Drs. Oz & Roizen: Prevention with a Pill

Our basic premise is: Your body is amazing. You get a do over: it doesn’t take that long, and isn’t that hard if you know what to do.

In these notes we give you a short course in what to do so it becomes easy for you and then to teach to others. We want you to know how much control you have over your quality and length of life.

We’ve been asked just about everything in our combined 64 years of medical practice, and recently we were asked by AARP The Magazine about statins in the water supply (especially for older folks like Dr. Mike). Our answer: Despite their being the top-selling drugs in the world, you may want to find alternatives to putting statins in your water supply.

Statins prevent thousands of deadly strokes and heart attacks (not to mention episodes of impotence) every year by lowering artery-clogging LDL cholesterol, and some brands also raise plaque-clearing HDL levels. Statins work by shutting down the body’s LDL factory and increasing HDL to clear that lousy LDL cholesterol from your blood vessels. In a landmark move this year, the FDA expanded its criteria and approved the use of statins for people with normal cholesterol levels, even those without obvious risk factors for arterial disease, like family history or type 2 diabetes. This means statins can now be prescribed as preventive medicine to people at risk for cardiovascular disease. But should they? Relying on a pill may mean prevention is moving in the wrong direction. We’ve been advocating prevention based on lifestyle changes that offer proven, long-term benefits.

The new recommendations are based on research from the latest trial, which looked at men over 50 and women over 60 who had normal cholesterol levels, but high levels of C-reactive protein.

We worry about inflammation because it ages you from the inside out, like a bad sunburn to your internal organs and blood vessels. People with high levels of inflammation are at greater risk for heart attacks, strokes, auto-immune disorders and other maladies. The trial found that men over 50 and women over 60 who took a statin for about two years had a 44 percent lower risk of heart attack and stroke compared to those who did not take a statin. The findings were so compelling to the study evaluation committee (a group organized independently of the docs doing the study and the sponsors) that the trial was stopped with the conclusion that most individuals with elevated C-reactive protein should receive a statin if they are over 50 or 60. Because of these data, the FDA voted to approve the use of statins for this expanded use. That move has sparked controversy.

With “the Enforcer” e-coaching program (on The Dr. Oz Show and Dr. Mike’s PBS specials) we’ve witnessed dramatic benefits in more than 125 individuals who made lifestyle changes to get their LDL cholesterol levels way down, or HDL levels way up, without any drugs. You might have even seen how Rocco, the meat-loving cowboy, got rid of his type 2 diabetes and hypertension, and pulled plaque from his coronaries. With a Mediterranean diet low in saturated fat, along with 30 minutes of brisk exercise three to five days a week and meditation, many of our Enforcer e-coaching patients have seen remarkable improvements in cholesterol levels, waist size, blood sugar levels and overall energy.

Statin therapy alone (with the exception of rosuvastatin) does little to raise levels of healthy HDL cholesterol, and all statins come with risks such as muscle pain. Recent studies have even found a 9 percent increase in type 2 diabetes among statin users. Because of these risks and other concerns, it’s unlikely we’ll see statins tossed into the water supply right away.

But there are other purported benefits under study, like reduction in memory loss, which may make them more universally used. Not everyone with normal cholesterol should be treated with statins, but they are a good option for people with high enough risk for heart disease. Furthermore, most people who start taking a statin will be on drug therapy for the rest of their lives, so it’s not a decision you should take lightly. Too many people on statin therapy fail to change the unhealthy habits that landed them on the drug in the first place. That’s why—statin or no statin—the healthiest decision you can make for your heart and your body is to implement healthy lifestyle changes today.

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