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We Need Science In Medicine

One of the prevailing myths of modern life (I use the word here in the sense of something that everyone believes, not necessarily something that is false) is that cholesterol causes heart disease and stroke, and that reducing it will reduce the risk of heart disease and stroke. But the recent Vytorin issue should give us cause to question this conventional wisdom.

Whenever I've looked at the research, I've never been able to see any clear indication that taking cholesterol-reducing medication actually reduces risk, per se--all that the clinical studies that I've seen seem to indicate is that cholesterol reduction is taking place. But correlation is not causation. It could be that both high cholesterol and vascular disease are caused by some third factor that hasn't been identified, and that in reducing cholesterol, whether by diet or medication, or both, we are treating a symptom rather than a cause.

My point is, that I don't know the answer. But I don't have a lot of confidence that the medical community does, either. And I remain wary of taking medications with unknown side effects and potential for interaction with other things I ingest, when the benefit is unclear. And I write this as someone who lost both parents to heart disease (my father's first heart attack occurred when he was about forty five, and he died from a second one about a decade later). But they also had much different lifestyles than I did--they grew up with poor diets during the depression, they both smoked like chimneys, and they were both overweight. So I don't necessarily believe that genetics is destiny, at least in this case.

 
 

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3 Comments

Kevin B wrote:

Rand

I don't know whether you've read this site but it certainly caused me to question the whole cholesterol thing.

It's promoting a book but it does have synopses of the chapters that you can peruse.

I tend to think that the cholesterol panic will turn out to be another cascade like the animal fat thing.

I sometimes think that there were three drunk science students at a party somewhere who indulged in some bragging.

"I bet I can turn the perception of animal fat, a great source of energy that also contains micro-nutrients and plant sterols, into a poisonous killer."

"That's nothing. I bet I can turn the perception of salt, long known as a vital necessity for all animals, into deadly poison."

"Hah! Bunch of pikers! I'll turn the perception of carbon dioxide, the vital component of our atmosphere and oceans on which virtually all life as we know it depends into the most polluting substance on Earth"

"Oh, come on! Now you're going too far!"

Anonymous wrote:

or check out
The Rise and Fall of Modern Medicine
by James Le Fanu

Having already had a heart attack at age 33 I'm of a slightly different opinion: there is some kind of link between cholesterol level and heart disease but we're still not sure exactly what it is. So I'm going to err on taking my statins and deal with the consequences since not taking anything seems like just sticking my head in the sand.

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This page contains a single entry by Rand Simberg published on January 30, 2008 8:40 AM.

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