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
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
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.
- 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.
- Hecht HS, Superko, HR. Electron Beam Tomography
and National Cholesterol Education Program Guidelines
in Asymptomatic Women. J Am Coll Cardiol 2001,
- Ravnskov U. The Cholesterol Myths: Exposing the
Fallacy that Saturated Fat and Cholesterol
Cause Heart Disease, New Trends Publishing,
Washington, DC, 2000.
- McCully KS, McCully M. The Heart Revolution:
The Extraordinary Discovery that Finally Laid
the Cholesterol Myth to Rest. Harper Perennial, 2000.
- McCully, KS. Biomedical Signficance of Homocysteine.
J Scient Expl 2001;15: 5-20.
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