write an excellent blog or care for any patients. Perhaps I may therefore indulge my speculations, safe in the knowledge that those who wish to ignore me will feel free to do so:

Stress is normally thought of as something unpleasant that we try to avoid. And indeed it is, partly we do try to avoid it.

But in truth we are addicted to stress. We interpret a rapidly beating heart, high blood pressure, racing thoughts, etc, as pleasurable.

And they are. Or at least they seem to be (hangovers aside), from the perspective of the part of us that experiences them.

Trouble is they are damaging to the whole. For example, pleasure/stress numbs subtle feelings which might otherwise yield clues to solving our personal problems. Our immune systems our temporarily dampened (presumably an evolutionary adaptation).

Only relaxation and meditation (which we all do to a certain extent, whether we realise it or not), allow the mind to re-integrate and experience the deeper, forgotten joy of being alive.

I believe that here, and not in calorie burning, lies the secret benefit of exercise: diverting attention into the body and away from the frenetic mind.

I have no evidence for this that I can share, only a limited amount of fallible personal experience. But let me say that I have *felt* my blood pressure go down after a meditation session.

And upon standing up afterwards, I've become dizzy, which is a symptom of hypotension!

Anne
6/20/2009 6:36:35 PM |

In a totally uncontrolled study of one, here are the results.

While on the American Heart Association diet my lipids peaked in 2003. I even tried the Ornish diet for a short time, but found it impossible.
Total Cholesterol: 201
Triglycerides: 263
HDL: 62
LDL: 86

After I stopped eating gluten(I am very sensitive) my lipid panel improved slightly. This past year I started eating to keep my blood sugar under control by eliminating sugars and other grains. Now this is my most recent lab:
Total Cholesterol: 162
Triglycerides: 80
HDL: 71
LDL: 75

Not perfect, but getting there. I think I had a very serious case of post traumatic grain disorder.

TedHutchinson
6/20/2009 9:39:05 PM |

Gary Taubes recent lecture
For those who haven't yet read
Gary Taubes Good Calories Bad Calories
this talk is based on just a fraction of the research he discusses in greater detail in the book.
There are earlier version of this lecture online, this version is slicker, more jokes, and you can use the thumbnail slides to move around faster.
Slides 41~49 are the crux of the matter.
Interesting to hear what he says right at the end of slide 48.

Dr. William Davis
6/21/2009 2:24:20 AM |

Anne--

I love it!

I'd like to post your numbers in a future Heart Scan Blog post.

Thanks for sharing. Your experience is bound to help others also "see the light."

Kateryna
6/21/2009 3:24:36 AM |

Dr. Davis:

I'm 59 years old, was very sick, and if I had waited as others do for scientists to come to a consensus about diet and nutrition and for studies to be done, I would have died 13 years ago.

If you value your health a short 1 month trial of a grain free diet will tell you immediately if it's right for you especially if you have health issues. Don't be afraid to experiment.

As I said, I'm 59 and I'm still overweight, but I have resolved almost all my health issues by eliminating all sugar, processed foods and all grains and here are my latest lipids:

Total: 182
LDL: 95
HDL: 65
Trigs: 104
Ratio: 2.6

Also not perfect, but I know it will only get better as it has been for years.

Anonymous
6/21/2009 4:25:40 AM |

Some of the readers of this blog should be gluten free and not just wheat free. How to find which ones?
IMO, Mike's difficulty in keeping on weight as a younger man indicates he should consider further testing for gluten intolerance or perhaps other food intolerances.

Anne
6/21/2009 12:46:12 PM |

Dr. Davis, you have my permission to post my numbers, use my name and use my picture.

Thank you for thinking outside the box. I have coronary artery disease and had bypass in 2000 and I don't want to do that again ever. By incorporating TYP guidelines into my life, I feel I have greatly decreased my odds of having more heart problems.

Anonymous
6/21/2009 5:33:26 PM |

I tried moving back to meat and giving up wheat/grains. My blood lipid chemistry did not improve and I have to remind myself, a meat based diet is how I got here in the first place (2002) and why my father and his brothers had heart attacks at relatively young ages.

Until I see a pier reviewed study showing grains are causal to heart disease, I'm going back to what has kept me from suffering the same fate as my father. No animal products in my diet.

I'm off to make a few seitan steaks for the bbq

Grandma S.
6/22/2009 12:11:12 AM |

Anne,
I am very impressed with your results. Having trouble getting my husband's & my LDLs that low. Would like to know in more detail how you are doing it, can you email me? Thank You!

Dr. Usha C
7/22/2009 7:02:29 PM |

Homeopathy Diet Planning
Homeopathy together with proper diet can make wonders in medical field creating ability to treat most diseases effectively.

For more information log on to
http://homeopathydiets.blogspot.com/

simvastatin side effects
5/23/2011 7:41:44 AM |

Only relaxation and meditation (which we all do to a certain extent, whether we realise it or not), allow the mind to re-integrate and experience the deeper, forgotten joy of being alive.

Vegan4life
5/8/2013 10:49:01 AM |

Well said, Anonymous! Going VEGAN (and not merely vegetarian) is best for ones health, mind and spirit - and vital for anyone who has heart and/or weight problems, type-2 diabetes, high blood pressure, bad cholesterol, asthma, etc., or a family history thereof.

"Anonymous says:

June 21, 2009 at 11:33 pm

I tried moving back to meat and giving up wheat/grains. My blood lipid chemistry did not improve and I have to remind myself, a meat based diet is how I got here in the first place (2002) and why my father and his brothers had heart attacks at relatively young ages.

Until I see a pier reviewed study showing grains are causal to heart disease, I'm going back to what has kept me from suffering the same fate as my father. No animal products in my diet... "

What role cholesterol medication?

Supplement Mania!

What does heart scanning mean to you?

Coronary disease is drying up!

Mammogram for your heart

Is your doctor using "leeches"?

All in the family--What to do if there's heart disease in your family

Victim of Post-Traumatic Grain Disorder

Comments (14) -

Gretchen

Peter

Tom

Anne

TedHutchinson

Dr. William Davis

Kateryna

Anonymous

Anne

Anonymous

Grandma S.

Dr. Usha C

simvastatin side effects

Vegan4life

Add comment

Related posts

Comments (14) -

Gretchen

Peter

Tom

Anne

TedHutchinson

Dr. William Davis

Kateryna

Anonymous

Anne

Anonymous

Grandma S.

Dr. Usha C

Add comment