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Low Cholesterol Levels Associated with 990% Higher Mortality After Heart Attack

I remember when I graduated from medical school, the dean told our class, “What we have just taught you was the most up-to-date information about medicine. Unfortunately, 50% of what we taught you was wrong. Your job is to figure out which 50% was wrong.”

I remember feeling stunned  at the Dean’s admission. Now, 26 years later, I think the dean was too conservative. Now I feel that approximately 75% of what I was taught was wrong.

In my training, I was taught that high cholesterol was a risk factor for heart disease. Furthermore, I was taught that a high triglyceride level was also a risk factor for heart disease. It was drilled into every medical student’s head that a lower cholesterol was always better than a higher one.

Folks, what I was taught about cholesterol was 100% wrong. What I was not taught was that approximately 50% of people who suffer heart attacks have normal cholesterol levels. Furthermore, I was not taught that a higher cholesterol level was predictive of a longer life span in the elderly. Nor was I taught that lowering cholesterol levels with cholesterol-lowering medications fails well over 97% of the patients who takes them.

A recent study in Critical Care Medicine (43:1255-1264, 2015) is titled, “Lipid Paradox in Acute Myocardial Infarction- The Association with 30-Day In-Hospital Mortality.” This study followed 724 hospitalized patients who suffered an acute heart attack (i.e., myocardial infarction). The scientists attempted to clarify the relationship between the lipid profiles and the 30-day mortality in patients who suffered a heart attack.

The authors found that those with lower LDL-cholesterol and triglyceride levels had a significantly elevated mortality risk when compared to patients with higher LDL-cholesterol and triglyceride levels. In fact, lower LDL-cholesterol less than 110 mmg/dl and triglyceride less than 62.5 mmg/dl were identified as optimal threshold values for predicting 30-day mortality. The lower LDL-cholesterol level was associated with a 65% increased mortality and the lower triglyceride level was associated with a 405% increased mortality. Furthermore, as compared to patients with LDL-cholesterol levels >110mg/dl and triglycerides >62.5 mg/dl, those with lowered LDL and triglyceride levels had a 990% (or 10.9x) increased risk for mortality.

Why would lowered cholesterol and triglyceride levels be associated with a higher mortality rate? Fats from triglycerides are a major energy source and LDL-cholesterol is critical for cell membrane synthesis and is needed to fight infections. Adequate LDL-cholesterol and triglyceride levels may be critical for cell function and survival in the case of a heart attack—as well as in other conditions.

Folks, we have been hoodwinked to believe that we must all take cholesterol-lowering medications in order to prevent and/or treat heart disease. People do not get heart disease because their cholesterol level is elevated. Remember, 50% of patients who suffer a heart attack have normal cholesterol levels.

I have written extensively about the failure and danger of statin drugs in my book, The Statin Disaster. If you are taking or contemplating taking a statin medication, I would encourage you to educate yourself about what statins do in the body. Unfortunately, you cannot depend on your doctor to give you a balanced view of statins as most do not understand how statins poison the human biochemistry and the adverse effects associated with their use. I feel, since they fail the vast majority who take them—over 97%–and they are associated with serious adverse effects, statins should be pulled from the market place.

Remember, you are ultimately responsible for your medical decisions. The patients with the best results are the patients who take an active role in their health care decisions and educated themselves about the risks and benefits of any treatment.

(1) Am Heart J. 2009;157(1):111–117.e2

StatinDisaster-3T

 

 

Author Info

David Brownstein

Comments ( 62 )

  • Author Icon
    Betty Murphy

    I believe that your body will make more cholesterol if you take drugs. my ex husband takes l-arginine and cholesterol complete and had stopped taking statins. His cholesterol is now perfect. He did this at the suggestion of my chiropractor. He is the only person I trust in the medical field. No western medicine for me. Thank you Dr. B for all you do. Just for anyone allergic to soy and cant eat eggs you might try eggs from chickens who are not fed soy. That has helped me a lot.

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    Pete

    Cholesterol is also THE essential ingredient your body needs to make testosterone and vitamin D. Try eating a huge plate of grass-fed beef liver and onions. You’ll feel like a sexual tyrannosaurus.

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    I agree that statins are junk, but I have a problem with your statement, “People do not get heart disease because their cholesterol level is elevated. ” Clearly cholesterol is at the root of the problem when it comes to heart disease. If you do your homework, you’ll find that when peoples’ total cholesterol is below 150, they become virtually heart attack proof. There’s solid population data from regions of the world where the typical cholesterol levels are below 150 where, out of hundreds of thousands of people, there are zero reported incidence of heart attacks. In fact, a low fat cholesterol free diet has been proven to reverse atherosclerosis in numerous studies.

    http://www.dresselstyn.com/resolving_cade.htm
    http://www.dresselstyn.com/reversal01.htm

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    Jim

    dr brownstein could you pls explain this:

    ALPHA LIPOPROTEINS increased normal abnormal final ??????
    _______________________________________________________________________________

    my bloodwork shows a crp <1.0
    total cholesterol = 212
    triglycerides = 62
    ldl = 124
    vldl = 12
    hdl = 76

    would niacin be advisable? thank you!

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    Jill

    Dr. B how do you safely wean off of statin drugs? I’d like to get my mother off of them as soon as possible?

    • Author Icon
      David Brownstein

      Jill,
      I do not wean my patients off them. I have them stop cold-turkey.
      You can check with your doctor.
      DrB

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    Daniel

    Would it be safe to say then that eating up to 12 eggs a day should be perfectly safe if one can eat that much?

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    Tom Baker

    Dear Dr. Brownstein,

    I appreciate your integrity in admitting the medical “error” around low cholesterol, statins, etc.

    But it seems that our cherished Western medicine sometimes admits that drug A or procedure B wasn’t helpful after all, lets switch to drug C or procedure D. Well, change may be for the better.

    But are doctors and scientists looking to find the root of the problem? What is wrong with the whole field that allows such harmful medical treatments to be prescribed to so many?

    • Author Icon
      David Brownstein

      Tom,
      You ask a very good question at the end. Medicine has been hijacked by the Big Pharma Cartel. Until we recognize and deal with that, nothing will change.
      DrB

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    Gail

    Thank you, Rose, for your input. I will try it! I’ve used castor oil packs in the past so I have everything I need to do it again. I will try anything sane and NOTHING PHARMACEUTICAL!!!! : ) Thanks again!

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    Gail

    Dr. B–thanks so much for responding about eating low carb and doing a liver cleanse. I only eat low carb, mostly organic, now working on being gluten-free (really, really difficult!). Have done a liver cleanse. Don’t have a gallbladder but do take a biosalt/digestive enzyme with each meal and with every fat (i.e., with fish oil, vitamin D, etc.). Have worked with a functional physician, nutritionist, certified natural health practitioner (also versed in herbs and homeopathics). It’s very discouraging to be doing all the “right” things and still have issues! In addition to dealing with low cholesterol (all of it), I have Hashimoto’s, lichen planus (under control), psoriasis (under control), Crohn’s–in remission for 18 years! : ) I’ve worked hard but at times feel I’m getting no where fast. I’m actually somewhat surprised that I’ve made it to 63 years of age! Okay, enough complaining…

    I very much appreciate your blogs. I’ve listened to you many times and feel you have your finger on the heart and pulse of what is going on. Thanks for the encouragement you give!

  • Author Icon

    I’m very confused. My cardiologist has been concerned about my cholesterol and triglycerides for ages.He’s had me on fish oil for the cholesterol and 20 mg Lipitor (simvistatin before that) and he’s really thrilled when my numbers come back and all of those are lower now. Last test showed total cholesterol of 162 with HDL at 71 and LDL at 63 for a ratio of 0.88 (I’ve always had a really low ratio even when my total was in the high 200s.) My tryglyceritdes are at 142, down from high 200s.

    With everything I’ve been reading lately, including this article, I just very confused about what all these numbers mean. I thought I understood it all and have taken the meds my doctor said I needed but now I’m not so sure.

    I’m worried about everything I see about statins and would like to get off them. I won’t do anything without my doctor’s cooperation but what is the best way to get off them? Just quit or do you have to wean off them by taking less over time. If the second, how long does that take and what’s the process? I should add that since I’ve been on the statins, I been diagnosed with diabetes — I think about 3 years after I started taking them. Would getting off them help reducing that problem. Right now I’m on low carb and have reduced my blood sugar levels from consistantly in the high 100s down to hovering around 100 throughout the day.

    It’s very frustrating not knowing which information is right, wondering who has the really scoop, and who to trust. I’m 73. My mother lived to be 97 when she died quite unexpectedly. She had had medical problems along the way but they had been mitigated and she was in pretty good shape right to the end (sounds funny but it was true) and I’d sort of like to match her record.

    • Author Icon
      David Brownstein

      Gail,
      There are zero studies that show statins will significantly improve a woman’s mortality risk from heart disease. Zero.
      And, statins are known to cause diabetes.
      Perhaps it is time to find a new doctor to help you navigate the waters.
      DrB

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    Shasha

    HI, Gluten may lower thyroid which may raise cholesterol. People may need Amour thyroid and the Celiac diet (no gluten/dairy/soy/sugar/GMO) which may help lower inflammation/ help raise nutrients absorbed and help raise oxygen/pH, not statin drugs which lower cholesterol/coenyzme Q10 , which may eventually cause heart failure.

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    Melissa

    Dear Dr. B,

    “Dean’s omission” should read “Dean’s admission,” seems to me.

    Thanks for another great article. Now if I could just get my people on board. Sigh.

    Melissa

    • Author Icon
      David Brownstein

      Thanks Melissa.

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    Rebecca Cody

    From what plant-based advocates quote from research, native populations eating very little meat and fat have very low cholesterol (and probably triglycerides, since they aren’t fat) and NO heart disease. That makes me wonder if the hospital problem is caused by those levels being low or by the drugs and combinations of drugs they are given while in the hospital. Oh, and let’s not forget the hospital food!

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    Phyllis

    Is it possible that some of the people with lower cholesterol and triglycerides in the above mentioned study were on statin meds to lower their cholesterol?

    It would be interesting to see a study of people with naturally low cholesterol versus statin drug lowered cholesterol people to see if it is the low cholesterol or the statins causing the higher mortality rate.

    • Author Icon
      David Brownstein

      Phyllis,
      Good idea. However, there have been many other studies, well before the use of statins that have shown an inverse relationship between mortality and total cholesterol levels. In other words, those with higher cholesterol and LDL cholesterol had a lowered mortality when compared to those with lowered cholesterol levels. This does not directly answer your question but makes you think that a low cholesterol level may not be beneficial for aging or during an acute heart attack.
      DrB

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    Bill

    Another thought on the triglycerides finding. In the population of Americans that get MI’s there can’t be very many with triglycerides <62.5 mg/dl. So out of the 724 patients in this study I'd guess it was quite a small number (I don't have access to the full text to see if they tell us). Maybe some of those few people had a serious illness that caused their low triglycerides (e.g., hyperthyroidism, nutrient malabsorption), meaning that for them low triglycerides wasn't a sign of metabolic health but rather a sign of severe metabolic illness that would bode poorly for survival after MI. A few people like that might have skewed the whole analysis. Of course the researchers should have looked into all this, and maybe they did.

    Also, maybe as someone with fasting triglycerides of 20-40 I need to find a way to rationalize this study! Luckily my LDL is high enough to scare the bejeezus out of my doc 🙂 so maybe I'm OK.

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    Gail,
    Edgar Cayce in his practice would raise cholesterol with caster oil packs to the shins. Maybe Dr.B could weigh in on this.
    Rose

    • Author Icon
      David Brownstein

      Rose,
      I have not tried this but I have had a very difficult time raising a very low cholesterol level in certain individuals. Does anyone have experience with this?
      DrB

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    Bill

    I’d have thought low triglycerides would predict better outcomes since it suggests insulin sensitivity and absence of metabolic syndrome. Aren’t triglycerides <62.5 mg/dl generally a sign of excellent metabolic health?

    I wonder if low triglycerides in this population (MI) is just a marker for something else, e.g. something awful predisposing even very healthy people to a quick demise from MI. Or maybe the statistical "adjustments" the researchers made for "risk factors" created a spurious conclusion?

    Dr. B., any thoughts? People who eat the diet you recommend often see triglycerides plummet.

    • Author Icon
      David Brownstein

      Bill,
      Good thoughts. You might make a similar argument about low cholesterol. However, the every cell needs cholesterol and triglycerides are also needed for fuel. The fats in triglyceride-rich lipoproteins serve as a quick and easy energy source. I think in a damaged heart situation–heart attack–the fats from triglycerides may be life-saving.
      DrB

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    Clint Summer

    I’m very glad to see your blog post, Dr B. I’ve been following your writings for some years, and recent news I’ve seen made me concerned for your well being. I wonder what you think of information such as what’s presented on this web page: http://healthimpactnews.com/2015/is-the-u-s-medical-mafia-murdering-alternative-health-doctors-who-have-real-cures-not-approved-by-the-fda/ (I’ve heard that 8 or 9 doctors or other alternative medical professionals have died or disappeared.) This leaves me wondering whether it’s safe to speak the truth about pharmaceuticals in this country. I wonder what you think.

    • Author Icon
      David Brownstein

      Clint,
      My mother voiced the same concerns. Here’s how I responded to my mother. I quoted Edmond Burk who said, “The only thing necessary for the triumph of evil is for good men to do nothing.”
      My mother responded by telling me just be careful.
      We all need to speak out about the wrongs of the world.
      DrB

  • Author Icon
    John Pindorski

    There is ample scientific evidence that a whole foods, plant based diet can stabilize and even reverse blockages in heart arteries. Dr. Dean Ornish has published on this as well as Dr Caldwell Esselstyn from the Cleveland Clinic. This vegan – no oil life style would, I assume, naturally lower your triglycerides and LDL-cholesterol. I know for me personally, I followed Ornish’s protocol after having 4 x CABG surgery in 1993 and still taking 6 or 7 sub lingual nitrostats every day. After 6 months I was taking zero nitrostats and got to the point where vigorous exercise and hard work were possible. So I’m very confused by this study.

    BTW, I’ve been on statin drugs, first Pravachol and now Lipiitor for the past 25 or so years with no side effects. My latest LDL was 67 with triglyceride around the 100 mark.

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    Mort

    Dr B. Please review and comment. I just read the Abstract of that study. I have been weaning myself off statins for some time.
    The way I read that abstract is there appears to have been a study of critical care Hospital MI patients who had NO INTERVENTION and only drugs consisting of statins for 30 days.
    That seems almost incredible to me because it is hard to believe no STENTS and no open heart surgery was performed as INVENTIONS for those patients in a UNIVERSITY hospital, unless they were there as specimens for testing.
    Please comment.

    • Author Icon
      David Brownstein

      Mort,
      It was a non-interventional observation study.
      DrB

  • Author Icon
    Kat

    But I thought you wrote that CHF patients treated with Testosterone and DHEA was it? will show immediate improvement in cholesterol levels. So this news now makes it a trade-off?

    • Author Icon
      David Brownstein

      Kat,
      Testosterone and DHEA are DOWNSTREAM from where cholesterol is produced. Higher cholesterol levels can lead to elevated testosterone and DHEA levels, not vice versa.
      DrB

  • Author Icon
    Marie

    Dr. B.,

    My husband’s health history is as follows:

    doesn’t smoke or drink, not overweight, no high cholesterol levels. BUT, at the age of 40 he had a near death scare and ended up having a triple bypass – left main artery was 90% blocked along with 2 other blockages. 7 years later he had another issue with chest pain, etc… RCA was 90% blocked in 2 places – 2 stents were put in. 6 months later has more problems, and the RCA has another 99% blockage leading to another stent. He is now on 80mg Lipitor 1 per day and 90mg Brilinta 2x per day as well as an aspirin. I read the book ” The Cholesterol Myth” and he wouldn’t read it. It explains the same things you explain and makes perfect sense. I am doing all I can to encourage him and be positive, cook healthy meals etc.. but ultimately it is his choice and he seems to want to stick with the western doctors plan of care. I think you know my concern here. Is there anything I can do to help negate the side effects of these meds? Thank you for all you do!

    • Author Icon
      David Brownstein

      Marie,
      I would at least take CoQ10 along with statins. And, I would encourage having his hormone levels checked particularly testosterone and DHEA. I describe this in my book, The Miracle of Natural Hormones.
      DrB

  • Author Icon
    Edward Sullivan

    As an alternative healthcare provider I take four thousand Mg of Vitamin C daily ( which does lower cholesterol) and recently had my cholesterol levels tested and had 185 mg/dl . My primary MD plus a cardiologist still believes I should take a statin drug despite the 185mg/dl. Figure that one out! Statin drugs besides causing liver, brain, mucusle pain problems can also cause diabetes and cancer. Statin drugs for lowering cholesterol block the mevalonate pathway which is the same pathway used by cells to make cholesterol as well as used by cells for growth and division. When cholesterol regulation is blocked then cancer can follow. While vitamin C does lower cholesterol levels somewhat it does not block the mevalonate pathway nor causes cancer.

    • Author Icon
      David Brownstein

      Edward,
      Well said.
      DrB

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    Dee

    Dr. Browstein,

    I think I found it – where you mention that mean life expectancy is no different for those with hypercholesterolemia, and that you see healthy patients with levels in the 300s?

    My problem is that my total cholesterol is closer to 500, with a strong family history of heart disease and stroke. No triglyceride or blood sugar/insulin problems even by functional standards. I’m very thin and basically eat a Paleo diet, mostly grass fed and organic, and a moderate amount of fruit, not too heavy on the meat.

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    Dee

    Thank you for responding Dr. Brownstein. I’m sorry I didn’t find anything before about natural treatment for familial hypercholesterolemia (I don’t want to take statins). I will try searching again.

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    Dee

    Thank you for sharing this information. I believe low cholesterol levels can be very dangerous. I recently spoke about this with one of my siblings, who has borderline low cholesterol, she is the only one in the family who does not have severely elevated cholesterol levels.

    I am wondering why my previous comment was not allowed? I did ask for advice about the opposite problem.

    • Author Icon
      David Brownstein

      Dee,
      I answered the same basic question (at least I thought I did) for someone else–you can find it in the list.
      DrB

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    Shane Owens

    In fact, lower LDL-cholesterol less than 62.5mg/dl and triglyceride less than 110mg/dl were identified as optimal threshold values for predicting 30-day mortality. The lower LDL-cholesterol level was associated with a 65% increased mortality and the lower triglyceride level was associated with a 405% increased mortality. Furthermore, as compared to patients with LDL-cholesterol levels >110mg/dl and triglycerides >62.5mg/dl, those with lowered LDL and triglyceride levels had a 990% (or 10.9x) increased risk for mortality.

    Am I reading this correctly? It appears the numbers for LDL and Triglycerides may be reversed in these sentences.

    • Author Icon
      David Brownstein

      Shane,
      Oy–two typos! My bad, again. You were right. Sorry for the mix up.
      DrB

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    Mj

    “The patients with the best results are the patients who take an active role in their health care decisions and educated themselves about the risks and benefits of any treatment.” may be true IF YOU NEVER ARE IN THE HOSPITAL ….

    ONCE YOU ARE IN THE HOSPITAL, ALL THAT EDUCATED PREPARATION OF YOU AS THEIR PATIENT, WILL BE NEGATED BY THE ATTITUDE OF THOSE IN CHARGE…. you will be subjected to the medical mafia’s opinions and some of those MDs will INTENTIONALLY HARM PATIENTS WHO CHALLENGE THEIR PRESCRIBING…….. guaranteed, we’ve seen that EVIDENCE REPEATEDLY……

    We’ve been considering the idea of setting up a service that employess a PRIVATE NURSE FOR THE GROUP authorized to arrive with subscribers at the hospital if the subscribers are ever in an EMERGENCY event that puts them in the hospital. Each member would be responsible for finding a suitable MD when they subscribe, even if it requires arms-length relationships online with an MD of their chosen hippocratic philosophy.

    The protection would be better but we’ve even seen hospital MDs engage police and courts to separate patients from their own chosen doctors not in that state……. more to work on……. ttyl

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    James

    Shane Ellison, a biochemist and former drug maker for Merck and others has also debunked the low cholesterol myth. However he notes that high triglycerides are indeed damaging to the body. My conclusion is that low cholesterol and low triglycerides aren’t implicated together.

    Would you read this entry on his blog and provide your opinion as it contrasts with yours but just in reference to triglycerides?

    Thanks
    James

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    Gail

    Yikes–I have been battling LOW cholesterol levels for years. My TOTAL cholesterol is down to 132 and I’m very, very upset about that. I have talked with doctors, nutritionists, alternative care providers–NO ONE can tell me how to raise my cholesterol. Frustrating and very scary–does anyone have any ideas?? I’d be so grateful for some help! Thanks…

    • Author Icon
      David Brownstein

      Gail,
      Diet can help–eating a low-carb diet is useful. Also, a liver cleanse can help.
      DrB

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    Gudrun Schindler

    I have a friend who says she absolutely has to take statin drugs because she is diabetic. None of the reasons why statins are bad apply to her. Having diabetes makes her a totally different case.
    Is this correct?

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      David Brownstein

      Gudron,
      Statins cause diabetes!!
      DrB

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    Eric aragon

    So , what are optimal levels of each?

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      David Brownstein

      Eric,
      Good question. There is not a ‘perfect’ level for everyone. However, I feel, for most of us, a cholesterol level over 150mg/dl is beneficial. For those over 65 years, the higher the total cholesterol, the longer they will live (statistically).
      DrB

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    Judy

    mj, I think you bring up a excellent situation about what happens when you end up in the hospital, or ER, or even with
    ‘your MD if you don’t have a holistic, etc. type of Dr.

    Hope someone actually can figure out a workable way to solve this problem. Please let me know of any solutions!

  • Author Icon

    “50% of what we taught you was wrong.” I was told the exact same thing when I graduated from Hahnemann Medical College in 1978. Like you, I soon realized that way more than half of what they taught us was wrong. I practised orthomolecular (nutritional) medicine, and eventually became a homeopath. Bonnie Camo MD

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    Barbara

    This confused me too.

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    Pat

    Dr. Brownstein – what are your thoughts on someone who has been prescribed statin drugs after a heart attack. So many articles/books address preventative methods and the avoidance of statin drugs prior to any heart surgery or heart conditions, but what would be your recommendation for post cardiac surgery. Are there alternative treatments for someone who has already suffered a heart attack to avoid statins? TY.

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      David Brownstein

      Pat,
      You are referring to taking a statin drug to prevent a secondary problem. This is referred to as secondary prevention. In my book, I describe how statins, in the best of the studies, have been found to have a 3% benefit when used in secondary prevention. In other words, they fail in 97% who take them for secondary prevention.
      DrB

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    Rita Romney

    I caught that also and it was confusing to say the least. I know Dr. Brownstein will fix it pronto.

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    R. Stone

    I was reading this sentence and it didn’t make sense:

    The authors found that those with higher LDL-cholesterol and triglyceride levels had a significantly elevated mortality risk when compared to patients with higher LDL-cholesterol and triglyceride levels.

    Is this a typo?

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      David Brownstein

      Yes. Sorry for that. I have corrected it.
      DrB

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    Alechandro

    Indeed. I believe the first “higher” was meant to say “lower”. confused me as well as foist

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      David Brownstein

      You are correct!
      DrB

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    Dr. Lee Ann

    I think there may be an error is the most pivotal sentence: The authors found that those with higher LDL-cholesterol and triglyceride levels had a significantly elevated mortality risk when compared to patients with higher LDL-cholesterol and triglyceride levels.

    You basically say higher LDL vs higher LDL; I imagine one of these is meant to be LOWER LDL…

    • Author Icon
      David Brownstein

      Again, thanks. My wife saw it BEFORE I published it and I forgot to change it!
      Oy.
      DrB

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