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by Donald B. Ardell, Ph. D.
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Wellness in the Headlines
(Don's Report to the World)

Reject the New Cholesterol Guidelines In Favor of A Wellness Alternative

Tuesday July 20, 2004

Last week, the American Heart Association and our always-to-be-trusted (just kidding) federal government released new guidelines concerning who should take cholesterol-lowering drugs. The new advice urged lower levels for LDL, or "bad cholesterol" readings that warrant medications. This change will add about 7 million more patients to the current 36 million who take Lipitor and Pravachol and related drugs to prevent heart attacks. Assuming it is really necessary to medicate another large segment of the population, does anyone benefit from this advice besides the affected patients?

You bet! The drug companies do, big time. In 2003, the makers of "statins," the cholesterol-lowering medicines the 7 million are being urged to buy, earned $26 billion worldwide! This advice is a boon for an already booming business. Is this recommendation unbiased and fully warranted? The latter is up for debate; the former is not--this recommendation is NOT unbiased. It turns out that six of the nine cholesterol experts are at least indirectly on the dole of major US pharmaceutical companies and thus have a flagrant conflict of interest. An Associated Press report on July 16, confirmed by many other sources since, revealed the six tainted scientists on the NCEP panel "received consulting or speaking fees, research money or other support from makers of the most widely used anti-cholesterol drugs." It is a scandal that these people were allowed to serve on such a committee. This failure to protect the public interest demonstrates a lack of ethics at the federal level, specifically at the National Cholesterol Education Program (NCEP), a part of the National Heart, Lung, and Blood Institute.

If nothing else, full disclosure of any potential conflicts of interest should be required for all members of such committees. A spokesman for the consumer watchdog agency, the Center for Science in the Public Interest (CSPI), made the following statement: "It doesn't mean that their research is wrong, but doctors and the public need to know that the people who are giving you this advice have their research funded by a party who has a self-interest in the outcome of that research." ("New Cholesterol Guidelines Face Criticism Over Conflict of Interest," Health, July 16, 2004, Wall Street Journal.) Just so. 

Recently, the Attorney General for New York, Eliot Spitzer, sued pharmaceutical giant GlaxoSmithKline PLC for just such an offense. In this case, the charge related to withholding information. Not revealing conflicts is also a failure to disclose, it seems to me. 

What is needed, and supported by the American Medical Association (AMA) and other groups, is an independent registry that makes available results of all drug studies. The public should have access to all findings, favorable or otherwise--along with data on industry ties of involved parties in both the research projects and the government review panels. 

It is obvious why conflicts of interest should not be permitted. CSPI physician Sidney Wolfe noted, for example, that possible side effects as liver and muscle damage could make the statin drugs more dangerous than beneficial to people who have only a moderate risk of heart attack. The experts on the NCEP panel did NOT mention this, and the skeptic wonders why not? 

While the guidelines did note the need for people to adopt a healthier lifestyle, this was not the focus of the report, which should have been the case. The best way to prevent heart disease, stroke, diabetes, obesity and twekve kinds of cancer--plus gallstones and diverticulitis, not to mention grumpiness and a bad complexion, is to improve cardiovascular fitness, and strength and balance. This kind of lifestyle reform will do wonders for blood lipid profiles, and none of the activities involve spending big bucks on products made by GlaxoSmithKline PLC, Pfizer Inc., Merck & Co., Bristol-Myers Squibb, AstraZeneca LP or any other drug company. 

Exercise, not statins, will make your bones stronger and grow new capillaries in your heart, skeletal muscles and brain. Exercise will improve the blood flow to your sex organs as well as to your heart--by aiding the delivery of oxygen and nutrients. Exercise will give you a better attention span. If you already have a disease, say arthritis, it will lessen the symptoms. Exercise will regulate your appetite. Exercise will make you look better, feel younger and do better on all the standard physiologic measures. Exercise will increase your blood volume and help you better burn fats. Exercise will boost your immune system.

Alas, exercise does not come in pill form. You have to work your butt off to get these benefits. You can't even hire someone to exercise for you!

Unlike the NCEP panel advice noted above, I wish to reveal a conflict of interest in making these recommendations. I am a true believer in exercise, and I think no medicine is good medicine, as a bendable rule. Don't bend the rule until you have tried vigorous exercise first! There--consider that in assessing my advice. 

Good luck. Look on the bright side, and always be skeptical about recommendations to lower standards of health that lead to MORE pill taking.

Domain: mental
Subdomain: factual knowledge

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