I.M.120 Helping you to BE YOUR BEST SELF

Lipitor for everybody?

A few years ago I was walking through the corridor of the hospital when I  bumped into a cardiologist colleague of mine.

"How are things going?" I asked.

"Terrible" He replied. "My rate of catheterizations is down, damn Lipitor."

He was grumbling that Statin drugs and their capacity to prevent clogged arteries had decreased his business. Over the years the use of these drugs have increased to the point where over 25% of Americans over age 40 now take them. The anti-cholesterol dogma has permeated medicine to the point that many doctors feel cholesterol is simply bad, and the lower it goes the better.

Against this backdrop, the American Heart Association and the American College of cardiology have attempted to lend some guidance to the important question of who should take these drugs, and the partner question of how low we should go with cholesterol.

The new dogma throws the old dogma into question. Concrete objectives of achieving certain numbers have been abandoned for a more thoughtful and complex approach that considers other risk factors. This is especially important since we now know that achieving a given number does not guarantee a good outcome. Take the drug Zetia for instance. It helps lower cholesterol numbers but has never been shown to reduce  heart attacks or strokes, yet it is a multibillion dollar product. It turns out showing patients good numbers is comforting, even if it doesn't improve their health.

On the other hand we have compelling evidence that high-quality omega-3 products can significantly reduce vascular risk even though they have modest impact on cholesterol numbers
Achieving a certain number with drugs is easy. Improving an individuals health with thoughtful intervention is much more difficult.

Cholesterol lowering drugs have represented a breakthrough in modern medicine and can be truly life extending for certain high-risk patients. Yet they can also leave us with a false sense of comfort. Some studies have shown that half of patients with heart attacks had normal cholesterol levels.

Good health doesn't come in a pill and never will. Good health is not a number on your lab report. Good health doesn't focus only on how well your heart pumps, But considers all elements of life and how they interact. Mind, body, spirit, nutrition all need to be considered. Herein lies the advantage of the holistic antiaging approach. Why just preserve the heart? Why not go for it all including the brain? Since cholesterol is essential to healthy functioning of the brain, and appropriate production of sex hormones, the goal should not be the lowest possible cholesterol level, but the best cholesterol level for you.

Thus I welcome the new guidelines for being less rigid. Now if we could all stop perseverating about our cholesterol number, perhaps we can move forward with the objective of living longer and healthier.

-Dr. Stephen Petteruti