A long awaited study – the Enhance study – indicates that the combination medicine Vytorin not only doesn’t stop the growth of plaque but may actually increase it, which isn’t particularly pleasing to Merck and Schering-Plough, the pharmaceutical giants that make the drug.

We’ve all seen the annoying commercials ad naseum. Cholesterol comes from two sources: Fettuccine Alfredo and your grandfather, Alfredo. The various people from whom you’ve allegedly inherited your tendency are dressed in outfits that kind of match the look of the foods that cause your cholesterol to increase. If you’ve been lucky enough to have avoided these ads, I’ve included one at the bottom of this post so that you can be as annoyed as the rest of us. I never watch TV other than the occasional football game (or in the case of this past weekend, every NFL playoff game), and I’ve seen the Vytorin commercials countless times. I’m sure it’s one of the most heavily run ads on TV.

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A recent study published in the online journal Lipids in Health and Disease demonstrates that low-carbohydrate diets act in much the same way statin drugs do to reduce cholesterol.

Before we delve into what this study shows, let’s take a moment and discuss the synthesis of cholesterol in the body.

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I received an email today containing the December edition of the E-newsletter from the International Atherosclerosis Society. Right there on the first page was a announcement for a new book and a link to Amazon.com for it. The new book is

Hyperlipidaemia: Diagnosis and Management – 3rd Edition

The review of this book states the following: Read more »

The last post I wrote was on statin drugs and the couple before that were on the many benefits of vitamin D, one of which is the prevention of heart disease. According to a number of papers, statin drugs seem to increase levels of vitamin D in those who take them, which makes me wonder if any benefits that statins provide don’t come from this increase in vitamin D levels. If so, it would be a whole lot cheaper and a whole lot safer to simply take vitamin D3 supplements.

This issue reminds me of a talk on the mechanism of action of statins that I sat through at a medical meeting in Napa, California about 10 years ago. At that time researchers knew that along with their cholesterol-lowering capabilities statins also acted as anti-inflammatory agents. Statins increase the production of nitric oxide, an extremely short acting substance that has relaxing and anti-inflammatory effects on the lining of the arteries. The researcher giving the talk was from Harvard, and he had done a study in which he compared the nitric oxide releasing ability of l-arginine (an amino acid) and a statin drug. He found that the way that statins increased the production of nitric oxide mimicked the way l-arginine did the same thing. He proudly announced that his research showed for the first time how statins really worked to exert their anti-inflammatory effects. I wondered at the time why he didn’t just recommend that patients be given l-arginine – a natural substance with virtually no side effects – instead of statins? I would have asked the question, but this was a mainstream medical meeting, and I figured if I asked that question I might be stoned.

Thanks to this and subsequent research, we know that the anti-inflammatory benefits provided by statins can be had cheaper and more safely by taking l-arginine, available at health stores everywhere. ( Incidentally, know what the best natural source of l-arginine is? Wild game. Just another piece of evidence in favor of a Paleolithic diet.) And now we know that statins increase production of vitamin D, another heart-healthy substance.

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MD and I are safely ensconced in Dallas after a flawless U.S. Air flight that even involved a connection that went smoothly. I’m still immersed in comment hell, but I’m working through them (about halfway, so far). I’m going to give it my best effort to get completely caught up by Christmas.

While zipping through the winter skies I got caught up with a lot of my reading that had stacked up while I was in New York. Buried deep within one of the sections of last week’s Wall Street Journal was an article about a lawsuit against Pfizer, the maker of Lipitor. It seems that one of their own is turning on them.

According to the lawsuit, a former employee, Dr. Jesse Polansky, who was the former director of outcomes management strategies from 2001 to 2003 got the boot because he complained to his superiors about marketing practices he considered improper. What marketing practices? Well, for starters, the Pfizer physician education campaign that
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