Heart Disease Risk Factors: Mostly Baloney
by Dr. Bruce West
Except for those with heart disease or those at the highest risk for heart disease, all the standard medical risk factors add up to almost nothing when it comes to predicting heart disease, heart attack, or stroke. And for healthy adults, even the “alternative” risk factors, like homocysteine and C-reactive protein (CRP) findings are practically useless.
This is important to know since so many multiple risk factor intervention programs are in full swing, with more planned, throughout the United States and Europe. The typical risk factors include high cholesterol, smoking, high blood pressure, and diabetes. Prescription drugs serve as these programs’ centerpiece, with counseling and education as adjunct treatments. They are spearheaded by the American Heart Association, the American Medical Association, local and state governments, and even the federal government.
Yet 10 years ago study results by the Cochrane Heart Group and The Cochrane Collaboration (www.cochrane.org) showed that treating risk factors was “ineffective in achieving reductions in total or cardiovascular disease mortality (death).” Indeed the findings of these interventional programs showed that some people actually got worse. Overall deaths actually increased among the drug-treated high blood pressure group. In addition, some did benefit—the folks with the very highest risk of heart disease.
Risk Factors: Poor Predictors
In the end, the Cochrane study showed once again that high cholesterol, high blood pressure, etc., are poor predictors of heart disease, stroke, or death in healthy people. And the same can be said for biomarker risk factors such as homocysteine, CRP, and B-type natriuretic peptide. The conclusions were that the costs of using these risk factors and treating for them are very high, and these resources would be better spent in other areas, or simply on those at the highest risk levels.
So if you are healthy, and your health screening finds your cholesterol at 250 (which is normal), or your blood pressure to be 140/90 (which is normal), do not be fooled into powerful, dangerous, usually life-long prescription drug treatments. This is “not particularly effective in terms of reducing the risk of clinical events (stroke, heart attack, angina, etc.).”
But What About CRP and Homocysteine?
Around 2005, I began wondering about the relevance of homocysteine levels. After all, synthetic B vitamins would often lower homocysteine to safe levels, yet do nothing to help heal the heart. Was this finding not as important as I previously thought? That may indeed be the case. I now feel that lowering the homocysteine levels has little direct correlation to heart disease.
And while I still monitor the CRP levels in heart patients, I now feel that a high CRP level is just an ancillary finding. In some cases, it can help diagnose inflammation or infection in the coronary arteries. But it is probably not the major risk factor that many of us were convinced it was.
So taking all the tests, getting all the counseling, following the low-fat diet, taking drugs like Caduet (a cholesterol-lowering and blood pressure drug combined into one), don’t amount to much, and can even hurt you. Instead it is back to basics: eat whole foods, exercise, drink pure water, keep a positive attitude, and use phytonutrients when needed. This is the formula for heart success.
This will be a hard pill to swallow for most in the medical profession. After all, screenings, interventions, and drugs are critical to their ongoing patient management. There are thousands of well-meaning physicians right now who truly believe a statin (cholesterol-lowering) drug should be prescribed for every American over age 50!
More on Medical Myths
The risk factors for heart disease are taking their place among medical myths. While the list of myths is growing, some of the classics are:
- Taking an aspirin every day will make you live longer.
- Low-carbohydrate diets are unsafe and ineffective for losing weight.
- Nearly everyone would benefit by using statin (cholesterol-lowering) drugs.
- Nearly everyone over age 50 should take blood pressure drugs.
- All radiation is dangerous unless administered by an oncologist.
- Annual mammograms and follow-up treatment prolong life.
- Cancer treatments are better than ever—with cure rates of over 60%.
- Water fluoridation prevents tooth decay and is perfectly safe.
These are classic medical myths. They become malignant myths when they are prolonged for more than 15 years. Most of these fit that definition.