CONTACTS 

SUBJECTS
Cholesterol LDL Low-density Lipoprotein Low Levels Reduce Risks Adve

1303 -
1303 -    ..
1304 - Summary/Objective
1305 -
130501 - Follow up ref SDS 9 6F8F.
130502 -
130503 -
130505 -  ..
1306 -
1307 -
1308 - Progress
1309 -
130901 - Received call today from Richard.  He reported public news reports on
130902 - television that statin drugs to control cholesterol, particularly
130903 - simvastatin, has caused deaths. 110802 1005, ref SDS 9 6F8F
130905 -  ..
130906 - Current medications for meeting with Doctor Egan at VA in Martinez
130907 - Cardiology Department on 110415 0900, ref SDS 7 E83F, lists
130908 - simvastatin. ref SDS 7 II95
130910 -  ..
130911 - VA reports plan to consider increasing Simvastatin from 40 mg per day
130912 - to 80 mg, shown on 110415 0900, ref SDS 7 MG3I, and shown in medical
130913 - chart. 110415 0900, ref SDS 7 E637
130915 -  ..
130916 - Objectives to avoid coronary artery disease (CAD) by reducing risk of
130917 - blood clots, also thromus and hemostasis, explained in part in
130918 - Wikipedia, as aggregation of platletts in blood vessels that slows
130919 - and eventually stops the flow of blood...
130920 -
130921 -              http://en.wikipedia.org/wiki/Thrombus
130923 -  ..
130924 - Cholesterol is an element that can cause blood clots, which may be the
130925 - same as "stenosis" reported in findings from angiogram test on 091021,
130926 - and presented in the record on 100928 0706. ref SDS 4 3495
130928 -  ..
130929 - Research on the Internet
130930 -
130931 -    1.  The New England Journal of Medicine
130932 -
130933 -        Health Policy and Reform
130934 -        Remaking Health Care
130936 -         ..
130937 -        Perspective
130939 -         ..
130940 -    2.  Weighing Benefits High-Dose Simvastatin against Risk of Myopathy
130941 -
130942 -              http://healthpolicyandreform.nejm.org/?p=14715
130944 -         ..
130945 -        NEJM | June 15, 2011 | Topics: Drugs, Devices, and the FDA
130947 -         ..
130948 -        Amy Egan, M.D., M.P.H., and Eric Colman, M.D.
130949 -
130951 -  ..
130952 - Simvastatin 80 MG Max Average Lower LDL 46%
130953 -
130954 -
130955 -    3.  Statins are the most widely prescribed class of drugs for
130956 -        treating dyslipidemia  in particular, elevated levels of
130957 -        low-density lipoprotein (LDL) cholesterol.  Nearly 20 years of
130958 -        research provide convincing evidence that statin-related
130959 -        reductions in LDL cholesterol decrease the risk of major
130960 -        adverse cardiovascular events in people with or without a
130961 -        history of known cardiovascular disease.  A meta-analysis
130962 -        including more than 90,000 patients has shown that for every 39
130963 -        mg per deciliter that statins lower the LDL cholesterol level,
130964 -        the risk of major adverse cardiovascular events is reduced by
130965 -        approximately 25%.1 The average LDL cholesterol lowering effect
130966 -        of the highest doses of approved statins are 63% for
130967 -        rosuvastatin (40 mg), 57% for atorvastatin (80 mg), 46% for
130968 -        simvastatin (80 mg), 41% for pitavastatin (4 mg), 40% for
130969 -        lovastatin (80 mg), 34% for pravastatin (80 mg), and 31% for
130970 -        fluvastatin (80 mg).2
130971 -
130972 -            [On 110817 1030 VA ended treatment with Simvastatin, which
130973 -            has reduced LDL by 50% but LDL 102 on lab 110727, well
130974 -            above LDL < 70 planned by VA, so Doctor Egan prescribed
130975 -            rosuvastatin 10 mg to replace Simvastatin. ref SDS 10 DG36
130977 -             ..
130978 -            [On 110818 1051 letter to medical team confirming change
130979 -            from simvastatin to rosuvastatin and work plan for testing
130980 -            effects of this change in 6 weeks, and to perform lab in 3
130981 -            months. ref SDS 11 4P7X
130982 -
130983 -
1310 -

SUBJECTS
Simvastatin Myopathy Side Effect 80 MG Muscle Ache Weakness Fatal Rh

3103 -
310401 -  ..
310402 - Simvastatin Prone Drug Drug Conflict Interaction FDA Study
310403 - Simvastatin Myopathy Side Effect 80 MG Muscle Ache Weakness FDA Study
310404 - Myopathy Side Effect Simvastatin 80 MG Muscle Ache Weakness FDA Study
310405 -
310406 -
310407 -    4.  Despite their cardiovascular benefits, all statins are
310408 -        associated with myopathy, ranging in severity from asymptomatic
310409 -        increases in creatine kinase to muscle aches or weakness to
310410 -        fatal rhabdomyolysis.  Recently, concerns have been raised
310411 -        about a disproportionate increase in the risk of myopathy with
310412 -        high-dose simvastatin. This possible association was the
310413 -        subject of a drug-safety communication issued by the Food and
310414 -        Drug Administration (FDA) on March 19, 2010.  Since that time,
310415 -        the FDA has completed a comprehensive review of data from the
310416 -        Study of the Effectiveness of Additional Reductions in
310417 -        Cholesterol and Homocysteine (SEARCH) clinical trial, other
310418 -        large clinical trials of high-dose statins, and the agencys
310419 -        Adverse Event Reporting System (AERS).
310420 -
310421 -            [On 110817 1030 meeting with Doctor Egan discussed symptoms
310422 -            and risks of worsening myopathy from continuing and/or
310423 -            increasing simvastatin dose to 80 mg, ref SDS 10 QF61,
310424 -            Doctor Egan switched treatment to rosuvastatin 10 mg.
310425 -            ref SDS 10 DG36
310427 -             ..
310428 -            [On 110826 1338 myppathy shoulder pain due to high dose
310429 -            simvastatin 40 mg and after switching to rosuvastatin 10 mg
310430 -            seems less playing golf for first time in over a year.
310431 -            ref SDS 12 QG7G
310433 -         ..
310434 -    5.  The SEARCH trial was a 6.7-year, randomized, double-blind trial
310435 -        comparing the efficacy and safety of 80 mg of simvastatin with
310436 -        those of 20 mg of simvastatin, with or without vitamin B12 and
310437 -        folate, in survivors of myocardial infarction.  The primary
310438 -        efficacy end point of the trial was the incidence of major
310439 -        adverse cardiovascular events, defined as death from coronary
310440 -        causes, myocardial infarction, stroke, or arterial
310441 -        revascularization.
310443 -         ..
310444 -    6.  At the end of the trial, the incidence of major adverse
310445 -        cardiovascular events was 25.7% in the 20-mg group, as compared
310446 -        with 24.5% in the 80-mg group (relative risk, 0.94; 95%
310447 -        confidence interval, 0.88 to 1.01; P=0.10).  In part because of
310448 -        greater use of off-study LDL cholesterollowering medication in
310449 -        the 20-mg group, the difference between the two treatment
310450 -        groups in mean levelsof LDL cholesterol was 13 mg per deciliter
310451 -        instead of the expected 20 mgper deciliter.  Nonetheless, the
310452 -        6% reduction in the relative risk of major adverse
310453 -        cardiovascular events observed in the SEARCH trial is
310454 -        consistent with the 13-mg-per-deciliter difference in LDL
310455 -        cholesterol levels.3
310457 -         ..
310458 -    7.  Myopathy - defined as a serum creatine kinase level more than
310459 -        10 times the upper limit of normal with unexplained muscle
310460 -        weakness or pain - developed in 52 patients in the 80-mg group
310461 -        (0.9%) but in only 1 patient in the 20-mg group(0.02%).
310462 -        Rhabdomyolysis - defined as unexplained muscle pain or weakness
310463 -        with a serum creatine kinase level more than 40 times the upper
310464 -        limit of normal - developed in 22 patients in the 80-mg group
310465 -        (0.4%) but in no patientsin the 20-mg group.  There were no
310466 -        deaths related to rhabdomyolysis.
310468 -         ..
310469 -    8.  It is critical to note that the risks of myopathy and
310470 -        rhabdomyolysis with the 80-mg dose of simvastatin decreased
310471 -        from 5 per 1000 person-years and 2 per 1000 person-years,
310472 -        respectively, during the first 12 months of treatment to 1 per
310473 -        1000 person-years and 0.4 per 1000 person-years, respectively,
310474 -        after the first 12 months of treatment.  This reduction
310475 -        indicates that in patients who are at risk for myopathy with
310476 -        high-dose simvastatin  for instance, those withcommon variants
310477 -        of SLCO1B1, which encodes a hepatic statin transporter  this
310478 -        risk will tend to manifest early in the course of treatment.4
310480 -         ..
310481 -    9.  Of the statins on the market, simvastatin is particularly prone
310482 -        to drugdrug interactions, in part because it is extensively
310483 -        metabolized by the CYP3A4 enzyme system.  Data from the SEARCH
310484 -        trial indicate that much of the increase in risk for myopathy
310485 -        noted in the high-dose simvastatin group was due to the
310486 -        concomitant use of medications such as amiodarone, diltiazem,
310487 -        and amlodipine.  Hence, judicious concomitant use of other
310488 -        medications with simvastatin will reduce the risk of myopathy.
310490 -         ..
310491 -   10.  The FDAs review of additional data from large clinical trials
310492 -        of high doses of statins indicates that the incidence of
310493 -        myopathy  defined as a serum creatine kinase level more than
310494 -        10 times the upper limit of normal with or without unexplained
310495 -        muscle weakness or pain though very low for all statins, was
310496 -        approximately 3 times as high with the 80-mg dose of
310497 -        simvastatin as with superior LDL cholesterollowering doses of
310498 -        rosuvastatin and atorvastatin.  The FDA also conducted analyses
310499 -        of U.S. rhabdomyolysis reports in AERS associated with use of a
310500 -        statin and with an outcome of death, from the date of initial
310501 -        marketing approval of each statin through January 1, 2010.
310502 -        With the caveat that spontaneous adverse-event reporting
310503 -        systems have recognized limitations (e.g., reporting rates are
310504 -        not incidence rates), the rates of reported fatal
310505 -        rhabdomyolysis were higher with 80 mg of simvastatin than with
310506 -        80 mg of atorvastatin or with 20 mg and 40 mg of rosuvastatin.
310508 -         ..
310509 -   11.  Thus, on the basis of the totality of the data, the FDA
310510 -        recommends that the 80-mg dose of simvastatin be used only in
310511 -        patients who have been taking this dose chronically (e.g.,
310512 -        for 12 months or more) without signs or symptoms of clinically
310513 -        significant muscle toxicity.  For these patients, the agency
310514 -        believes that the cardiovascular benefits of high-dose
310515 -        simvastatin outweigh the low absolute risk of myopathy.
310516 -        Patients who require a greater reduction inLDL cholesterol than
310517 -        can be achieved with 40 mg of simvastatin should be given an
310518 -        alternative LDL cholesterollowering therapy (e.g., a statin
310519 -        with greater potency that poses a lower risk of myopathy, such
310520 -        as atorvastatin or rosuvastatin).
310522 -         ..
310523 -   12.  To help ensure that high-dose simvastatin therapy is not
310524 -        initiated in new patients and that patients receiving any dose
310525 -        of simvastatin do not receive concomitant medications that
310526 -        could increase plasma concentrations of simvastatin to
310527 -        inappropriate levels, the FDA, exercising its authority under
310528 -        the FDA Amendments Act of 2007, has mandated safety-labeling
310529 -        changes for Zocor(simvastatin) and Vytorin (ezetimibe and
310530 -        simvastatin).  The key componentsof the labeling changes are
310531 -        shown in the box Under its Safe Use initiative, the FDA is
310532 -        working with creators of drug formularies, pharmacy benefit
310533 -        managers, and professional medical societies to increase
310534 -        awareness andimplementation of the new safety-labeling changes.
310536 -         ..
310537 -   13.  During the next year, the FDA will closely monitor
310538 -        prescription-use data to determine whether the safety-labeling
310539 -        changes and the communication outreach are having their
310540 -        intended effects of limiting new initiation of high-dose
310541 -        simvastatin therapy and guiding appropriate use of concomitant
310542 -        medications with simvastatin.  If evidence indicates that these
310543 -        measures are not effective,the agency will consider additional
310544 -        regulatory action, including withdrawal of high-dose
310545 -        simvastatin from the market.
310547 -         ..
310548 -   14.  Disclosure forms provided by the authors are available with the
310549 -        full text of this article at NEJM.org.
310551 -         ..
310552 -   15.  This article (10.1056/NEJMp1106689) was published on June 15,
310553 -        2011, at NEJM.org.
310555 -         ..
310556 -   16.  Source Information
310558 -         ..
310559 -   17.  From the Division of Metabolism and Endocrinology Products,
310560 -        Office of New Drugs, Center for Drug Evaluation and Research,
310561 -        U.S.  Food and Drug Administration, Silver Spring, MD.
310563 -         ..
310564 -   18.  References...
310566 -         ..
310567 -   19.  References
310568 -
310569 -        1.  Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of
310570 -            cholesterol-lowering treatment: prospective meta-analysis of data from
310571 -            90,056 participants in 14 randomised trials of statins. Lancet
310572 -            2005;366:1267-1278[Erratum, Lancet 2005;366:1358, 2008;371:2084.]CrossRef
310573 -            | Web of Science | Medline
310575 -             ..
310576 -        2.  Smith MEB, Lee NJ, Haney E, Carson S.  Drug class review:  HMG-CoA
310577 -            reductase inhibitors (statins) and fixed-dose combination products
310578 -            containing a statin.  Final report.  Update 5.  Portland:  Oregon
310579 -            Health &Science University, November 2009.
310580 -
310581 -            (http://www.ncbi.nlm.nih.gov/books/NBK47273/pdf/TOC.pdf.)
310583 -             ..
310584 -        3.  Study of the Effectiveness of Additional Reductions in
310585 -            Cholesteroland Homocysteine (SEARCH) Collaborative Group.
310586 -            Intensive lowering of LDL cholesterol with 80 mg versus 20 mg
310587 -            simvastatin daily in 12,064 survivors of myocardial infarction: a
310588 -            double-blind randomised trial. Lancet 2010;376:1658-1669CrossRef
310589 -            |Web of Science | Medline
310591 -             ..
310592 -        4.  The SEARCH Collaborative Group. SLCO1B1 variants and
310593 -            statin-induced myopathy  a genomewide study. N Engl J Med
310594 -            2008;359:789-799Full Text | Web of Science | Medline
310595 -
310597 -  ..
310598 - Another source reports....
310599 -
310600 -        Aboutlawsuits.com
310601 -        News and Information about Personal Injury Lawsuits
310602 -
310603 -        Simvastatin Lawsuit News and Information
310604 -
310605 -              http://www.aboutlawsuits.com/topics/simvastatin/
310607 -         ..
310608 -        Zocor Lawsuits
310610 -         ..
310611 -        High doses of the cholesterol drug Zocor, or generic
310612 -        simvastatin, have been linked to an increased risk of serious
310613 -        and potentially life threatening muscle problems. The FDA has
310614 -        warned that side effects of Zocor at 80 mg doses may increase
310615 -        the risk of muscle injury, myopathy or rhabdomyolysis.
310616 -
310617 -              http://www.aboutlawsuits.com/zocor-muscle-warning-high-dose-18713/
310619 -         ..
310620 -        As a result of its findings, the FDA is recommending that 80 mg
310621 -        Zocor only be given to people who have already used it for a
310622 -        year or more without problems.  The agency is asking doctors
310623 -        not to start any new patients on doses that high.  If patients
310624 -        do not achieve cholesterol control on 40 mg Zocor, FDA
310625 -        expertsurge doctors to try them on another treatment instead of
310626 -        upping the dosage.
310627 -
310628 -            [On 110817 1030 meeting with Doctor Egan discussed symptoms
310629 -            and risks of worsening myopathy from continuing and/or
310630 -            increasing simvastatin dose to 80 mg, ref SDS 10 QF61,
310631 -            Doctor Egan switched treatment to rosuvastatin 10 mg.
310632 -            ref SDS 10 DG36
310634 -  ..
310635 - Article lists comments from patients with anecdotal evidence of
310636 - harmful side effects from simvastatin...
310637 -
310638 -    1.  Comment by I. Annette Williams on 9 June 2011:
310640 -         ..
310641 -        Several years my doctor put me on Simvastatin.  It did lower
310642 -        mycholesterol rather quickly.  After several months, I began
310643 -        experiencing muscle weakness only in my lower body, which
310644 -        verygradually increased.  I discussed with my physician and
310645 -        sheassured me it wasn?t the medication as I would experience
310646 -        this throughout my entire body.  On subsequent visits, my
310647 -        doctor (and her nurse), still argued that it was not the
310648 -        drug.During my visits they kept using the description ?muscle
310649 -        pain? and I kept correcting them and telling them it was
310650 -        ?muscle weakness.? They both got quite nasty with me.  I
310651 -        finally took myself off the drug as the effects were getting
310652 -        worse.  For months afterward I went through a myriad of
310653 -        symptoms from lower body muscle wasting, dry eyes to muscle
310654 -        cramps.  I was previously a very active person, doing lots of
310655 -        walking and running in my weekend hobby of dog handling.  At
310656 -        myworst point, if I walked 50 feet on a level surface, my lower
310657 -        body became so fatigued that I would have to stop and recover
310658 -        for a few minutes before I could continue.  I would best
310659 -        describe it as similar to the effects of working out doing
310660 -        repetitions until the muscles simply can?t do any more.  Then
310661 -        you sit or stretch and rest, then do more sets/repetitions of
310662 -        exercise.  It has taken me a couple of years to get back to
310663 -        something near recovery, and I?m still atabout 70% of my
310664 -        previous capacity.  This has had and is continuing to have a
310665 -        major impact on my physical abilities.
310667 -         ..
310668 -    2.  Comment by patricia on 10 June 2011:
310670 -         ..
310671 -        I had a heart attack feb 1 of this year and when i was sent
310672 -        home i had my simvistatin dosage changed from 20 mg to 80 mg.
310673 -        for the past 4 months i have had pain in my legs, starting just
310674 -        above the knees down. i went to my heart doctor and he did a
310675 -        dopplar test on both legs and ruled out p.a.d. i went tomy
310676 -        family doctor today and tried to explain the pain i was having
310677 -        and he put me on lyraca.. i dont know which drug scaresme the
310678 -        most. does anyone else have the burning pain in your legs?
310680 -         ..
310681 -    3.  Comment by Tammy on 11 June 2011:
310682 -
310683 -        Several years ago my doctor put me on Simvastatin. It did
310684 -        lower my cholesterol but not as much as my endocrinologist
310685 -        wanted. She increased my dose a couple of times. When I
310686 -        started taking 40mg I began experiencing muscle pain and
310687 -        weakness in my upper arms and shoulders after only two weeks.
310689 -         ..
310690 -        I thought I had overexerted in some way and believed these
310691 -        symptoms would go away. A month later I was feeling much
310692 -        worse, so much so that my husband had to help me to get
310693 -        dressed. I started to think that it may be my Simvastatin
310694 -        because the symptoms started only after my dose had been
310695 -        increased.
310697 -         ..
310698 -        I finally took myself off the drug as the effects were getting
310699 -        worse.  I went to my family doctor and she assured me it wasn?t
310700 -        the medication as I would experience this throughout my entire
310701 -        body.  My symptoms had gotten better, but I was still
310702 -        experiencing impairment in the use of my arms.  I decided to
310703 -        see my family doctor and on this subsequent visit, my doctor
310704 -        still argued that it was not the drug and suggested that it may
310705 -        be arthritis.  During my next visit with my endocrinologist I
310706 -        explained these symptoms to her, what my family doctor had
310707 -        said, and that she suggested that it might be arthritis.  She
310708 -        ordered a test for arthritis, the results of which were
310709 -        negative, and I was told to follow up with my family doctor
310710 -        again.
310712 -         ..
310713 -        She also told me that my cholesterol had significantly
310714 -        increased and that I needed to be on some type of medicine.
310715 -        She prescribed Zetia, but it made me sick so I stopped taking
310716 -        it.  I returned to my family doctor, but she still insisted
310717 -        that if my symptoms had been caused by the medicine, my whole
310718 -        body would be affected and the pain and weakness wouldn?t be
310719 -        localized in my upper arms and shoulders.  My symptoms were
310720 -        getting better, but I still didn?t have full use of my arms and
310721 -        had continued pain and weakness.  I had another visit with my
310722 -        endocrinologist and had still had high cholesterol.
310724 -         ..
310725 -        She suggested that since the Zetia made me sick that I take
310726 -        Crestor because even though it was a statin as well, it could
310727 -        be taken at a low dose and still be as effective as a high dose
310728 -        of Simvastatin.
310730 -         ..
310731 -        I started taking the Crestor and just as quickly as when I had
310732 -        my Simvastatin dose increased, I my symptoms started getting
310733 -        worse again.  It has been about a year and a half since this
310734 -        all started and I have gotten back to something near recovery,
310735 -        but I continue to have pain, weakness, and impaired use of my
310736 -        arms.  This has had and is continuing to have a major impact on
310737 -        my physical abilities.
310739 -         ..
310740 -    4.  Comment by Penny on 15 June 2011:
310741 -
310742 -        Trying to figure out if zocor is causing all my pain.  I have
310743 -        been taking abt 7 years In the last 5 years I have had a
310744 -        rotator cuff tear, capsular release of same shoulder, tarsal
310745 -        tunnel in my ankle and now frozen shoulder in other shoulder.
310746 -        My doc wants to do capsular release on this.  None of this
310747 -        runs in my family, I have been evaled by neurologist,
310748 -        rheumotologist and don? t have diabetes .  But I have been in
310749 -        pain so long, I don? t know what it means to be pain free.  My
310750 -        doc says it can? t be the zocor.  But ortho is just stumped
310751 -        why this keeps happening looking for advice
310753 -  ..
310754 - This report of anecdotal pain possibly associated with simvastatin may
310755 - indicate that left shoulder pain reported on 101126, shown in case
310756 - study on 101010 0744, ref SDS 5 6E5I, and after increasing Simvastatin
310757 - 40 mg per day, prescribed on 100721 0800. ref SDS 3 RP4F, from taking
310758 - simvastatin 20 mg beginning on 091220 0527, ref SDS 1 OX5X, and shown
310759 - in medical chart for meeting with Doctor Sandhu at VA on 100104 0930.
310760 - ref SDS 2 WR4H
310761 -
310762 -            [On 110817 1030 meeting with Doctor Egan discussed symptoms
310763 -            and risks of worsening myopathy from continuing and/or
310764 -            increasing simvastatin dose to 80 mg, ref SDS 10 QF61,
310765 -            Doctor Egan switched treatment to rosuvastatin 10 mg.
310766 -            ref SDS 10 DG36
310768 -             ..
310769 -            [On 110826 1338 myppathy shoulder pain due to high dose
310770 -            simvastatin 40 mg and after switching to rosuvastatin 10 mg
310771 -            seems less playing golf for first time in over a year.
310772 -            ref SDS 12 QG7G
310773 -
310774 -
310775 -
310776 -
310777 -
3108 -

SUBJECTS
Default Null Subject Account for Blank Record

3203 -
320401 -  ..
320402 - LDL < 70 Goal Very High Risk CAD History Heart Attack
320403 -
320404 -
320405 - Research on Internet found....
320406 -
320407 -        Harvard Medical School
320408 -        Family Health Guide
320410 -     ..
320411 -    LDL cholesterol: Low, lower, and lower still
320412 -
320413 -    November 2004 update
320414 -
320415 -              http://www.health.harvard.edu/fhg/updates/update1104b.shtml
320416 -
320417 -    1.  A federal panel of experts released a revised set of
320418 -        cholesterol guidelines in July, 2004. The overall message on
320419 -        "bad" LDL cholesterol is much the same as it has been: Lower is
320420 -        better and how low your level should be depends on your
320421 -        cardiovascular risk factors.
320423 -         ..
320424 -    2.  But the standard for what low LDL means keeps on getting lower.
320425 -        These revisions say that an LDL level under 70 should be a
320426 -        "therapeutic option" for people at the highest risk for
320427 -        cardiovascular disease; the previous guidelines set under 100
320428 -        as the LDL goal for people at high cardiovascular risk and
320429 -        didn't have a separate very-high-risk category or mention
320430 -        therapeutic options. The revisions also ratchet down the
320431 -        thresholds for prescribing cholesterol-low erin g medications,
320432 -        so more people will be advised to take pills to meet LDL
320433 -        targets. (For more detail on the revisions see "LDL Targets"
320434 -        below.)
320435 -
320436 -            [On 110817 1030 VA end treatment with Simvastatin, which
320437 -            reduced LDL by 50% but LDL 102 on lab 110727, ref SDS 8
320438 -            E19L, well above LDL < 70 planned by VA, and Simvastatin
320439 -            even if increased to 80 mg cannot further lower LDL, and
320440 -            Simvastatin 80 mg has adverse side effects of debilitating
320441 -            myopathy; so Doctor Egan prescribed rosuvastatin 10 mg to
320442 -            replace Simvastatin, which is more potent and so has the
320443 -            chance to reach medical goal LDL < 70. ref SDS 10 DG36
320445 -         ..
320446 -    3.  The main impetus for the revisions came from some pretty
320447 -        remarkable results from studies of the statin drugs such as
320448 -        atorvastatin (Lipitor) and simvastatin (Zocor). The studies
320449 -        involved only people with heart disease, so the lessons learned
320450 -        don't directly apply to everyone, but there are certainly
320451 -        enough people with heart disease to make them important.  Two
320452 -        findings stand out. First, if LDL levels are pushed down to 60
320453 -        or so with statins, the risk of heart attack and other
320454 -        cardiovascular events falls further than if LDL levels are
320455 -        pushed down to just 90 or so. How much further varied with the
320456 -        study, but it was enough to matter. Second, although statins
320457 -        have been known to cause serious liver and muscle problems,
320458 -        side effects in these studies were relatively rare, and they
320459 -        were large studies involving thousands of people.
320461 -         ..
320462 -    4.  You can try to lower your cholesterol levels by changing what
320463 -        you eat, but studies have shown that the average person
320464 -        achieves only modest reductions (4%-13%) through dietary
320465 -        changes alone. Standard doses of statins reliably lower LDL
320466 -        levels by 30%-40%, so as a practical matter the vast majority
320467 -        of people who need to significantly cut their LDL levels need
320468 -        to take a statin.
320470 -         ..
320471 -    5.  The latest guidelines just tweak advice directed at people in
320472 -        the higher cardiovascular risk groups, but they are important
320473 -        because they're part of a larger trend. Over the past 20 years
320474 -        as new evidence about LDL rolls in, experts have been pushing
320475 -        their recommendations about the "ideal" LDL level lower and
320476 -        lower. So far, the experts recommend statins only for people
320477 -        who have heart disease or major heart disease risk factors.
320478 -        But that could change.  Some are already saying that many more
320479 -        people should be taking statins and that everyone should try to
320480 -        lower their LDL levels. The average American LDL level is now
320481 -        about 130.
320483 -         ..
320484 -    6.  We're not there yet, but perhaps someday there will be a
320485 -        consensus that nearly everyone should make aggressive attempts
320486 -        to lower their LDL cholesterol with statins. If the overall LDL
320487 -        recommendation were to become 50-70, taking a statin may become
320488 -        part of the daily health routine.
320490 -         ..
320491 -    7.  LDL Targets
320492 -
320493 -        If you are at...
320494 -
320495 -        1.  Very High Risk
320496 -
320497 -            1.  Presence of established cardiovascular disease and one
320498 -                of the following...
320500 -                 ..
320501 -            2.  Multiple major risk factors for cardiovascular disease,
320502 -                especially diabetes
320504 -                 ..
320505 -            3.  Severe and poorly controlled risk factors, especially
320506 -                smoking
320508 -                 ..
320509 -            4.  Multiple risk factors for metabolic syndrome,
320510 -                especially high triglycerides (200 or over) and low HDL
320511 -                (below 40)
320513 -                 ..
320514 -            5.  A history of heart attack or unstable angina.
320516 -             ..
320517 -            Guidelines say...
320519 -             ..
320520 -            An LDL of less than 70 is a "therapeutic option" if you
320521 -            fall into this new category.
320523 -             ..
320524 -        2.  High Risk
320525 -
320526 -            1.  A history of heart disease (heart attack, unstable or
320527 -                stable angina, a heart procedure such as angioplasty or
320528 -                bypass) or one of the following:
320530 -                 ..
320531 -            4.  Diabetes
320533 -                 ..
320534 -            5.  Evidence of diseased blood vessels (peripheral artery
320535 -                disease,blocked carotid arteries, transient ischemic
320536 -                attacks, etc.)
320538 -                 ..
320539 -            6.  Two or more risk factors for heart disease (cigarette
320540 -                smoking, high blood pressure, a family history of
320541 -                premature heart disease, age).
320543 -             ..
320544 -            Guidelines say...
320546 -             ..
320547 -            An LDL of less than 100 achieved with cholesterol-lowering
320548 -            medications if lifestyle changes haven't lowered it to this
320549 -            level.
320551 -             ..
320552 -        3.  Moderately High Risk
320553 -
320554 -                Having two or more risk factors for heart disease that
320555 -                create a 10%-20% chance of having a heart attack in the
320556 -                next 10 years.You can find a heart attack risk
320557 -                calculator at www.nhlbi.nih.gov/health/index.htm#tools.
320559 -             ..
320560 -            Guidelines say...
320562 -             ..
320563 -            An LDL of less than 130, but a "therapeutic option" to
320564 -            lower your LDL to less than 100.
320565 -
320567 -             ..
320568 -        4.  Moderate Risk
320570 -                 ..
320571 -                Having two or more risk factors for heart disease that
320572 -                create less than a 10% chance of having a heart attack
320573 -                in the next 10 years.
320575 -             ..
320576 -            Guidelines say...
320578 -             ..
320579 -            An LDL of less than 130.
320581 -             ..
320582 -        5.  Low Risk
320584 -                 ..
320585 -                Having one or no risk factors for heart disease
320587 -             ..
320588 -            Guidelines say....
320590 -             ..
320591 -            An LDL of less than 160.
320592 -
320594 -  ..
320595 - Another source says...
320596 -
320597 -    1.  About.com
320598 -        Heart Health Center
320599 -
320600 -        New Cholesterol Guidelines
320601 -        NCEP's latest upgraded recommendations
320602 -
320603 -              http://heartdisease.about.com/od/cholesteroltriglycerides/a/cholrecs.htm
320604 -
320605 -        By Richard N. Fogoros, M.D., About.com GuideUpdated October
320606 -        26, 2010
320607 -
320608 -        About.com Health's Disease and Condition content is reviewed
320609 -        by our Medical Review Board
320611 -         ..
320612 -        Jul 11 2011
320614 -         ..
320615 -    2.  Since the full report of the National Cholesterol Education
320616 -        Program Adult Treatment Panel III (NCEP ATP III) was
320617 -        publishedin 2002, new clinical evidence has suggested that - at
320618 -        least in high-risk and intermediate-risk patients - reducing
320619 -        LDL cholesterol to very low levels (i.e., to below 70mg/dL
320620 -        instead of the currently recommended 100 -130 mg/dL)
320621 -        significantly reduces the risk of death and cardiovascular
320622 -        events.
320624 -         ..
320625 -    3.  In response, the NCEP commented on this new information, ing an
320626 -        update on the ATP III guidelines in 2004.  In general, th e ATP
320627 -        III guidelines now recommend that LDL cholesterol levelsbe
320628 -        brought below 100 mg/dL in high-risk and moderate riskpatients.
320629 -        This is substantially lower than the target levels of 130 mg/dL
320630 -        or below in the past.
320632 -         ..
320633 -    4.  Specifically, the new recommendations are:
320634 -
320635 -        1.  High-risk patients
320636 -
320637 -            (those with a 10-year risk* of a cardiac event or 20%):
320638 -            The LDL cholesterol should be lowered to below 100 mg/dL,
320639 -            and consideration should be given to lowering it to below
320640 -            70 mg/dL.
320642 -             ..
320643 -        2.  Moderately high-risk patients
320644 -
320645 -            (those with a 10-year risk*a cardiac event between 10 and
320646 -            20%):  LDL cholesterol should be lowered to below 130 mg/dL
320647 -            and consideration should be given to lowering it to below
320648 -            100 mg/dL.
320650 -             ..
320651 -        3.  Intermediate-risk patients
320652 -
320653 -            (those with a 10-yer risk* of acardiac event less than
320654 -            10%):  LDL cholesterol should be lowered to below 130
320655 -            mg/dL.
320657 -             ..
320658 -        4.  Low-risk patients
320659 -
320660 -            (those with a 10-year risk* of a cardiac event less than
320661 -            1%):  LDL cholesterol should be below 160 mg/dL.
320663 -         ..
320664 -    5.  Most observers in the field have come out in strong support
320665 -        ofthese new recommendations, though there are some critics.
320666 -        Onone hand, some critics argue that even the new
320667 -        recommendations are not strong enough in light of recent
320668 -        clinical trials, and that a target of 70 mg/dL or lower
320669 -        shouldbe emphasized much more strongly. On the other hand,
320670 -        others (those fond of slamming the pharmaceutical industry)
320671 -        point out that many members of the NCDP ATP III panel have
320672 -        ties to the companies that make statin drugs, and that their
320673 -        recommendations are biased.
320675 -         ..
320676 -    6.  My own reading of the new data finds the evidence that there
320677 -        is benefit in reducing LDL cholesterol in high-risk patients
320678 -        to very low levels is compelling, and the 2004 revision to
320679 -        theATP III guidelines are, if anything, conservative.
320681 -         ..
320682 -    7.  You can find out how to assess your own 10-year risk of heart
320683 -        disease here...
320684 -
320685 -              http://heartdisease.about.com/od/assessyourrisk/a/assessrisk.htm
320687 -         ..
320688 -    8.  Sources:
320689 -
320690 -        Grundy SM, Cleeman JI, Bairey Merz CN, et al. Implications of
320691 -        recent clinical trials for the National Cholesterol Education
320692 -        Program Adult Treatment Panel III guidelines. Circulation.
320693 -        2004;110:227-239.
320694 -
320695 -
320696 -
3207 -

SUBJECTS
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3303 -
330401 -  ..
330402 - Risk Assessment Heart Disease How to Calculate
330403 -
330404 -
330405 -    1.  About.com
330406 -        Heart Health Center
330407 -
330408 -        Assessing Your Own Risk For Heart Disease
330409 -
330410 -              http://heartdisease.about.com/od/assessyourrisk/a/assessrisk.htm
330412 -         ..
330413 -        Docs often neglect this vital step - fortunately, you can do
330414 -        it yourself
330415 -
330416 -        By Richard N. Fogoros, M.D., About.com Guide
330418 -         ..
330419 -        Updated July 29, 2010
330421 -         ..
330422 -    2.  It is important for you to know how to assess your own risk
330423 -        for heart disease.
330425 -         ..
330426 -    3.  The bad news about heart disease is that it remains extremely
330427 -        prevalent in our society. The good news is that the factors
330428 -        that determine our risk of developing heart disease are, to a
330429 -        large extent, under our control. We ourselves have a lot to
330430 -        say about whether we will develop early cardiac disease.
330432 -         ..
330433 -    4.  Your doctor is supposed to assess your risk for you, and coach
330434 -        you on what you should be doing to reduce that risk.  But,
330435 -        despite pleas from medical experts and professional societies
330436 -        to do so, many doctors are still bad at performing risk
330437 -        assessments, and are particularly terrible about spending the
330438 -        necessary time to instruct their patients on appropriate steps
330439 -        to reduce that risk.
330440 -
330441 -    5.  (Note well: Doing a simple risk assessment is one of the most
330442 -        important jobs the primary care physician does. The failure
330443 -        todo such a risk assessment probably ought to be considered
330444 -        evidence that your doctor may be doing sub-standard work.
330445 -        Manyof the things doctors need to think about are complicated
330446 -        - this one isn't.)
330448 -         ..
330449 -    6.  Fortunately, the tools exist today for you to accurately
330450 -        estimate your own risk of getting heart disease, without
330451 -        waiting for your doctor to initiate the action. And lots of
330452 -        information is available as to what to do about it if your
330453 -        risk is elevated.
330455 -         ..
330456 -    7.  To assess your own risk, here's what you need to know
330458 -         ..
330459 -    8.  You need to gather the following information:
330460 -
330461 -        1.  whether you smoke or not
330462 -        2.  your total and HDL cholesterol levels
330463 -        3.  your blood pressure
330464 -        4.  whether you have evidence of diabetes or metabolic syndrome
330465 -        5.  whether you are overweight for your age and height
330466 -        6.  whether close relatives have had premature heart disease
330468 -         ..
330469 -    9.  With this information, you can place yourself into one of
330470 -        three categories: low, intermediate, or high.
330472 -         ..
330473 -   10.  To be in the low risk category, all of the following must be
330474 -        present:
330475 -
330476 -        1.  Non-smoker
330477 -
330478 -        2.  total cholesterol less than 200 mg/dL, HDL cholesterol
330479 -            greater than 40 mg/dL
330480 -
330481 -        3.  systolic BP less than 120, diastolic BP less than 80
330482 -
330483 -        4.  no evidence of diabetes
330484 -
330485 -        5.  not overweight
330486 -
330487 -        6.  no family history of premature cardiovascular disease
330489 -         ..
330490 -   11.  You are in the high risk category if you have any of the
330491 -        following...
330492 -
330493 -        1.  known coronary artery disease or other vascular disease.
330494 -
330495 -        2.  type 2 diabetes
330496 -
330497 -        3.  over age 65 with multple (more than one) risk factors.
330499 -         ..
330500 -   12.  And you are in the intermediate risk group if you don't fit
330501 -        into either the low or high risk groups.
330503 -         ..
330504 -   13.  If you are at low risk, you do not need any special medical
330505 -        interventions to reduce your risk, except perhaps for routine
330506 -        coaching on maintaining a healthy lifestyle. About 35% of
330507 -        U.S.adults fall into this category.
330509 -         ..
330510 -   14.  If you are in the high risk group, your doctor should strongly
330511 -        consider placing you on appropriate treatments that have been
330512 -        proven to reduce the risk of heart attack and death,such as
330513 -        statin drugs, beta blockers, and/or aspirin.  In addition, your
330514 -        doctor may want to do a stress/thallium study to assess whether
330515 -        you may have significant coronary artery disease already.
330516 -        About 25% of U.S. adults are in the high-risk category.  Here
330517 -        is more on what to do if you are in the high risk category.
330519 -         ..
330520 -   15.  If you are in the intermediate risk group, you should should
330521 -        take aggressive steps to modify the risk factors keeping you
330522 -        out of the low risk category.  Also, you should discuss with
330523 -        your doctor whether further testing should be done to
330524 -        characterize your risk more accurately.  Such testing might
330525 -        include having your C-reactive protein (CRP) level measured,
330526 -        and perhaps getting a calcium scan.  Roughly 40% of U.S.
330527 -        adultsare in the intermediate risk category.
330529 -         ..
330530 -   16.  Again, if your doctor has not performed a formal cardiac risk
330531 -        assessment, you should estimate your risk yourself.  And, if
330532 -        your risk appears to be intermediate or high, you need to
330533 -        talkto your doctor about taking aggressive measures to
330534 -        preventheart disease.
330535 -
330536 -
330537 -
3306 -

SUBJECTS
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3403 -
340401 -  ..
340402 - Proactive Remedy Reduce Risk Heart Disease
340403 -
340404 -
340405 -    1.  About.com
340406 -        Heart Health Center
340407 -
340408 -        What To Do If You Are At High Risk For Heart Disease
340409 -
340410 -              http://heartdisease.about.com/cs/riskfactors/a/highrisk.htm
340412 -         ..
340413 -        By Richard N. Fogoros, M.D., About.com Guide
340415 -         ..
340416 -        Updated July 28, 2010
340418 -         ..
340419 -    2.  So you've assessed your risk of developing heart disease, and
340420 -        it turns out to be high. What do you do now?
340422 -         ..
340423 -    3.  Because some high-risk patients will already have significant
340424 -        CAD, a non-invasive evaluation ought to be strongly
340425 -        consideredto rule out this possibility. This evaluation
340426 -        generally will consist of a stress/thallium study. In some
340427 -        cases a cardiac calcium scan might be appropriate.
340429 -  ..
340430 - Doctor Egan ordered a stress test, performed on 110406 1230.
340431 - ref SDS 6 OF8F
340433 -  ..
340434 - Article What to Do High Risk CAD continues...
340435 -
340436 -    4.  At the same time, your doctor should also lay out a clear
340437 -        planfor attacking all modifiable risk factors -- including
340438 -
340439 -        1.  diet,
340440 -        2.  weight loss,
340441 -        3.  smoking cessation,
340442 -        4.  hypertension [...blood pressure...], and
340443 -        5.  cholesterol --
340444 -        6.  stress -- reduce medical mistakes
340445 -
340446 -        ...and should initiate therapy immediately.  Your doctor
340447 -        should offer you all the resources at his/her disposal to
340448 -        encourage and assist in exercise, weight loss, and smoking
340449 -        cessation, and should ride you pretty hard about
340450 -        accomplishing these things.
340452 -  ..
340453 - Doctor Egan has done a good job on these issues.
340455 -  ..
340456 - Article What to Do High Risk CAD continues...
340457 -
340458 -    5.  He/she should display an especially aggressive attitude
340459 -        towardreducing LDL cholesterol, increasing HDL cholesterol,
340460 -        and controlling the blood pressure, since accomplishing these
340461 -        tasks is usually primarily the doctor's responsibility, and
340462 -        since doing so often requires using the right drug therapy in
340463 -        the right doses. In general, controlling cholesterol and
340464 -        hypertension will require fairly frequent office visits and
340465 -        frequent measurements of blood pressure and/or cholesterol
340466 -        levels, as well as many medication adjustments. This all
340467 -        should be done on a fairly aggressive schedule, with clear
340468 -        targets in mind.
340470 -  ..
340471 - Cholesterol is measured every 6 months, most recently on 110727 1238.
340472 - ref SDS 8 E19L
340474 -  ..
340475 - Blood pressure is taken everyday, listed with patient history of
340476 - medication and exercise, reported in case study on 101010 0744.
340477 - ref SDS 5 QJ5I
340479 -  ..
340480 - Article What to Do High Risk CAD continues...
340481 -
340482 -    6.  However, also keep in mind that doctors are human, and human
340483 -        nature makes it difficult to pull out all the stops for a
340484 -        patient who is refusing to act in his/her own best interests.
340485 -        It's hard to motivate yourself as a doctor to go the extra
340486 -        mile for the patient who just won't make a genuine and
340487 -        persistent effort to exercise, lose weight, or stop smoking.
340488 -        Which brings us to -
340489 -
340490 -
340491 -
340492 -
340493 -
340494 -
3405 -

SUBJECTS
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3503 -
350401 -  ..
350402 - Cholesterol Produced by Body Essential for Life
350403 -
350404 - Research today found an article...
350405 -
350406 -    1.  The Truth About Cholesterol
350407 -
350408 -        By Dr. James Howenstine, MD.............. ref SDS 0 T68I
350409 -        February 20, 2005
350410 -        NewsWithViews.com
350411 -
350412 -              http://www.newswithviews.com/Howenstine/james23.htm
350414 -         ..
350415 -    2.  Cholesterol is not really the villain portrayed in the
350416 -        pharmaceutical ads.  It is actually a vital substance needed in
350417 -        every cell of the body as it is the chemical precursor from
350418 -        which the body produces bile acids, provitamin D3, male and
350419 -        female sex hormones, and adrenal hormones (hydrocortisone and
350420 -        aldosterone that regulates sodium and potassium balance).
350421 -        Cholesterol is needed to construct the important membranes
350422 -        which surround cells.
350424 -         ..
350425 -    3.  The body is able to manufacture cholesterol but is unable to
350426 -        destroy this substance.  Cholesterol is removed from the body
350427 -        combined with bile acids.  This removal is increased by dietary
350428 -        fiber and diminished in the absence of dietary fiber.  Up to
350429 -        94% of cholesterol and bile acids are reabsorbed and reused
350430 -        when dietary fiber is lacking.[1] This is one reason that low
350431 -        fiber diets may increase blood cholesterol levels.
350433 -         ..
350434 -    4.  The body can make cholesterol whether there is any cholesterol
350435 -        in the diet or not.  By removing all cholesterol from the diet,
350436 -        the blood cholesterol will only fall by about 20% to 25%.
350438 -         ..
350439 -    5.  Cholesterol is dissolved and kept in solution as a flowing
350440 -        liquid when there are adequate amounts of essential fatty
350441 -        acids.  The melting point of cholesterol, where it would
350442 -        deposit on artery walls, is 300 degrees F.  When lecithin is
350443 -        present, the melting point of cholesterol falls to 180 degrees
350444 -        where it is still insoluble. However, when the essential fatty
350445 -        acids linoleic and linolenic are present in sufficient
350446 -        quantity, the melting point of cholesterol falls to 32 degrees
350447 -        which is below normal body temperature.  Even in the presence
350448 -        of an arterial injury, cholesterol will have a more difficult
350449 -        time depositing with fibrin and platelets on an injured artery
350450 -        surface because the essential fatty acids have made the blood
350451 -        more fluid.
350453 -         ..
350454 -    6.  After gazing at a television advertisement depicting an
350455 -        attractive young woman collapse on the street with a heart
350456 -        attack because her cholesterol was 280 mg. % you would
350457 -        certainly be justified in having considerable fear if your
350458 -        cholesterol is elevated. Massive amounts of money are being
350459 -        spent by pharmaceutical firms on advertisements to convince the
350460 -        public that their lives are in great danger if their
350461 -        cholesterol levels are high.
350463 -         ..
350464 -    7.  These firms have gained nearly total control over the
350465 -        curriculums taught in medical schools, the articles published
350466 -        in medical journals and who receives research grants and what
350467 -        they are going to be allowed to study in these grants.  This
350468 -        control over research expenditures prevents research that might
350469 -        lead to cures of serious diseases (cancer, schizophrenia, HIV,
350470 -        Alzheimer's Disease).  Conventional medical therapy uses drugs
350471 -        which generally have no ability to cure these diseases.
350472 -        Persons thinking outside the box who might discover information
350473 -        that would disturb the current pharmaceutical dogma about
350474 -        diseases will experience considerable difficulty getting funds.
350476 -         ..
350477 -    8.  Of great importance the pharmaceutical industry has established
350478 -        the precedent with the state boards of medical license that any
350479 -        therapies that do not use pharmaceutical drugs are quackery
350480 -        which is dangerous to the public and should be suppressed.
350481 -        This pressure to conform to pharmaceutical drug use has caused
350482 -        great personal anguish and financial loss to many innovative
350483 -        physicians who have dared to treat patients with alternative
350484 -        therapies that do cure patients.  Often these physicians must
350485 -        spend large amounts of money defending themselves from attempts
350486 -        to remove their licenses.
350488 -         ..
350489 -    9.  The current dogmas about treating cholesterol are formulated by
350490 -        a committee named National Cholesterol Education Program NCEP.
350491 -        This committee is a part of the National Institute of Health
350492 -        within the National Heart, Lung and Blood Institute.
350494 -         ..
350495 -   10.  Their most recent recommendations (2004) included more
350496 -        aggressive efforts to lower blood cholesterol.  The lower limit
350497 -        of safety for LDL cholesterol was lowered from 130 mg. to 100
350498 -        mg.  Cholesterol lowering drugs were recommended for all
350499 -        diabetics and elderly patients with high cholesterol levels.
350500 -        If implemented, these recommendations would add about 4,000,000
350501 -        persons to the multitudes already taking statin drugs. (What a
350502 -        bonanza for drug company profits).  Six out of the nine
350503 -        members[2] of the NCEP making these new recommendations are
350504 -        affiliated with the drug companies that manufacture statin
350505 -        drugs. Do you think this is a coincidence?
350507 -         ..
350508 -   11.  This 2004 call for the "aggressive and increased use of statin
350509 -        medication to treat high blood cholesterol values" would not be
350510 -        alarming if there would actually be many lives saved by these
350511 -        new recommendations.  The disturbing part of this information
350512 -        is that there is little credible scientific information to
350513 -        support these changes and there is a large amount of valid
350514 -        scientific information suggesting that many persons taking
350515 -        statin drugs are suffering serious even fatal side effects.
350516 -        Obviously increasing the number of persons taking statin drugs
350517 -        would greatly increase the number of patients being injured by
350518 -        these drugs.
350520 -         ..
350521 -   12.  Two years ago Dr. Julian Whitaker proposed to the FDA that the
350522 -        package insert supplied with a statin drug contain information
350523 -        that statin drugs decrease the levels of the critical nutrient
350524 -        CoQ 10 in patients.  He wisely suggested. that all patients
350525 -        taking statin drugs should also be taking 100 to 200 mg. of CoQ
350526 -        10 daily to avoid complications (heart failure, muscle
350527 -        breakdown with potentially fatal kidney failure
350528 -        {myoglobulinuria}, muscle weakness, peripheral neuritis,
350529 -        transient global amnesia etc.) The FDA ignored Dr.  Whitaker's
350530 -        suggestion because admitting that there was a danger from
350531 -        statin drugs, even if true, might hurt the sales of statin
350532 -        drugs.
350534 -         ..
350535 -   13.  Cholesterol Is Not A Major Cause Of Arterial Disease
350536 -
350537 -        Several factors appear to be of greater importance than
350538 -        cholesterol in causing arterial disease.  Among these are
350539 -        deposition of toxic metals in the lining endothelium of
350540 -        arteries, Vitamin C deficiency, excessive amounts of
350541 -        lipoprotein (a), inflammation in arteries, excessive clotting
350542 -        of blood, homocysteine elevation (hyperhomocystinemia) and
350543 -        dangerous foods.
350545 -         ..
350546 -   14.  An important study by Dr. Harlan Krumholz revealed that persons
350547 -        with low cholesterol levels over the age of 70 died twice as
350548 -        often from heart attacks[3] as older persons with high
350549 -        cholesterol values.  Most studies in old persons have shown
350550 -        that cholesterol is not a risk factor for coronary artery
350551 -        disease.  Approximately 90% of cardiovascular disease is seen
350552 -        in persons over 60 years of age.  Almost all studies have shown
350553 -        that high cholesterol is not a risk factor for women.[4] This
350554 -        leaves cholesterol as a risk factor for less than 5% of those
350555 -        persons dying of a heart attack.
350557 -         ..
350558 -   15.  High cholesterol values protect against infection. In a review
350559 -        of 19 studies involving 68,000 persons low cholesterol values
350560 -        revealed an increased risk for dying from lung and
350561 -        gastrointestinal diseases.  Both lung and g.i. diseases are
350562 -        often related to infections. This information was confirmed by
350563 -        a 15 year study of 100,000 healthy persons in the San Francisco
350564 -        area.  Persons entering this study with low cholesterol values
350565 -        were more often admitted to hospitals because of infectious
350566 -        diseases.[5] Patients with a history of a sexually transmitted
350567 -        disease or liver disease were twice as likely to develop HIV
350568 -        infection[6] over 7 to 8 year follow up if they had a low
350569 -        cholesterol value when entering the study.
350571 -         ..
350572 -   16.  Patients with severe heart failure have high levels of
350573 -        endotoxins and cytokines in their blood.  Endotoxins are toxic
350574 -        substances derived from gram negative bacteria.  Cytokines are
350575 -        hormones secreted from white blood cells responding to an
350576 -        inflammatory process in the body. A medical team in Germany
350577 -        learned that the strongest predictor for death in a patient
350578 -        with heart failure was the concentration of cytokines[7] in the
350579 -        blood.  They felt that bacteria in the gut found it easier to
350580 -        penetrate tissues when the pressure in abdominal veins was
350581 -        elevated by heart failure. Endotoxins were highest in patients
350582 -        with edema and endotoxin levels fell significantly when heart
350583 -        failure improved with therapy.  Patients with heart failure
350584 -        whose immune function is unable to respond to bacterial
350585 -        antigens (anergy) had a higher mortality than patients who
350586 -        still responded to bacterial antigens.  In addition the
350587 -        mortality was higher in those patients who had the lowest
350588 -        cholesterol, LDL, and triglyceride values.  The risk of dying
350589 -        in a group of 1000 patients with heart failure followed for 5
350590 -        years was 62% in patients whose cholesterol was below 129
350591 -        mg/dl. whereas patients whose cholesterol was over 223 mg./dl
350592 -        had only one half this risk of death.
350594 -         ..
350595 -   17.  When arteries are examined visually, by xrays or ultrasound
350596 -        there has never been any correlation between changes in
350597 -        cholesterol values and the extent of arteriosclerosis.
350599 -         ..
350600 -   18.  Why Metal Deposition In Artery Linings (Endothelium) Is So Important
350601 -
350602 -        After more than 30 years of use intravenous chelation therapy
350603 -        (EDTA) has become an accepted form of therapy because it has
350604 -        been found to be an effective, safe relatively inexpensive way
350605 -        to reverse occluded arteries to the heart, brain, kidneys and
350606 -        extremities.  Chelation is known to have powerful anti-oxidant
350607 -        effects but this may not afford a complete explanation for the
350608 -        benefits observed.
350610 -         ..
350611 -   19.  An important new concept about chelation relates to the inner
350612 -        lining of blood vessels (endothelium).  This lining tissue
350613 -        generates the powerful arterial vessel dilator nitric oxide.
350614 -        The endothelium also produces prostacyclin which decreases the
350615 -        clotting of blood and also causes dilating of arteries.  A
350616 -        third important endothelial product is heparin, a potent
350617 -        substance that helps prevent clots from forming.  Excessive
350618 -        deposition of heavy metals in the endothelium diminishes the
350619 -        endothelium's ability to produce nitric oxide, prostacyclin,
350620 -        and heparin.[8] Chelation may restore the body's ability to
350621 -        create these important substances by removing these metals
350622 -        (iron, cadmium, lead, mercury) from the endothelial lining.
350623 -        Additionally removal of excess iron can decrease the risk of
350624 -        subsequent heart attacks.[9] By improving blood circulation,
350625 -        chelation may benefit patients with angina pectoris,
350626 -        claudication, impotence, macular degeneration, glaucoma,
350627 -        pancreatitis, gout, rheumatoid and osteoarthritis, chronic
350628 -        fatigue syndrome, fibromyalgia, dementia, multiple sclerosis,
350629 -        and cancer.  Several of the pioneers in chelation therapy are
350630 -        alive in good health in their 90's after receiving thousands of
350631 -        intravenous chelation treatments.
350633 -         ..
350634 -   20.  The latest improvement in chelation permits this therapy to be
350635 -        adminstered orally.  Oral chealtion obviously will not be as
350636 -        fast as intravenous chelation but this is not an important
350637 -        issue for most patients who have massive amounts of metals
350638 -        needing removal. Doing chelation orally is simpler and less
350639 -        expensive than the intravenous approach.
350641 -         ..
350642 -   21.  Lead poisons enzyme systems in the body. The bones of modern
350643 -        man contain 1000 times more lead[10] than the bones of men
350644 -        living 400 years ago.  It takes 7 to 20 years for the body to
350645 -        completely replace the tissue in bone.  Since bone is the
350646 -        primary storage area for lead there is clearly no necessity in
350647 -        most patients for rapid chelation by intravenous therapy.
350648 -        Nearly all health problems (learning disorders, cancer, heart
350649 -        disease, infections, AHHD, autism, hypertension etc.) are made
350650 -        worse by the high levels of lead found in our bodies.  Lead is
350651 -        an important cause for hypertension and removal of lead from
350652 -        patients with hypertension often permits blood pressure values
350653 -        to return to normal.  Recent studies have implicated lead in
350654 -        the genesis of cataracts.  The EDTA present in chelating
350655 -        solutions binds lead so it can be excreted by the kidneys.
350657 -         ..
350658 -   22.  One of the leading authorities in chelation therapy, Dr.  Garry
350659 -        Gordon, has developed an oral chelation product Essential Daily
350660 -        Defense EDD.  EDD contains Niacin, garlic powder, Calcium EDTA,
350661 -        MSM (Methyl Sulfane Methane), Malic Acid, Betaine HCL,
350662 -        Carrageenan, Papain, Silica, dl Methionine, Beta-Sitosterol,
350663 -        Crataegus 6x (Hawthorne Berry), Modified Cellulose Gum,
350664 -        Cholesterol Free Stearic Acid, and Gelatin.
350666 -         ..
350667 -   23.  Iron is now being recognized as a health hazard. The malic acid
350668 -        in EDD derived from apples binds iron and decreases iron stores
350669 -        in the body.  This does not proceed to a state where iron
350670 -        deficiency anemia appears but it does lead to decreased
350671 -        production of free radicals which is, of course, desirable.
350673 -         ..
350674 -   24.  One of the most important components in EDD is the sulfated
350675 -        polysaccharide derived from red algae.  This polysaccharide
350676 -        interacts with EDTA to produce a definite decrease in the
350677 -        clotting tendency of blood (lower viscosity due to heparin).
350678 -        This decrease in viscosity permits blood to flow more freely
350679 -        which decreases the work load on the heart.  Additionally, this
350680 -        heparin anti-clotting effect acquired with EDD therapy makes it
350681 -        nearly impossible for a patient to have a heart attack, stroke
350682 -        or gangrene.  In this state of absent clotting and high
350683 -        anti-oxidant activity arteriosclerotic plaques are slowly and
350684 -        steadily dissolved.  There is no problem with bleeding.  Blood
350685 -        clots in arteries often occur in sites where there is no or
350686 -        minimal plaque formation.  The anticlotting effect of heparin
350687 -        produced by chelation may help explain the nearly complete
350688 -        disappearance of strokes and heart attacks in patients
350689 -        receiving chelation therapy.  Patients with severe
350690 -        arteriosclerosis may need 6 to 9 capsules daily along with
350691 -        other measures to improve arteries (anti-oxidants, correct
350692 -        diet, cessation of cigarettes etc.) The garlic, which EDD
350693 -        contains, binds mercury facilitating its removal from the body.
350695 -         ..
350696 -   25.  Anyone taking EDD needs to be taking a good vitamin mineral
350697 -        supplement because EDD over time might deplete the body of
350698 -        minerals.  Half of all Americans are taking a daily Multiple
350699 -        Vitamin Mineral Supplement.  The results of this
350700 -        supplementation are less than optimal because our bodies are
350701 -        being steadily poisoned by toxic substances found in our water,
350702 -        food, and air.  Oral chelation is proving so effective in
350703 -        improving health that many practitioners have largely switched
350704 -        from intravenous to oral forms of chelation.
350706 -         ..
350707 -   26.  Oral and intravenous chelation are complex so therapy ideally
350708 -        should be guided by a practitioner experienced in chelation.
350709 -        At times the metals simply move from one site in the body to
350710 -        another instead of leaving the body.  There is no doubt that
350711 -        removing metals from the endothelial membranes improves
350712 -        oxygenation and nutrient entry into cells resulting in improved
350713 -        health.  Because of the toxic metal, chemical, herbicide and
350714 -        pesticide exposure we all are exposed to I think everyone
350715 -        should consider taking EDD or a similar oral chelation product
350716 -        and remain on it permanently. Many leaders in the natural
350717 -        health field are already doing so.
350719 -         ..
350720 -   27.  Essential Daily Defense can be obtained from Longevity Plus
350721 -        sales@longevityplus.net or 800-580-7567. and from Natural
350722 -        Health team at 1-800-416-2806 or www. naturalhealthteam.com
350724 -         ..
350725 -   28.  Vitamin C Deficiency
350726 -
350727 -        The late Dr. Linus Pauling and his associates were convinced
350728 -        that the arteriosclerotic plaque is formed because of a
350729 -        deficiency of Vitamin C.  In their explanation of
350730 -        arteriosclerosis the structural protein (collagen) of arteries
350731 -        is lacking due to Vitamin C deficiency. This causes the body to
350732 -        supply lipoprotein (a) to these weak areas in an attempt to
350733 -        patch the weakness.  This substance lipoprtotein (a) is very
350734 -        sticky and when it deposits onto an injured artery surfaces it
350735 -        seizes platelets, calcium, fibrin and cholesterol from the
350736 -        blood which causes a deposit (plaque) that narrows the opening
350737 -        in the artery.  These narrowed openings can proceed to clot
350738 -        over (heart attack, stroke, or gangrene), produce symptoms
350739 -        (angina, leg pain with exertion, brain symptoms from lack of
350740 -        adequate blood flow) and small pieces of fibrin clot may break
350741 -        off the plaque and are thrown to arteries more distant again
350742 -        producing strokes, heart attack and gangrene.
350744 -         ..
350745 -   29.  In 1994 Linus Pauling and his associates announced that
350746 -        arteriosclerosis could be cured by a substance important in
350747 -        making collagen (lysine 6 grams daily) and large doses of
350748 -        Vitamin C (6 grams daily).  The Pauling associates have never
350749 -        seen an individual who was taking 10 grams of Vitamin C daily
350750 -        who had any evidence of arteriosclerosis.  Ninety five per cent
350751 -        of patients with advanced arteriosclerosis admitted they took
350752 -        no Vitamin C or less than 500 mg. daily.  These findings have
350753 -        been confirmed by the Life Extension Foundation of Hollywood,
350754 -        Florida.
350756 -         ..
350757 -   30.  The Pauling associates relate that end stage arteriosclerosis
350758 -        patients have been completely cured by high dosage Vitamin C
350759 -        and lysine often within weeks.  These individuals lose their
350760 -        anginal pain, blood pressure drops to normal, arterial
350761 -        blockages disappear, lipid profiles become normal, and energy
350762 -        increases. They become able to pass treadmill tests normally.
350764 -         ..
350765 -   31.  Human beings and guinea pigs are unable to manufacture Vitamin
350766 -        C.  Depriving guinea pigs of vitamin C leads to the production
350767 -        of arteriosclerotic lesions similar to human arteriosclerosis.
350768 -        No plaque forms in control guinea pigs getting Vitamin C.  Dr.
350769 -        Kilmer.  McCulley has shown that guinea pigs depleted of
350770 -        Vitamin C get high blood levels of homocysteine whereas the
350771 -        control guinea pigs have normal homocysteine values.
350773 -         ..
350774 -   32.  Animals other than guinea pigs do not develop arteriosclerosis.
350775 -        Arteriosclerotic plaques were studied by Dr. Earl P.  Benditt
350776 -        with an electron microscope[11] in 1977.  His studies showed
350777 -        that plaques contain almost no cholesterol.  They are actually
350778 -        composed of new cell growth resembling what would be seen in a
350779 -        tumor.  The absence of cholesterol is certainly not what would
350780 -        expect if cholesterol circulating in the blood was the cause of
350781 -        the atherosclerotic plaque.
350783 -         ..
350784 -   33.  The human arteriosclerosis plaques are often located at sites
350785 -        where injury to blood vessels occurs from the impact of the
350786 -        arterial stream of blood rather than in a random fashion which
350787 -        should occur if a toxic material in blood i.e. cholesterol was
350788 -        the cause of arteriosclerosis.  This explains why major plaque
350789 -        formation often occurs at the sites where the forceful blood
350790 -        stream from the aorta strikes the arteries to the heart and the
350791 -        arteries to the brain.  Dr.  Pauling's findings have been
350792 -        ignored by the conventional medical community because to accept
350793 -        such convincing insights would spell the end of the multi
350794 -        billion dollar coronary bypass industry and the lucrative sales
350795 -        of cholesterol lowering drugs.
350797 -         ..
350798 -   34.  All this evidence makes a strong argument that lack of vitamin
350799 -        C plays a role in causing arteriosclerosis and that taking
350800 -        large quantities of vitamin C along with lysine should help
350801 -        narrowed arteries open back up.  Large dosages of vitamin C are
350802 -        safe but may cause loose stools.
350804 -         ..
350805 -   35.  Another aspect of Vitamin C therapy that has considerable
350806 -        importance is the widely acknowledged role that Vitamin C has
350807 -        in healing infections (polio, HIV etc.) The healing of
350808 -        infections might also be a reason for favorable response of
350809 -        arteries to high doses of Vitamin C therapy as infections are
350810 -        becoming recognized as a probable cause for arteriosclerosis.
350812 -         ..
350813 -   36.  High Levels Of Lipoprotein (a. Cause Accelerated Arteriosclerosis
350814 -
350815 -        Elevation of blood levels of Lipoprotein (a^]is considered one
350816 -        of the best predictors of impending trouble with heart disease.
350817 -        Lipoprotein (a) is a substance found in the blood that has a
350818 -        "sticky" character.  It has a strong tendency to attach to
350819 -        sites of artery damage.  This permits a clumping together with
350820 -        platelets, calcium, cholesterol and fibrin derived from
350821 -        circulating blood at this location decreasing the size of the
350822 -        artery.  Free flow of blood past this site is obstructed which
350823 -        may produce symptoms (angina, brain ischemic symptoms and
350824 -        muscle ischemic symptoms i.e. claudication) or actual occlusion
350825 -        of an artery (stroke, heart attack, gangrene).
350827 -         ..
350828 -   37.  The amino acid N-Acetyl Cysteine has been found to be the most
350829 -        effective agent to lower lipoprotein (a) levels in the blood.
350830 -        With NAC therapy lipoprotein (a) levels may decrease by up to
350831 -        70 %.  Obtaining lipoprotein (a) values during health
350832 -        evaluations is a wise idea. Patients with elevated levels of
350833 -        lipoptotein (a) should take N-acetyl cysteine 500 mg. twice
350834 -        daily.  This can be obtained from Natural Health Team and
350835 -        health food stores.
350837 -         ..
350838 -   38.  Arteriosclerosis Caused By Elevated Homocysteine And Its Correction
350839 -
350840 -        Methionine from red meat, milk and milk products is converted
350841 -        in the body into homocysteine.  When the body's stores of B6
350842 -        (pyridoxine), folic acid and B12 fail to bring this
350843 -        homocysteine down to normal values there is a three times
350844 -        greater risk of heart attack in males than in males with normal
350845 -        homocysteine values.
350847 -         ..
350848 -   39.  Dr. Kilmer McCulley gets credit for discovering the critical
350849 -        role homocysteine plays in the genesis of arteriosclerosis.
350850 -        Homocysteine stops the production of the valuable vasodilating
350851 -        nitric acid, causes blood to thicken, and facilitates the
350852 -        oxidation of LDL cholesterol, thus setting the stage for an
350853 -        atherosclerotic plaque and blood clots to form.  As more
350854 -        patients are studied it has become evident that elevated levels
350855 -        of homocysteine are a common cause for arteriosclerosis (at
350856 -        least 40 % of patients).  If you have artery problems,
350857 -        measuring homocysteine in the blood will frequently provide
350858 -        clear evidence that homocysteine is causing the problem, not
350859 -        cholesterol.
350861 -         ..
350862 -   40.  A Norwegian[12] study discovered that in 587 patients with
350863 -        coronary heart disease the risk of death within four years was
350864 -        proportional to total plasma homocysteine level.  The risk rose
350865 -        from 3.8 % with homocysteine below 9 micromols per liter to
350866 -        24.7 % in patients with homocysteine levels above 15 micromols
350867 -        per liter.
350869 -         ..
350870 -   41.  The only way to be certain that you are getting the proper
350871 -        dosage of folic acid, Vitamin B 12, Vitamin B6 and
350872 -        trimethylglycine to treat homocysteine excess is to have
350873 -        regular blood homocysteine tests.  Each 3 unit increase in HC
350874 -        causes a 35% increase[13] in the risk of heart attack.
350876 -         ..
350877 -   42.  Trimethylglycine (TMG) also called Glycine Betaine is the most
350878 -        effective[14] agent to lower homocysteine levels.  The usual
350879 -        dose is 500 mg. three times daily.  If Homocysteine levels have
350880 -        not fallen adequately, up to 9000 mg. daily of TMG may be
350881 -        needed daily.
350883 -         ..
350884 -   43.  Folic acid (800 mcg with each meal) and 1000 mcg. of B 12 daily
350885 -        is also needed.
350887 -         ..
350888 -   44.  B6 (pyridoxine) reduces HC by a different method than folic
350889 -        acid.  The dose of B6 should be 100 to 200 mg. daily.
350891 -         ..
350892 -   45.  In a patient with previous bypass surgery, anginal chest pain
350893 -        reappeared along with new areas of blockage of heart arteries.
350894 -        This man was taking 15,000 mcg. of folic acid daily.  His blood
350895 -        homocysteine (HC) level was very high risk at 18.  On 6 grams
350896 -        daily of trimethylglycine, his HC fell to 4 in one month.
350898 -         ..
350899 -   46.  Trimethylglycine functions in treating elevated HC levels by
350900 -        donating methyl groups, which convert HC to the harmless
350901 -        aminoacid methionine.  Trimethylglycine (Glycine Betaine) can
350902 -        be purchased in health food stores.
350904 -         ..
350905 -   47.  Inflammatory Conditions In the Body Predispose To Artery Damage
350906 -
350907 -        Inflammation in the body is strongly associated with the
350908 -        development of occlusion in arteries.  For this reason blood
350909 -        tests that measure inflammatory reactions (sedimentation rate,
350910 -        C reactive protein) have been found to be of great value in
350911 -        detecting persons who are at higher risk of developing heart
350912 -        attacks and strokes.
350914 -         ..
350915 -   48.  Bacteria and viruses from inflammatory conditions in the body
350916 -        (gingivitis) and acute infections (cytomegalovirus, Chlamydia
350917 -        pneumonia (TWAR bacteria), Coxsackie, herpes, etc. appear to be
350918 -        responsible for 25 % of heart attacks and a similar percentage
350919 -        of strokes.  Evidence of bacterial and viral infections in the
350920 -        walls of arteries have been found by electron microscopy and
350921 -        immunoflourescence microscopy in many patients. Two hundred
350922 -        reviews about infectious relationships to arteriosclerosis[15]
350923 -        have been published but this evidence has been largely ignored
350924 -        as it does not encourage the use of statin drugs which remains
350925 -        the prime focus of the pharmaceutical industry with their
350926 -        control over the media and medical community.  Infectious
350927 -        disease causes deleterious affects on blood clotting with
350928 -        sludgy blood flow which promotes vascular occlusion.
350929 -        Discovering and treating inflammatory conditions like
350930 -        gingivitis may permit patients to avoid vascular occlusions.
350932 -         ..
350933 -   49.  During the weeks preceding a heart attack or stroke many
350934 -        patients have experienced a bacterial or viral infection.
350935 -        Thirty seven of 166 patients with a stroke had a bacterial or
350936 -        viral infection[16] within 7 days of the vascular accident.
350937 -        Eleven of 40 male patients below age 50 had suffered an
350938 -        influenza like illness within[17] 36 hours of onset of their
350939 -        heart attack.
350941 -         ..
350942 -   50.  During infections an inflammatory infectious reaction may be
350943 -        occurring in the arteries.  Infections also are associated with
350944 -        slow sludgy blood flow which would make it easier for a clot to
350945 -        occlude an already narrowed artery where blood flow is already
350946 -        slower than normal.
350948 -         ..
350949 -   51.  There appears to be a conflict between the concept that high
350950 -        cholesterol causes arterial disease and the observation that
350951 -        high levels of cholesterol have an ability to protect against
350952 -        infection.  The high cholesterol causing arteriosclerosis
350953 -        theory is damaged by the observations that:
350954 -
350955 -        1.  Persons with high cholesterol do not have any more
350956 -            arteriosclerosis than persons with low cholesterol values
350958 -             ..
350959 -        2.  Lowering cholesterol values by drugs does not cause a
350960 -            decrease in the amount of arterial disease
350962 -             ..
350963 -        3.  High cholesterol is associated with longevity in older
350964 -            persons.  High cholesterol occurs in elderly persons with
350965 -            the lowest mortality rates and appears to protect against
350966 -            infectious illnesses.
350968 -             ..
350969 -        4.  Less than 50 % of persons having heart attacks have abnormal
350970 -            cholesterol values
350972 -         ..
350973 -   52.  Measuring indices of inflammation appears to be a wise
350974 -        preventative health measure.  There is evidence that the statin
350975 -        drugs have an anti-inflammatory effect and this may be the main
350976 -        reason for any beneficial effects seen with statin therapy
350977 -        rather than actual lowering of cholesterol values.
350979 -         ..
350980 -   53.  Dangerous Foods Cause Arteriosclerosis
350981 -
350982 -        The proper diet for patients with angina and heart attacks to
350983 -        follow has been a source of controversy.  The two parts of the
350984 -        world that have the lowest incidence of arteriosclerotic heart
350985 -        disease are the island of Crete and the Japanese island of
350986 -        Kohama.  People in both these places eat a diet that is high in
350987 -        linolenic acid, an essential fatty acid. The Cretans get their
350988 -        linolenic acid from walnuts and purslane, whereas the Japanese
350989 -        islanders are getting their linolenic acid from non genetically
350990 -        modified soybeans and canola oil (rapeseed oil).
350992 -         ..
350993 -   54.  Researchers in France followed 605 patients after a first heart
350994 -        attack, with one half receiving the American Heart Association
350995 -        Diet (low cholesterol) and the other half receiving the Cretan
350996 -        Diet (lots of whole grains, roots, and green vegetables, fish,
350997 -        daily fruit, chicken and olive oil).  The study was terminated
350998 -        at 27 months and all patients were switched to the Cretan diet
350999 -        because of dramatic benefits from this diet (see chart)
351000 -
351001 -               American Heart Association Diet
351002 -               Total # of Heart Attacks 33
351003 -               Deaths from Heart attacks 16
351004 -               Sudden Death 8
351006 -                ..
351007 -               Mediterranean Diet Cretan
351008 -               Total # of Heart Attacks 8
351009 -               Deaths from Heart attacks 3
351010 -               Sudden Death 0
351012 -         ..
351013 -   55.  Linolenic acid has two desirable qualities. It makes blood less
351014 -        likely to clot and prevents ventricular arrhythmias.  Note the
351015 -        8 sudden deaths on the AHA diet and the absence of sudden death
351016 -        in the Cretan diet.
351018 -         ..
351019 -   56.  Sudden death is caused by an electrical gradient being
351020 -        established between an area of well oxygenated heart muscle and
351021 -        an adjacent area of poorly oxygenated heart muscle.  This
351022 -        gradient often permits a dangerous heart rhythm (ventricular
351023 -        fibrillation) to occur.  This is a condition where purposeless,
351024 -        small, feeble muscle contractions move no blood and cause
351025 -        instant death.  This is seen often in smokers, when the
351026 -        nicotine constricts a coronary artery so much a gradient is
351027 -        created leading to ventricular fibrillation.  When smokers quit
351028 -        cigarettes their incidence of sudden death instantly returns to
351029 -        the same as a nonsmoker.  Tragically, in approximately 35% of
351030 -        individuals, the presence of serious coronary artery
351031 -        arteriosclerosis is uncovered by the occurrence of sudden
351032 -        death.
351034 -         ..
351035 -   57.  Linolenic acid is found mainly in seeds (flax, hemp, soybean,
351036 -        walnut, pumpkin).  It is easily destroyed by light, air, and
351037 -        heat.  By the end of 27 months, the blood linolenic acid levels
351038 -        in the French patients had reached the same range as those seen
351039 -        in Crete. Notice that all foods consumed in the Cretan diet
351040 -        will spoil (no processed food).
351042 -         ..
351043 -   58.  The processed food diet consumed by 90% of Americans certainly
351044 -        contributes to promoting arteriosclerosis.  The U.S. soil has
351045 -        been seriously depleted of nutrients with important minerals
351046 -        lacking.  Selenium is no longer found in much of the U.S. soil.
351047 -        This mineral has dramatic effects in lowering the incidence of
351048 -        cancer when 200 mcg. is consumed daily.
351050 -         ..
351051 -   59.  Highly significant deterioration in the health of U.S. citizens
351052 -        was brought about by the introduction of Nitrogen, Phosphorus,
351053 -        Potassium NPK chemical fertilizer which has promoted the
351054 -        development of chronic degenerative diseases.  This use of
351055 -        chemical fertilizer instead of manure caused the protein
351056 -        content of vegetables to drop.  Additionally farmers no longer
351057 -        can afford to replace the vital soil minerals.  This has lead
351058 -        to steadily decreasing deficiencies in the mineral content of
351059 -        food grown from U.S. soil.  Humans lacking the trace minerals
351060 -        from food have failure of proper enzyme function. The trace
351061 -        minerals (zinc, chromium, manganese, vanadium, selenium etc)
351062 -        are vital to normal enzyme performance in the body.  Many soil
351063 -        samples lack some or most of these minerals and the quantity of
351064 -        minerals in U.S. soil has been steadily declining since the
351065 -        introduction of NPK fertilizer.
351067 -         ..
351068 -   60.  Numerous foods have been genetically modified which subjects
351069 -        the consumer to a myriad of unnecessary dangerous problems.  No
351070 -        testing for safety could be done on GMO foods because these GMO
351071 -        foods were likely to increase the incidence of cancer and
351072 -        degenerative diseases like arteriosclerosis.  Powerful
351073 -        agribusiness forces wanted GMO foods released.
351075 -         ..
351076 -   61.  One of the world's leading geneticists Dr. Mae-Wan Ho states
351077 -        "Genetic engineering bypasses conventional breeding by using
351078 -        artificially constructed, parasitic, genetic elements,
351079 -        including viruses as vectors to carry and smuggle genes into
351080 -        cells. The insertion of foreign genes into the host genome has
351081 -        long been known to have many harmful and fatal effects[18]
351082 -        including cancer of the organism".
351084 -         ..
351085 -   62.  Ninety percent of U.S. families are using synthetic chemical
351086 -        oils to cook food.  These are dangerous transfats that the body
351087 -        has a hard time processing.  Use of this synthetic food causes
351088 -        massive production of free radicals and leads to the
351089 -        development of Type 2 diabetes, arteriosclerosis and cancer.
351091 -         ..
351092 -   63.  The substances Americans think they use in cooking (corn,
351093 -        saffola, canola, sunflower, and soy oils) are actually
351094 -        chemicals compounds manufactured at high temperatures using
351095 -        harsh chemicals that completely remove all nutrient value from
351096 -        food. These chemical oils will not spoil, have no nutritional
351097 -        value and are very hard for the body to process and eliminate.
351098 -        Prolonged usage of these synthetic chemical oils leads to
351099 -        arteriosclerosis, Type 2 diabetes and cancer.  These synthetic
351100 -        oils are a major factor in the deteriorating health of the
351101 -        American people.
351103 -         ..
351104 -   64.  The nutrients, vitamins, minerals and fiber have been largely
351105 -        removed from white bread, white flour, and white rice.  Non
351106 -        organic food consumed by most persons has heavy metals,
351107 -        pesticides, herbicides, chemicals and estrogenic hormones.  A
351108 -        simple remedy would be to eat only organic food that spoils.
351110 -         ..
351111 -   65.  Increased Clotting Can Produce Heart Attacks And Strokes
351112 -
351113 -        An increased tendency of blood to clot can have a major
351114 -        influence in causing vascular occlusions in persons with
351115 -        narrowed arteries.  Among the conditions which make blood clot
351116 -        easier are fibrinogen excess, increase in number of platelets,
351117 -        abnormal platelet function, lipoprotein [a] excess, high blood
351118 -        lipids values and infections. Screening tests for fibrinogen
351119 -        excess are prudent as systemic enzyme therapy with products
351120 -        like Vitalzym or Wobenzyme may correct the increased clotting
351121 -        tendency and prevent vascular accidents from occurring.
351123 -         ..
351124 -   66.  Males living in Kampala, Kenya in 1960 were found to have the
351125 -        same degree of arteriosclerosis in their heart arteries as
351126 -        those living in St.  Louis, Missouri.  However, an autopsy
351127 -        study of 2237 males in St.  Louis and 827 males in Kampala
351128 -        revealed only one well healed heart attack in the Ugandan males
351129 -        whereas in the black and white males in St.  Louis one quarter
351130 -        of the deaths were caused by heart attacks.  There was
351131 -        extensive clotting in the arteries in St.  Louis males and
351132 -        nearly none in Kampala males. The population of Uganda at that
351133 -        time were grain vegetarians existing on corn and millet.
351134 -        Millet contains a protease inhibitor that prevents blood from
351135 -        clotting which may explain the lack of blood clots in the
351136 -        arteriosclerotic arteries of the Ugandan males.
351138 -         ..
351139 -   67.  Dr. Kilmer McCully,[19] who discerned the importance of
351140 -        homocysteine in producing -arteriosclerosis, believes that B6
351141 -        (pyridoxine) has unique anti-oxidant[20] properties that cause
351142 -        the human body to be protected from damage from sugar loaded
351143 -        diets by blocking the infectious problems usually caused by
351144 -        excess sugar. Studies have shown that individuals consuming
351145 -        Western diets are more depleted of B6 than other vitamins.
351146 -        Fats, which constitute 30 to 40 % of the calories in the
351147 -        Western diet, are lacking in water soluble B vitamins.
351148 -        Additionally, foods grown in soils fertilized for decades by
351149 -        NPK (Nitrogen, Phosphorus, Potassium) fertilizer (USA) are low
351150 -        in micronutrients including B6 even if grown organically.  In
351151 -        addition to both these problems Vitamin B6 is fragile so much
351152 -        of the B6 found in western food is lost in food processing,
351153 -        storage, transport and cooking.
351155 -         ..
351156 -   68.  To compound this problem sugar intake depletes[21] B6 from the
351157 -        body.  The air we inhale, our food and medicines are full of
351158 -        substances that destroy B6 in our bodies and thus increase our
351159 -        need for it.  Stress, which is high and rising, depletes the
351160 -        body of B6 as does the new sources of electromagnetic
351161 -        radiation[22] according to Dr. Robert Becker.
351163 -         ..
351164 -   69.  The simple taking of B6 (Pyridoxine) in doses of 100 mg or
351165 -        more.daily decreased the incidence of heart attacks by 70 % in
351166 -        two large medical practices.  Additionally, B6 decreases the
351167 -        incidence of cancer[23] even in persons who continue to
351168 -        smoke.[24]
351170 -         ..
351171 -   70.  The Ireland Boston Brothers Heart Study[25] compared the health
351172 -        of a brother eating Irish food with a brother who had
351173 -        immigrated to the U.S.  At that time the Irish brothers were
351174 -        eating approximately 1 ½ pounds of butter weekly and had
351175 -        oatmeal daily for breakfast. The brother living in the U.S. was
351176 -        eating the standard low cholesterol and saturated fat and high
351177 -        polyunsaturated fat diet consumed by most Americans.  Many were
351178 -        surprised by the results which showed that there were far more
351179 -        heart attacks in the U.S. brothers that those in Ireland.  The
351180 -        protease inhibitor found in oatmeal appeared to be protecting
351181 -        the Irish brothers from heart attacks while the synthetic low
351182 -        saturated fat diet in the U.S. was proving to be dangerous.
351184 -         ..
351185 -   71.  In England during the 1800s persons ate lots of saturated fats
351186 -        like butter, lard, meat, milk and eggs and there were almost no
351187 -        heart attacks discovered by reviewing London hospital records.
351188 -        In the 1960s persons living in Udaipur, India ate large
351189 -        quantities of ghee (butter) but had very few deaths from heart
351190 -        attacks. Sharp increases in deaths from heart attacks were
351191 -        noted in Udaipur in the 1980s when inexpensive margarine had
351192 -        replaced ghee as the primary fat eaten.  Obviously type and
351193 -        character of the food we eat has major influences on heart
351194 -        disease.
351196 -         ..
351197 -   72.  Many Health Problems Are Associated With Statin Drug Usage
351198 -
351199 -        Among the health conditions related to therapy with statin drugs are:
351200 -
351201 -        1.  Congestive Heart Failure
351202 -
351203 -            The decrease in CoQ 10 blood levels caused by statin
351204 -            therapy diminishes the energy output of heart muscle cells
351205 -            leading to congestive heart failure.  A mysterious rise in
351206 -            the incidence of heart failure has been noted in the U.S.
351207 -            in recent years which may well relate to the continually
351208 -            increasing use of statin drugs
351210 -             ..
351211 -        2.  Muscle Weakness
351212 -
351213 -            Weakness of muscles when taking statin drugs probably
351214 -            relates to decreased muscle cell energy production caused
351215 -            by diminished levels of CoO Q 10.  When severe this muscle
351216 -            weakness may progress to a state where muscle soreness and
351217 -            pain appears.  In this state the muscle cells break up
351218 -            releasing muscle protein and enzymes into the blood.  If
351219 -            the muscle damage is extensive kidney failure
351220 -            (myoglobulinuria) and severe acidosis due to lactic acid
351221 -            production may occur (often a fatal problem).
351223 -             ..
351224 -        3.  Hyperinsulinemia
351225 -
351226 -            Rise in fasting insulin values by 13 % is seen after statin
351227 -            therapy is started.  This is undesirable because high
351228 -            levels of insulin increase the construction of
351229 -            arteriosclerotic plaques over time.  Also high insulin
351230 -            values accelerate the rate of development of both diabetes
351231 -            and aging.
351233 -             ..
351234 -        4.  Anti-Oxidant Blood Levels Decrease
351235 -
351236 -            Alpha Tocopherol and Beta Carotene levels in the blood fall
351237 -            by up to 22 % in patients taking statin drugs.  Decreasing
351238 -            one's anti-oxidant stores in the blood is obviously
351239 -            undesirable as this means that our ability to remove free
351240 -            radicals will be impaired.
351242 -             ..
351243 -        5.  Peripheral Neuritis
351244 -
351245 -            The cause for peripheral neuritis is often obscure.  The
351246 -            incidence of peripheral neuritis is 15 times greater in
351247 -            persons taking statin drugs than in control subjects.  This
351248 -            could also relate to deficiency of CoQ 10.
351250 -             ..
351251 -        6.  Transient Global Amnesia TGA
351252 -
351253 -            This interesting neurologic disorder causes patients to
351254 -            have a total loss of memory for several hours.  During
351255 -            these episodes the person does not know who he or she is,
351256 -            does not know what they are doing and often has a complete
351257 -            loss of memory about their past history.  Recently it has
351258 -            been discovered that many persons taking statin drugs have
351259 -            experienced TGA and that there are thousands of persons
351260 -            with memory dysfunction, extreme forgetfulness,
351261 -            incapacitating confusion and profound disorientation for
351262 -            every person who has an episode of TGA.  The relationship
351263 -            of these memory problems to usage of statin drugs is nearly
351264 -            completely unknown in the medical community.  Stopping the
351265 -            statin drug leads to recovery which may take several
351266 -            months.
351268 -             ..
351269 -        7.  Liver Injury
351270 -
351271 -            Abnormal results of liver function tests are common in
351272 -            persons taking statin drugs.  Severe abnormalities are
351273 -            uncommon and the abnormal liver function disappears when
351274 -            statin therapy is stopped.  The package insert gives
351275 -            guidelines for the levels where abnormal liver tests should
351276 -            cause therapy to be terminated.
351278 -             ..
351279 -        8.  Stroke risk goes up when cholesterol values are lowered below 140 mg.
351280 -
351281 -            Dr Gilbert Gordon suggests keeping cholesterol values near
351282 -            220 mg.[26] to preserve the natural antioxidant benefits of
351283 -            cholesterol for the body.
351285 -         ..
351286 -   73.  A large population study of cholesterol levels in patients
351287 -        taking statin drugs revealed a decrease in deaths from heart
351288 -        disease but this occurred at the expense of an equivalent
351289 -        increase in deaths from suicide and cancer.  Lowering
351290 -        cholesterol decreases the number of receptors for serotonin on
351291 -        brain cell membranes.  Serotonin acts to suppress aggressive
351292 -        behavior so lowered serotonin levels could lead to increased
351293 -        violence and suicide.
351295 -         ..
351296 -   74.  Possibly of greater importance several early studies of the
351297 -        results of statin therapy suggested that there might be an
351298 -        increased risk of developing cancers and lymphomas in persons
351299 -        taking statin drugs.  These studies were ignored and aggressive
351300 -        marketing of statins began. Such adverse results could easily
351301 -        take more than 10 years of statin usage to become manifest and
351302 -        the rapidly increasing rates of cancer might tend to obscure
351303 -        cancers being caused by statin therapy.  Certainly some of this
351304 -        increase in cancer incidence could be due to the rapidly
351305 -        increasing statin drug usage. Knowing that CoQ 10 is a fine
351306 -        therapy for cancer suggests that lowering the levels of CoQ 10
351307 -        with statin drugs might increase the risk of cancer.  All
351308 -        persons using statin drugs should be taking 100 to 200 mg. of
351309 -        CoQ 10 daily which could probably prevent some of these adverse
351310 -        effects.
351312 -         ..
351313 -   75.  The availability of natural substances like food (flax oil) to
351314 -        lower cholesterol and fish oil to lower triglycerides suggests
351315 -        that these natural products might be able to safely replace the
351316 -        more expensive and somewhat dangerous statin drugs.  Many
351317 -        physicians are not aware of the necessity for patients taking
351318 -        statin drugs (Mevacor, Lipitor, Lescol, Zocor, Pravachol, etc.)
351319 -        to take regular doses of Co Q10 (at least 100 mg. to 200 mg.
351320 -        daily).  If you take statins be sure you get CoQ 10.
351322 -         ..
351323 -   76.  Footnotes:
351324 -
351325 -            1.  Fats That heal Fats That Kill Udo Erasmus page 68 Alive Books
351326 -                Vancouver, Canada
351327 -
351328 -            2.  Well Being Journal September/October 2004 pg. 44
351330 -                 ..
351331 -            3.  Krumholz HM et al Lack of association between cholesterol and
351332 -                coronary artery mortality and morbidity and all-cause mortality in
351333 -                persons older than 70 years. Journal of the Americam Medical
351334 -                Association 272, 1335-40, 1990
351336 -                 ..
351337 -            4.  Ravnskov U. Quarterly Journal of Medicine 96, 927-934, 2003
351339 -                 ..
351340 -            5.  Iribarren C et al Serum total cholesterol and risk of
351341 -                hospitalization, and death from respiratory disease.  International
351342 -                Journal of Epidemiology 26, 1191-1202, 1992
351344 -                 ..
351345 -            6.  Claxton AJ et al Association between serum total cholesterol and HIV
351346 -                infection in a high risk cohort of young men Journal of Acquired
351347 -                Immune Deficiency Syndromes and Human Retrovirology 17, 51-57, 1998
351349 -                 ..
351350 -            7.  Rauchhaus M et al Plasma cytokine parameters and mortality in
351351 -                patients with heart failure. Circulation 102, 3060-3067, 2000
351353 -                 ..
351354 -            8.  Arnold, J., Clean out your arteries -at home, without the needle,
351355 -                and at a fraction of the cost.Health Sciences Institute Members Alert
351356 -                August 2003 pg. 1-4
351358 -                 ..
351359 -            9.  Sullivan, J.L., Iron and the sex differences in heart disease risk
351360 -                Lancet 1981 June 13; 1(8233):1293-1294
351362 -                 ..
351363 -           10.  Dr. Garry Gordon
351365 -                 ..
351366 -           11.  Benditt, Earl P. Scientific American Feb. 1977 pg 74-80
351368 -                 ..
351369 -           12.  New England Journal Of Medicine July 24, 1997
351371 -                 ..
351372 -           13.  American Journal Of Epidemiology 1996, 143:9:845-859
351374 -                 ..
351375 -           14.  Disease Prevention and Treatment (Life Extension Media) 3rd Edition
351376 -                page 86
351378 -                 ..
351379 -           15.  Ravenskov, Uffe Cholesterol Not Guilty New Research Shows
351380 -                Cholesterol is Natural and Beneficial The Benefits of High Cholesterol
351381 -                Well Being Journal Sept/Oct 2004 pg 43
351383 -                 ..
351384 -           16.  Grau AJ et al Recent Bacterial and viral infection is a risk factor
351385 -                for cerebrovascular ischemia Neurology 50, 196-203, 1998
351387 -                 ..
351388 -           17.  Mattila KJ Viral and bacterial infections in patients with acute
351389 -                myocardial infarction. Journal of Internal Medicine 225, 293-296, 1989
351391 -                 ..
351392 -           18.  Ciola Greg Beware of the Coming Food Apocalypse GMOs (genetically
351393 -                modified organisms) pg. 9
351395 -                 ..
351396 -           19.  Surfontein, William S. DSc. Interview near Pretoria, South Africa,
351397 -                1992
351399 -                 ..
351400 -           20.  Vir SC et al Vitamin B6 levels in the elderly Vitamin Nut Res
351401 -                1977;47:364-372
351403 -                 ..
351404 -           21.  Louis J Iguarro, M.D. Nobel Laureate 1998 for his discovery of
351405 -                functions of nitric acid in the body. Interview in Bland JS, Funct Med
351406 -                Update 2002 Sept
351408 -                 ..
351409 -           22.  Becker, Robert O. MD Cross Currents: The Perils of
351410 -                Electropollution. Los Angeles, Ca: Tarche,r 1990.
351412 -                 ..
351413 -           23.  Maksymowych AB et al Efficacy of Pyridoxal treatment in controlling
351414 -                the growth of melanomas in cell cultures and an animal pilot study
351415 -                Anticancer Research 1993, 13; 1925-1938
351417 -                 ..
351418 -           24.  Hattersley JG Enough Vitamin B6 Reduces Heart Attacks by 70
351419 -                %.Townsend Letter forDoctors & Patients August/September 2004 pg. 125
351421 -                 ..
351422 -           25.  Stare F World Review of Nutrition and Dietetics Vol 12, 1970 pg
351423 -                1-42
351425 -                 ..
351426 -           26.  Dr. Garry Gordon Chelation Discussion Group Feb 11, 2004 How low
351427 -                for cholesterol?
351428 -
351430 -  ..
351431 - 2005 Dr. James Howenstine - All Rights Reserved
351433 -  ..
351434 - Dr. James A. Howenstine is a board certified specialist in internal
351435 - medicine who spent 34 years caring for office and hospital patients.
351436 - After 4 years of personal study he became convinced that natural
351437 - products are safer, more effective, and less expensive than
351438 - pharmaceutical drugs.  This research led to the publication of his
351439 - book A Physicians Guide To Natural Health Products That Work.
351440 - Information about these products and his book can be obtained from
351441 - amazon.com and at www.naturalhealthteam.com and phone 1-800-416-2806
351442 - U.S.  Dr.  Howenstine can be reached at jimhow@racsa.co.cr and by mail
351443 - at Dr.  James Howenstine, C/O Remarsa USA SB 37, P.O.  Box 25292,
351444 - Miami, Fl. 33102-5292.
351445 -
351446 -
351447 -
351448 -
351449 -
351450 -
351451 -
351452 -
3515 -