Pfizer announced yesterday that they were abandoning their newest “miracle drug”, torcetrapib. Rolls off the tongue, doesn’t it? Torcetrapib.
Turns out that in a recent large-scale controlled study, “rolls-off-the-tongue” killed more people than even the previous miracle drug, Lipitor. Pfizer had invested over $800 million in their most recent attempt to stem the rise of heart attacks and stroke by lowering cholesterol.
The main focus of torcetrapib was to raise HDL (the “good” cholesterol that has been shown to reduce fatty plaque formation on arterial linings). Since Lipitor is coming off patent soon, Pfizer needs a new blockbuster to fill the income pipeline – now at $51 billion a year. Meanwhile, news wire services are suggesting that this is a huge setback for millions with heart disease who have been awaiting another magic pill to reverse the damage brought on by poor lifestyle choices.
Here’s the deal: as long as the medical community continues to approach heart disease by promoting cholesterol reducing drugs, they will fail.
Cholesterol is not necessarily the bad guy here. It is the inflammatory processes of C-reactive protein and homocysteine, occurring within the arterial walls, that begin the process of coronary artery disease. These inflammatory processes are the real culprits. Cholesterol production is merely the response mechanism! Attempting to avert heart problems by reducing cholesterol is literally akin to removing scabs from wounds as they try to heal. (If that analogy turns your stomach, you’ll have an inkling as to how sickened I am by Big Pharma.)
The root cause of inflammation is a combination of poor diet, sloth and stress. The good news is that most cardiovascular disease is completely preventable and largely curable without side effects.
Cholesterol is the unfortunate scapegoat in all this. It’s a shame, because this endlessly-eviscerated lipid is one of the body’s most useful and dynamic substances. Among other duties, it’s a necessary component of every cell membrane and it’s involved in hormone production. The body makes about 1400 mg a day just to keep reserves up. Unfortunately, when you have a stressful lifestyle, toss in a bad diet and lack of exercise and you can get an inflammatory process within the arteries that causes lesions on arterial walls. The inflammation problem is completely unrelated to amounts or types of cholesterol.
Nevertheless, the ever-inventive human body adapts to this inflammation sequence by using cholesterol as a band-aid to cover up the lesions until healing can take place – which, of course, almost never happens since most of us keep living the inflammatory lifestyle with little regard for how destructive it is. We’re inflammation rock stars.
Eventually, the cholesterol band-aids harden (sclerosis), narrow the arteries and sometimes break off, causing a heart attack or stroke. Of course, we blame the cholesterol for all this and embark on a national campaign to rid the body of this important substance by dousing everyone with drugs, instead of focusing on the foods (and other stresses) that promote inflammation in the first place. And these drugs have some pretty nasty side effects. And yet, we continue to worship at the idol’s altar.
Bottom line: In my opinion, diet, exercise, stress reduction and prudent supplementation should be the primary focus of any primary care physician.
UPDATE 12/11/06: Another interesting analysis.