This is a contribution from a member of THINCS, 
The International Network of Cholesterol Skeptics

The following letter was sent to American Heart Journal on 10 Jun 01, but has not yet been acknowledged.

Editors, American Heart Journal
Duke Clinical Research Institute
P. O. Box 17969
Durham, NC, 27715

Dear Editors:
     The recent report in AHJ on the use of electron beam tomography (EBT) to detect calcified plaques in coronary arteries by Raggi et al.1 was very circumspect in interpreting the findings, especially in their abstract.  Besides the fact that EBT was very predictive of hard coronary events, as shown in their Table I, the difference in hypercholesteremia between the patients with events and those without was not significant.  Therefore, these authors' recommendations that conventional risk factors be used to select patients for EBT screening does not seem to make sense.
     A similar study by an entirely different group, reported by Hecht et al.2 found that the National Cholesterol Education Program (NCEP) guidelines were of no value in predicting the existence of calcified plaques in coronary arteries as shown by EBT.  While their Table I shows absolutely no significance for HDL-cholesterol (HDLC) levels as predictive, the spread in the values for LDL-cholesterol, total cholesterol (TC), TC/HDLC and triglycerides shows none of these to be usefully predictive despite the low p values.  Therefore, it makes no sense for these authors to lament that half the women who might have calcified plaques according to the NCEP guidelines might not receive either dietary or drug treatment. 
     Without the benefit of this new data on EBT, Ravnskov had already shown that no form of cholesterol is an actual cause of atheroscleosis, and that no conventional diet or drug treatment will have any significant effect.3  The statin drugs, in clinical trials, reduced the number of heart attacks, but they cause more overall deaths in the worst case, and only 3% absolute fewer deaths in the best cases.  And this occurs when they are taken for only the 3-5 years of the trials in which the overall death rates are actually reported, not the 30-50 years now being recommended.
     McCully has shown that homocysteine may be a cause of atherosclerosis4, not cholesterol; and that elevated blood cholesterol may be a reactive change to an underlying deficiency of vitamins B6 and B12 and of folic acid.5 
     As the American Heart Association and the National Heart, Lung and Blood Institute can hardly be expected to change direction, it is up to individual cardiologists to begin a beneficial change, including screening with EBT, use of supplements when indicated, and avoidance of interventions that are not effective.

  1. Raggi P, Cooil B, Callister TQ. Use use of electron beam tomography to develop models for prediction of hard coronary events. Am Heart J 2001; 141: 375-82.
  2. Hecht HS, Superko, HR. Electron Beam Tomography and National Cholesterol Education Program Guidelines in Asymptomatic Women. J Am Coll Cardiol 2001, 37: 1506-11.
  3. Ravnskov U. The Cholesterol Myths: Exposing the Fallacy that Saturated Fat and Cholesterol Cause Heart Disease,  New Trends Publishing, Washington, DC, 2000.
  4. McCully KS, McCully M. The Heart Revolution:  The Extraordinary Discovery that Finally Laid the Cholesterol Myth to Rest. Harper Perennial, 2000.
  5. McCully, KS. Biomedical Signficance of Homocysteine. J Scient Expl 2001;15: 5-20.

     Very sincerely,

     Joel M. Kauffman
     65 Meadowbrook Rd.
     Wayne, PA 19087-2510


Unpublished contributions