Real evidence-based information for those who face heart disease
Sep 06, 2024
I have recently found out that my father is suffering from coronary artery plaques. This has caused me great distress not merely because I worry for my father, but because I am frustrated with the general lack of competence in mainstream medical professionals to treat heart disease in any kind of evidence-based and efficacious way. They go down the normal route of “statins, stents and low fat in your diet”. Not only is this information not helpful in treating heart disease, it is actively detrimental and causes more problems for the patient.
I am not a doctor, but I am highly scientifically literate thanks to my eight years of hard science education that has allowed me to ask and find answers to my questions about medical science.
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I recently wrote this letter to my father’s healthcare team so that they might make more informed decisions about his treatment moving forward. I also wrote an email to my father about what he needs to be doing to improve his chances at a long and healthy life. Both are attached below.
I owe a lot of this education to a variety of keen scientists who have pointed me the right way including Dr. Stephen Hussey.
Obviously this is not medical advice, but it is worth discussing with your doctor. Most people have terrible outcomes with chronic disease and a lot of this is due to the poorly educated and incurious doctors that are charged with their care. I hope that if you are in a similar situation, this might help you too.
To the healthcare team of ————,
I am very grateful for the help and treatment you are providing to my father during this difficult time. Heart disease is unfortunately a very common phenomenon in our modern society; however, I believe there persist many erroneous and therefore dangerous misconceptions about this disease in the healthcare community. I have both an MSc and a Bachelors of Medical Science, and I mention this not as an appeal to authority, but rather to explain that I have been trained to read and interpret scientific literature in the context of medicine. In view of this, I have compiled some information that I believe should inform your advice regarding my father’s treatment for his recent healthcare issues.
Statins are a commonly prescribed drug to lower cholesterol and to prevent heart disease and they have also been prescribed to my father. Without going into too much detail about the science of cholesterol as it relates to heart disease, I am going to summarize the findings about the efficacy and safety of statins to treat heart disease so that you might be able to make more informed recommendations to my father and he might make more informed decisions for his own treatment protocol.
The JUPITER (Justification for the use of statins in primary prevention) trial was published in 2009 and it reported a substantially decreased risk of cardiovascular disease in those with lowered cholesterol and advocated for statin drugs for this purpose. High (LDL) Cholesterol is thought to be one of the primary, if not the primary, cause of heart including coronary plaque build up which leads to heart attack and disease. The study included 1315 sites in 26 countries and included 17802 people, half taking 20mg/d of the drug and half in a placebo group. At this point, three other major trials of rosuvastatin had failed to show evidence of benefit. The JUPITER trial was halted early on because it showed “unequivocal reduction in cardiovascular mortality”.
In 2010, a group of researchers reassessed the JUPITER trial. This paper was “Cholesterol lowering cardiovascular diseases and the rosuvastatin JUPITER controversy–a critical appeal” published by Michel de Lorgeril et al in Archives of Internal Medicine. At the time the JUPITER study was stopped, there was no difference in incidence of serious adverse events between the two groups. Furthermore, there was also no difference in death rates, although the statin group death rate was increased compared to the placebo. There were 9 fatal heart attacks in the statin group and 6 in the placebo group. There were 3 fatal strokes in the statin group and 6 in the placebo group. So 12 cardiovascular deaths in each group.
The JUPITER study was conducted by the maker of the drug, Astra Zeneca. Nine of the 14 authors of the trial had financial ties to Astra Zeneca. The lead investigator had a personal conflict of interest as he held a patent on one of the tests used in the trial. Astra Zeneca’s own investigators had handled the raw data. This means that the study was riddled with conflicts of interest that would misrepresent and bias the data in favour of the drug despite actual efficacy and safety, which was non-existent.
The authors concluded that the results of the JUPITER trial were clinically inconsistent and should not influence medical practice. JUPITER had failed to show a protective effect of rosuvastatin and this confirms results from 12 other studies published in recent years which show no evidence of protection from heart disease by lowering cholesterol.
The negative effects of Statins
Statins have been known to cause muscle pain (Dirks AJ and Jones KM 2006), depletion of antioxidants (Fuhrmeister J et al 2012), atherosclerosis and heart failure (Okuyama H et al 2015), insulin resistance and diabetes (Rees-Milton KJ et al 2020, Crandall JP et al 2017), cognitive decline, decreased lifespan and increase cancer and stroke risk. The driver behind all of these adverse events is due to the negative effects statins have on mitochondria.
Statins inhibit the production of cholesterol and in doing so, also inhibit the production of Farnesyl-PP, a compound that is required to make a coenzyme called CoQ10. Without CoQ10, the electron transport chain in mitochondria cannot pass electrons down the chain which is required for ATP production. This is especially problematic for the heart which is a muscle and therefore one of the most mitochondrial rich tissues in the body. In fact, it has been shown that statin drugs increase the risk of myopathy by impairing the mitochondria of the heart (Langsjoen PH and Langsjeon AM 2003, Silver MA et al 2004).
Coronary Artery Plaques
Plaque on the coronary artery is not an accumulation of cholesterol and has got nothing to do with having high blood levels of LDL (cholesterol). Plaque in an artery has been found to be made up of 87% clotting tissue (Gertz DS et al 1991, Stary HC et al. 1995). Clotting occurs as a response to damage.
Anything that causes inflammation and oxidative stress (inflammatory diet, toxin exposure, chronic stress, high blood pressure due to obesity) and/or impairs the ability of the artery to repair itself appropriately, creates a situation where excess clotting occurs and plaque builds up. Damage happens most readily on coronary arteries because they are under the most pressure. Initially, the clotting tissue becomes soft plaque which can rupture, but these almost never result in a heart attack (0.06% of the time according to Arbab-Zadeh A and Fuster V 2015). When a plaque ruptures, the clot seals off and further narrows the artery but it is not yet blocked. Plaques continue rupturing and sealing for a long time until eventually the body deposits calcium there and turns the soft plaque into a hard plaque (CAC score).
Rupturing of soft plaque does not result in full blockage and the body therefore has time to respond gradually. It has been found that 100% of the time that an artery reaches 70% narrowed mark, the body builds collateral arteries around it to compensate the heart tissue (Baroldi G and Silver MD 2004). These collateral arteries, in fact, form in less than a week (Khouri EM et al 1968; Schaper W and Paysk S 1976). This means that narrowing of the coronary arteries is not as dangerous as we think. Elective stent placements and bypass surgeries are not shown to prevent future heart attacks (DeVore AD et al 2019, Bowden W et al 2007, Malhotra A 2014, McIntosh HD et al 1978, CASS study 1984, Alderman EL et al 1990, Rihal CS et al 2003, Velazquez EJ et al 2011).
Here is an excerpt from Stanford Medicine regarding a large international study done in 2019 that found that invasive procedures were no better than lifestyle changes when treating heart disease that is severe but stable. Patients with persistent angina, however, did benefit from invasive procedures. This was done by David Maron, director of preventative cardiology at the Stanford School of Medicine.
https://med.stanford.edu/news/all-news/2019/11/invasive-heart-treatments-not-always-needed.html
To conduct the study, investigators randomly divided the patients into two groups. Both groups received medications and lifestyle advice, but only one of the groups underwent invasive procedures. The study followed patients between 1½ and seven years, keeping tabs on any cardiac events.
Results showed that those who underwent an invasive procedure had roughly a 2% higher rate of heart events within the first year when compared with those on medical therapy alone. This was attributed to the additional risks that come with having invasive procedures, the researchers said. By the second year, no difference was shown. By the fourth year, the rate of events was 2% lower in patients treated with heart procedures than in those on medication and lifestyle advice alone. This trend resulted in no significant overall difference between the two treatment strategies, the investigators said.
Among patients who reported daily or weekly chest pain at the start of the study, 50% of those treated invasively were found to be angina-free after a year, compared with 20% of those treated with lifestyle and medication alone.
“Based on our results, we recommend that all patients take medications proven to reduce risk of heart attack, be physically active, eat a healthy diet and quit smoking,” Maron said. “Patients without angina will not see an improvement, but those with angina of any severity will tend to have a greater, lasting improvement in quality of life if they have an invasive heart procedure. They should talk with their physicians to decide whether to undergo revascularization.”
Heart attacks happen when instant spontaneous clotting occurs in a coronary artery that is big enough to block an artery. There is no time for collaterals to form. Researchers have found, for example, that heart attacks happen in totally different areas than where someone had narrowing (Baroldi G and Silver MD 2004). However, narrowing of less than 70% can make clotting more likely in this area because the narrowing alters blood flow and a smaller clot could block this artery.
Conclusion
Unfortunately, this information continues to be ignored by medical professionals. In light of this information, I urge you to find alternative methods of helping my father to manage and prevent atherosclerosis and heart disease. An inconvenient truth for both the pharmaceutical industry and for patients of heart disease is that the only true preventions and treatments for heart disease are lifestyle related and cannot be accessed through a drug.
This includes lowering visceral body fat by building muscle, grounding, improving emotional health, increasing protein uptake, reducing processed foods and vegetable oils in the diet, and reducing sedentary lifestyle habits. If these were simple to implement, no one would have heart disease.
I hope that you are able to give my father better advice and treatment based on this information provided both regarding the stent placement decision and the decision to prescribe statins. I want my father to have the best possible chance at a long and healthy life and I believe it is important for us to collaborate and make sure we are making the most informed decisions possible.
Thank you,
Megha Lillywhite
And here is the email I wrote to my dad about what he should do instead of taking these drugs to reduce risk of heart attack in the future:
Dear Papa,
Please read the attached letter and show it to your heart specialist at the next appointment. It is very important to make informed decisions about your health rather than do what everyone else is doing, because clearly everyone else does not have good outcomes.
The real solution to heart disease is this:
1) Wake up at sunrise and go to bed shortly after sunset. Make sure to see the light throughout the day and improve circadian rhythm via good sleep.
2) Grounding for 30 minutes at least every day.
3) Reduce grains and carbs in the diet and cut out all vegetable oils completely. Limit fish and pork intake because this has unsaturated fats as well. Stick to ghee, eggs, chicken, beef and lamb. Ensure you are eating at least 100g of protein every day.
4) Build muscle. Visceral fat is the number on contributor to disease. Building muscle prevents this. Make sure to lift heavy weights in the gym 3-4 days per week for at least one hour. Swimming is not enough.
5) Walk for at least one hour every day outside, no matter the weather
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Knock nock 
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