Wednesday, April 30, 2008


The ENHANCE Study widely discussed in the press and in the halls of Congress was reported as showing that Vytorin was a bad drug for heart disease.
The study compared Vytorin, which is a combination of a simvastatin (a statin) and Zetia (a drug that blocks cholesterol absorption), we have all seen the clever commercials, with simvastatin alone, both drugs at high doses.

The study measured the effect of the drugs on the thickness of the line of the carotid artery (CIMT); this measures the progress of arteriosclerosis.
The thickness of the lining of the artery increased in both groups, 0.0111 mm in the Vytorin group and 0.0058 mm in the simvastatin group.
LDL cholesterol, the so-called bad cholesterol was reduced by 58% in the Vytorin group and only 41% in the simvastatin group.

Lost in all the fuss about the delay in reporting the study is the fact that this study destroys the theory that “lower is better” which is the main mantra in the Temple of LDL.
If lower is better, then the Vytorin group should have had better results, they didn't.
Cardiologists from university centers either ignored this inconvenient truth or lamely try to explain it away.

Eric Topol M.D. famously ran out of the Cleveland Clinic for daring to speak out against a drug produced by a company, which heavily supported the Cleveland Clinic, was the only one who said that we should rethink our worship in the Temple of LDL.

Overwhelming evidence shows that heart disease is caused by low-grade inflammation.
Statin drugs do lower LDL cholesterol, statin drugs do help reduce heart attacks in certain groups of people. But this effect occurs, long before the LDL is lowered. Statin drugs have been shown to have an anti-inflammatory effect.

Marketing has triumphed over medicine and stifled the progress in understanding and eliminating heart disease. There is beginning to be cracks in the Temple of LDL.