Wednesday, July 29, 2009


All of us physicians need to stop referring to the medicines we use for cholesterol control as 'cholesterol lowering medications.' This is just not so and another example of the ignorance of physicians. For most people, even those with cholesterols over 200; we need to raise their cholesterol, not lower it. By this I mean we need to raise their HDL or heart protective cholesterol.

So what's all this cholesterol lowering mumbo jumbo. We learned in an earlier blog that lowering the total cholesterol number has not had an effect on lowering the prevelence of heart disease. This is because total cholesterol is an irrelevent number. It means nothing. All it is is the summation of all the carrier molecules of cholesterol, one of these being the HDL. When one's HDL is greater than 59, it will almost always drive up the total just based on the fact total cholesterol depends on how high (or low) the HDL is.

What we are really doing by using the so-called 'cholesterol lowering medications' is causing an effect known as plaque stabilization. You see, it is the buildup of plaque with the subsequent breaking off of a piece of that plaque that creates the problems. Once a plaque ruptures, the body will attempt to heal this by accumulating platelets at the rupture site. If we accumulate too many platelets at a plaque site, this will prevent the flow off blood past this site. Since blood cannot flow past this area, a heart attack or stroke can occur. The medications like Lipitor, Crestor and Zocor etc. stabilize plaques making it less likely to rupture and hence lower one's risk for heart attacks or strokes. This is obviously a good thing.

Again, cholesterol lowering is not what we should be focused on when using these meds. We need to change our thinking and stop saying cholesterol lowering and start focusing on plaque stabilization. Once this happens we will be in a better position to prevent heart disease.

Dr Jim

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