One of several highly anticipated clinical trials presented at the 2023 American Heart Association meeting was the heart-1 study (NCT05398029) from Verve Therapeutics. Some leading voices have hailed this a “game-changer” and the dawn of a new era. This was a small study of 10 individuals with heterozygous familial cholesterolemia (HeFH) – a genetic disorder affecting ~1 million Americans which causes elevated low-density lipoproteins (LDL or “bad cholesterol”). Patients with this condition often experience heart attacks, strokes and die prematurely. Fortunately, we have many treatment options available to mitigate (but not completely eliminate) the increased risks these patients experience including at least three types of oral medications (statin drugs are the mainstay) and several injectable options which can be added on. Three injectable drugs target a protein called PCSK9 which is involved in the processing of LDL. Individuals who lack PCSK9 have very low LDL and experience very low rates of cardiovascular disease. Two of these are monoclonal antibodies (evolocumab & alirocumab), which are dosed every 2-4 weeks by the patient using a self-injection system, somewhat akin to insulin. These two drugs have been tested in large randomized clinical trials showing a reduction in major adverse cardiac events. A third (inclisiran) is an RNA drug, given in a doctor’s office twice per year. A mega-trial of inclisiran aimed at evaluating if it lowers major adverse cardiac events is ongoing.
Time to realize that your body makes most of its own cholesterol and it's best not to use drugs to interfere with that process. You body needs cholesterol to work properly and survive. Just ask your brain, liver and gut.
There is no valid proof that cholesterol causes heart attacks as that 60 year mantra is now 100% bogus. Good verses bad cholesterol is another of the many sad jokes perpetrated upon unsuspecting patients all in the name of creating fear to sell more drugs.
I used to think like you because we all know correlation does not automatically mean causation, the correlation wasn't all that big even if it was statistically significant, and of course, we all know the vital role that cholesterol plays for various bodily functions. I figured the reason statins lowered the risk of CVE's, even though the ARR isn't all that impressive, is because they don't just lower LDL, they are also anti-inflammatory, and it's inflammation that is the root cause. In other words, I now understand that LDL can be a source of atherosclerosis, but only if it undergoes oxidation, which initiates the inflammatory process that allows it to penetrate the endothelium and become atherosclerotic. Now recent research shows it's a bit more complicated than that, as LDL undergoes multiple modifications as explained in the article (link #1) below. So don't worry about LDL unless it undergoes these modifications. Unfortunately, there are many factors in modern life, some difficult to avoid, that cause these changes. My advice to anybody who wants to know for sure if their heart has any atherosclerosis is to have a coronary artery calcium CT scan (link #2). Some of the doctors on this substack don't believe they are worth it, but I found it helpful, as did my husband, to know that, indeed, we DO have some atherosclerosis in our hearts, even though we did NOT have any in our 40's, we do now. So don't just take it once if you have a score of zero; get them periodically to see if it changes over time. My husband's score increased so much he decided to start a statin, which he was not inclined to do before. Mine is lower but I will start a statin if it goes up any more, until the day the smart docs figure out how to stop the inflammatory process without causing any harm. (I will only go on Pravastatin like my husband, as it decreases insulin resistance, while the lipophilic statins increase insulin resistance.). Oh, and if you're thinking lifestyle modification, we've done them all, and still exercise like maniacs. The calcium score didn't respond. UGH!
I've been taking a "high potency" K2 supplement for years, and no, it did not prevent calcium from penetrating my coronary arteries. If only. If you read the article I linked, it's complex and multifactorial. The human body always is.
One of the limitations of CAC test is that it measures *advanced* atherosclerotic disease, after calcification of atheromas takes place. It does not allow one to comment on ASCVD that has not yet calcified. So while a score >0 tells you there is some pathology, a score of 0 does not mean you don't have disease.
Good point. I did know that soft plaque doesn't show up on the CAC, and you'd need to get a CT coronary angiogram for that. But an angiogram isn't something a doctor would ever recommend for screening. If only we could detect soft plaque non-invasively! Having that score just does something to you! :) For those who are interested, I included the MESA 10-Year CHD Risk with Coronary Artery Calcification calculator below.
Crixcyon, this technology and PCSK9 inhinitors were developed when it was discovered that there are people without PCSK9 who don't develop ASCVD. The drugs and technology target low density lipoproteins, which are atherogenic proteins that transport cholesterol through our blood stream. You are correct that your body needs cholesterol, but incorrect if you are claiming there is not a strong association between LDL and heart disease.
"Most troubling though is the reaction of the media and cardiology community. They have systematically played down the issues and limitations."
Which is exactly what happened regarding myocarditis and the Covid vaccine. Same thing happening again. And this is why a lot of us don't trust pharma and the medical community anymore.
My dad was an Angus farmer. Much of the research of the type reported here makes me think of herd management for cattle. Ok if it gets the cattle to market. In our case, over generalizing incredibly individual and complex physiology, and making a fortune in the process.
Cholesterol meds made my wife physically weak and caused her to have brain fog. This “lower is better” regarding cholesterol is poorly thought out. I am appalled by the poor intellectual performance of the general medical community on any number of issues: Covid-19, cholesterol, diet, vaccines in general and in particular.
The cardiac arrest, the myocardial infarction that are described here... Seem like natural consequences of the inflammatory LNPs together with gene editing. Where have we seen that before?
A one and done treatment.. In other words, irreversible damage. Hubris on roller skates. And we're relying on Wall Street to tell us that this is a really bad idea?
Have you read Duane Graveline's book "The Statin Damage Crisis"? He had total amnesia twice from the statins and then died of ALS. My dad died of dementia after being on statins, and a younger brother of mine died of ALS, also on statins. What a mess. People terrified of egg yolks and butter, taking meds that I wouldn't allow anyone to give my dog.
A philosopher once described the theory of an opponent as "Nonsense upon stilts." This is insanity upon stilts. There is no scientifically credible evidence that cholesterol has anything to do with atherosclerosis. The foundational study that is most cited as proving the benefit of cholesterol reduction employed fraudulent statistical manipulation in order to "prove" their thesis.
"Patients with this condition often experience heart attacks, strokes and die prematurely."
What about cholesterol and it's effect on Vitamin D and ultimately the immune system?
"Report in the New England Journal of Medicine about the Nurses’ Health study involving 120,000 women since the 1970s. Eighty-two percent of coronary events in the study…could be attributed to lack of adherence to (these five factors).” One, don’t smoke. Two, drink alcohol in moderation. Three, engage in moderate-to-vigorous exercise for at least half an hour a day on average. Four, maintain a healthy weight (BMI under 25). Five, eat a wholesome, low-glycemic (low-sugar) diet with plenty of omega-3 fats and fiber. Where’s the part about lowering cholesterol? It’s not there."
Cholesterol is the boogie man of our day. LDL is Dracula. The anticholesterol meds are the remedy, with all their lovely side effects, of dementia, ALS, rhabdomyolysis, joint pain, and someone, somewhere is making a lot of money selling them.
I have recently read about over the counter Omega 3s causing Atrial fib. So, is better to get it in your diet than in a pill. I was taking Krill Oil when I developed
Where did you read this? I've had AFib, and was told looking for causes can be like looking for a needle in a haystack. For example, mine came on one quiet Sunday afternoon when I bent over to pick something up off the floor (I'm not not fat, I'm very fit and had no history of heart trouble, and none in my family.) I went into atrial flutter that lasted five hours till the ER doc slowed it down. So I might conclude that bending over to pick up a pen off my kitchen floor is a cause of AFib.
I think everyone experiences it to some extent at some point in life. The MD who did the atrial ablation told me even elephants have it. So I'd like to know how anyone can say OTC omega 3 gel caps/krill oil can cause it.
Pretty sure coffee/caffeine is a contributor. Had a friend in his 40s who was in and out of Afib, the doctor started the questionaire, got to "How much coffee do you drink?" Friend said "A pot every morning." He said "We can stop there. That's probably your problem."
People have been saying for years that caffeine causes all kinds of cardiac arrhythmias. As far as I know there is no scientific evidence that it does anything more than raising the heart rate a little.
The only correlations I've personally experienced with irregular heartbeat (besides going into atrial flutter after picking up a pen off the floor) have been: bad reactions to meds like beta and calcium channel blockers (for me those are skull and crossbones); bad reactions to Aleve and Mobic, and plain exhaustion from things like breaking down on cross country drives and walking all night to get to a service station (college days). The ER doc told me things like oxymetazolone nasal spray can trigger it. So, I give up. Can't live in fear. So I put it out of my mind.
I think this is only for a very small percentage of the population, who would also get afib from eating fatty fish. So very low risk for the average person. If you can eat fatty fish without afib you can probably take dha/epa
Have always eaten Salmon and Tuna at least once a week without a hint of afib. I stopped the Krill Oil immediately. Have eaten Salmon since my diagnosis and it did not precipitate an episode.
The point I find most compelling is that statins reduce the cholesterol in the blood (medicating for the test result) but does not reduce the risk of heart attack or stroke. Just like diabetes meds reduce the blood sugar (medicating for the test) but do nothing to reduce the damage done by food choices, nor slow progression of the disease. They make it look like you’re doing something when you’re not.
And then there are negative side effects to deal with. No benefit and side effects
You are 100% correct. I spent a lot of time and effort in my medical practice advising patients to stop taking statins and the so called anti-diabetic drugs---sometimes successful and some times not.
isnt that dana carvys dx? remember when the surgical team missed the near 100% occluded LAD, instead attaching something else to somewhr else & telling him his continued symptoms were psychogenic? good times. (bc his son just died, i was thinking about that case) _JC
there is NO GENE which produces cholesterol, every gene expresses PROTEINS or nucleic acids, via action of ribosomes or polymerases. To say CRISP will fix an entire pathway of countless proteins/DNA/RNA's processes involved in ANY disease is a TIP of criminal LIE, including the covid criminal gene modification treatments, performed on billions of clueless victims!
It is TIME TO STOP EUGENICS and those who feed it!
That's true. But it's not being acknowledged by pharma-backed researchers so it's going to be a future of killed and injured people who trusted that the AMA, AHA, NEJM, Lancet, and JAMA were looking out for them.
Time to realize that your body makes most of its own cholesterol and it's best not to use drugs to interfere with that process. You body needs cholesterol to work properly and survive. Just ask your brain, liver and gut.
There is no valid proof that cholesterol causes heart attacks as that 60 year mantra is now 100% bogus. Good verses bad cholesterol is another of the many sad jokes perpetrated upon unsuspecting patients all in the name of creating fear to sell more drugs.
I used to think like you because we all know correlation does not automatically mean causation, the correlation wasn't all that big even if it was statistically significant, and of course, we all know the vital role that cholesterol plays for various bodily functions. I figured the reason statins lowered the risk of CVE's, even though the ARR isn't all that impressive, is because they don't just lower LDL, they are also anti-inflammatory, and it's inflammation that is the root cause. In other words, I now understand that LDL can be a source of atherosclerosis, but only if it undergoes oxidation, which initiates the inflammatory process that allows it to penetrate the endothelium and become atherosclerotic. Now recent research shows it's a bit more complicated than that, as LDL undergoes multiple modifications as explained in the article (link #1) below. So don't worry about LDL unless it undergoes these modifications. Unfortunately, there are many factors in modern life, some difficult to avoid, that cause these changes. My advice to anybody who wants to know for sure if their heart has any atherosclerosis is to have a coronary artery calcium CT scan (link #2). Some of the doctors on this substack don't believe they are worth it, but I found it helpful, as did my husband, to know that, indeed, we DO have some atherosclerosis in our hearts, even though we did NOT have any in our 40's, we do now. So don't just take it once if you have a score of zero; get them periodically to see if it changes over time. My husband's score increased so much he decided to start a statin, which he was not inclined to do before. Mine is lower but I will start a statin if it goes up any more, until the day the smart docs figure out how to stop the inflammatory process without causing any harm. (I will only go on Pravastatin like my husband, as it decreases insulin resistance, while the lipophilic statins increase insulin resistance.). Oh, and if you're thinking lifestyle modification, we've done them all, and still exercise like maniacs. The calcium score didn't respond. UGH!
https://www.frontiersin.org/articles/10.3389/fphar.2020.613780/full
https://www.health.harvard.edu/heart-health/should-i-get-a-calcium-score#:~:text=A coronary artery calcium scan,the more plaque is present.
I thought this was your body's way of protecting fragile blood vessels and well as sequestering calcium floating around in your blood.
If you want to reduce atherosclerosis, try taking a K2 supplement. It gets the Calcium into the bones and teeth where it belongs.
I've been taking a "high potency" K2 supplement for years, and no, it did not prevent calcium from penetrating my coronary arteries. If only. If you read the article I linked, it's complex and multifactorial. The human body always is.
Interesting. Good to know. (not that it's *good*, just good to know)
One of the limitations of CAC test is that it measures *advanced* atherosclerotic disease, after calcification of atheromas takes place. It does not allow one to comment on ASCVD that has not yet calcified. So while a score >0 tells you there is some pathology, a score of 0 does not mean you don't have disease.
Good point. I did know that soft plaque doesn't show up on the CAC, and you'd need to get a CT coronary angiogram for that. But an angiogram isn't something a doctor would ever recommend for screening. If only we could detect soft plaque non-invasively! Having that score just does something to you! :) For those who are interested, I included the MESA 10-Year CHD Risk with Coronary Artery Calcification calculator below.
https://www.mesa-nhlbi.org/MESACHDRisk/MesaRiskScore/RiskScore.aspx
Crixcyon, this technology and PCSK9 inhinitors were developed when it was discovered that there are people without PCSK9 who don't develop ASCVD. The drugs and technology target low density lipoproteins, which are atherogenic proteins that transport cholesterol through our blood stream. You are correct that your body needs cholesterol, but incorrect if you are claiming there is not a strong association between LDL and heart disease.
Then show the statistics.
"Most troubling though is the reaction of the media and cardiology community. They have systematically played down the issues and limitations."
Which is exactly what happened regarding myocarditis and the Covid vaccine. Same thing happening again. And this is why a lot of us don't trust pharma and the medical community anymore.
Your mistrust for the pharmaceutical and medical communities shows uncommonly good common sense.
My dad was an Angus farmer. Much of the research of the type reported here makes me think of herd management for cattle. Ok if it gets the cattle to market. In our case, over generalizing incredibly individual and complex physiology, and making a fortune in the process.
Yes and it is always based on creating fear and insecurity. They have succeeded in "medicalizing" normal life.
You're so right. It's a mental strait-jacket and so very depressing.
Cholesterol meds made my wife physically weak and caused her to have brain fog. This “lower is better” regarding cholesterol is poorly thought out. I am appalled by the poor intellectual performance of the general medical community on any number of issues: Covid-19, cholesterol, diet, vaccines in general and in particular.
The cardiac arrest, the myocardial infarction that are described here... Seem like natural consequences of the inflammatory LNPs together with gene editing. Where have we seen that before?
A one and done treatment.. In other words, irreversible damage. Hubris on roller skates. And we're relying on Wall Street to tell us that this is a really bad idea?
Yes and isn't it interesting that they use the same technology as the Covid-19 "vaccines---RNA molecules enclosed in lipid nanoparticles.
Have you read Duane Graveline's book "The Statin Damage Crisis"? He had total amnesia twice from the statins and then died of ALS. My dad died of dementia after being on statins, and a younger brother of mine died of ALS, also on statins. What a mess. People terrified of egg yolks and butter, taking meds that I wouldn't allow anyone to give my dog.
My mom ended up with her eyelid drooping from statins. Thankfully she got off before something worse happened.
A philosopher once described the theory of an opponent as "Nonsense upon stilts." This is insanity upon stilts. There is no scientifically credible evidence that cholesterol has anything to do with atherosclerosis. The foundational study that is most cited as proving the benefit of cholesterol reduction employed fraudulent statistical manipulation in order to "prove" their thesis.
So this statement where are the statistics?
"Patients with this condition often experience heart attacks, strokes and die prematurely."
What about cholesterol and it's effect on Vitamin D and ultimately the immune system?
"Report in the New England Journal of Medicine about the Nurses’ Health study involving 120,000 women since the 1970s. Eighty-two percent of coronary events in the study…could be attributed to lack of adherence to (these five factors).” One, don’t smoke. Two, drink alcohol in moderation. Three, engage in moderate-to-vigorous exercise for at least half an hour a day on average. Four, maintain a healthy weight (BMI under 25). Five, eat a wholesome, low-glycemic (low-sugar) diet with plenty of omega-3 fats and fiber. Where’s the part about lowering cholesterol? It’s not there."
https://www.lifeextension.com/magazine/2013/2/br?utm_source=substack&utm_medium=email
Cholesterol is the boogie man of our day. LDL is Dracula. The anticholesterol meds are the remedy, with all their lovely side effects, of dementia, ALS, rhabdomyolysis, joint pain, and someone, somewhere is making a lot of money selling them.
If Pharma had any ethics it wouldn't be such a big industry!
That would make a great bumper sticker.
I have recently read about over the counter Omega 3s causing Atrial fib. So, is better to get it in your diet than in a pill. I was taking Krill Oil when I developed
afib.
Where did you read this? I've had AFib, and was told looking for causes can be like looking for a needle in a haystack. For example, mine came on one quiet Sunday afternoon when I bent over to pick something up off the floor (I'm not not fat, I'm very fit and had no history of heart trouble, and none in my family.) I went into atrial flutter that lasted five hours till the ER doc slowed it down. So I might conclude that bending over to pick up a pen off my kitchen floor is a cause of AFib.
I think everyone experiences it to some extent at some point in life. The MD who did the atrial ablation told me even elephants have it. So I'd like to know how anyone can say OTC omega 3 gel caps/krill oil can cause it.
Pretty sure coffee/caffeine is a contributor. Had a friend in his 40s who was in and out of Afib, the doctor started the questionaire, got to "How much coffee do you drink?" Friend said "A pot every morning." He said "We can stop there. That's probably your problem."
I cut back on caffeine after my episode but I sure hadn't chugged it the day my AFib happened. It's pretty random.
People have been saying for years that caffeine causes all kinds of cardiac arrhythmias. As far as I know there is no scientific evidence that it does anything more than raising the heart rate a little.
The only correlations I've personally experienced with irregular heartbeat (besides going into atrial flutter after picking up a pen off the floor) have been: bad reactions to meds like beta and calcium channel blockers (for me those are skull and crossbones); bad reactions to Aleve and Mobic, and plain exhaustion from things like breaking down on cross country drives and walking all night to get to a service station (college days). The ER doc told me things like oxymetazolone nasal spray can trigger it. So, I give up. Can't live in fear. So I put it out of my mind.
SB
just now
I think this is only for a very small percentage of the population, who would also get afib from eating fatty fish. So very low risk for the average person. If you can eat fatty fish without afib you can probably take dha/epa
Have always eaten Salmon and Tuna at least once a week without a hint of afib. I stopped the Krill Oil immediately. Have eaten Salmon since my diagnosis and it did not precipitate an episode.
The point I find most compelling is that statins reduce the cholesterol in the blood (medicating for the test result) but does not reduce the risk of heart attack or stroke. Just like diabetes meds reduce the blood sugar (medicating for the test) but do nothing to reduce the damage done by food choices, nor slow progression of the disease. They make it look like you’re doing something when you’re not.
And then there are negative side effects to deal with. No benefit and side effects
You are 100% correct. I spent a lot of time and effort in my medical practice advising patients to stop taking statins and the so called anti-diabetic drugs---sometimes successful and some times not.
isnt that dana carvys dx? remember when the surgical team missed the near 100% occluded LAD, instead attaching something else to somewhr else & telling him his continued symptoms were psychogenic? good times. (bc his son just died, i was thinking about that case) _JC
there is NO GENE which produces cholesterol, every gene expresses PROTEINS or nucleic acids, via action of ribosomes or polymerases. To say CRISP will fix an entire pathway of countless proteins/DNA/RNA's processes involved in ANY disease is a TIP of criminal LIE, including the covid criminal gene modification treatments, performed on billions of clueless victims!
It is TIME TO STOP EUGENICS and those who feed it!
Btw. our hearts ARE NOT numerical.
That's true. But it's not being acknowledged by pharma-backed researchers so it's going to be a future of killed and injured people who trusted that the AMA, AHA, NEJM, Lancet, and JAMA were looking out for them.