The definition of high cholesterol may be changing again soon – but what does this really mean? Is someone just trying to sell us more drugs?

I've been checking out exposes of the pharmaceutical industry. According to authors Moynihan and Cassels, experts who write the guidelines get paid substantial sums of money by companies that sell cholesterol-lowering drugs. And once every 5 or 10 years, the guidelines get updated to recommend that millions more Americans get treatment for high cholesterol. The next report is due in spring 2010. See http://www.nhlbi.nih.gov/guidelines/cholesterol/atp4/index.htm.

Statin drugs are effective in lowering cholesterol levels in the blood. But they have risks as well, including damage to the liver and muscles. For complete warnings, see http://www.pfizer.com/files/products/uspi_lipitor.pdf. Warnings for Lipitor's competitors are similar, and are available on each of their web sites.

Cholesterol, on the other hand, is not a problem as long as it stays in the blood. The health risks occur when lipids precipitate out of the bloodstream to form deposits on the artery walls. Oxidation is a key step in this process. Thus, antioxidants from a healthy diet may give you more protection than drugs if your cholesterol is not extremely high. See http://vrp.com/articles.aspx?ProdID=art2423&zTYPE=2.

And how high is that? Today (May 2009), total cholesterol between 200 and 240 is considered borderline (http://www.nhlbi.nih.gov/guidelines/cholesterol/atglance.pdf). Next year, the definition may change. Be sure to consider whether the risks of high cholesterol outweigh the risks of drug treatment.

by Linda Fugate, Ph.D.

References:

Ray Moynihan and Alan Cassels, Selling Sickness: How the World's Biggest Pharmaceutical Companies are Turning Us All into Patients, Nation's Books, 2005.

Marcia Angell, The Truth About the Drug Companies, Random House, 2005.

Jerry Avorn, Powerful Medicines: The Benefits, Risks, and Costs of Prescription Drugs, Random House, 2004.