Why LDL Cholesterol Won’t Predict Your Risk of Heart Attack, But This Will...

If you have a family history for heart disease and see a doctor these days, in all likelihood he/she will place the major focus on cholesterol. Specifically, your LDL cholesterol.

But is this really the best approach to prevent heart disease? Is there a better, more accurate way to learn about your risk and prevent a heart attack?

It turns out, that when predicting who is going to have a heart attack and who isn’t, monitoring LDL cholesterol levels is virtually a complete waste of time.

But one study shows a much better way.

To do the study, scientists enlisted the help of a group of men and women who had no history or symptoms of heart disease, but who did have elevated LDL cholesterol and a coronary calcium score greater than 30. Coronary calcium scoring (also known as a Heart Scan) is a specialized CT scan of the heart. Unlike other CT exams, it uses very little radiation. The exam measures the amount of calcified plaque in the coronary arteries. The greater the amount of calcium, the greater the amount of plaque.

In essence, coronary calcium scoring is an effective, safe, easy, and inexpensive way to get an idea of how much plaque you have in your coronary arteries. After the researchers obtained the coronary calcium scores, they put the entire group on statin drugs. And then, for the next five-to-seven years, they monitored their LDL cholesterol levels and their calcium scores. Here’s what happened.

In the years following the initial scan, 41 of the participants ended up having a heart attack. And it turned out that measuring their calcium scores was an incredibly effective way to predict who was going to have a heart attack and who wasn’t.

The patients who had a heart attack had a greater than 15% annual increase in their calcium scores. That increase made them a remarkable 17 times more likely to have a heart attack. But the patients with less than a 15% annual increase in their calcium scores had a zero risk for a heart attack. And this was regardless of whether or not they had a high calcium score to start with. This makes the coronary calcium score the best way to predict risk for heart disease. But the LDL cholesterol levels were another story.

Unfortunately, for those cardiologists who still think that LDL cholesterol levels are a good way to predict who is going to have a heart attack, there was absolutely no difference in the LDL levels between the heart attack patients and the other 450 men and women who did not have a heart attack. Basically, the study showed that your LDL cholesterol is a completely useless marker for predicting your risk of having a heart attack. But why was LDL such a poor indicator of risk?

According to the authors of the study, we should not be too surprised. They point out that previous studies have shown that lowering LDL levels by taking a statin drug only reduces the risk of having a heart attack by 30-33%. That means that other factors are more than two times more influential than LDL levels. For example, compare it to exercise.

A 2016 study shows that those in the top levels of fitness reduce their risk of dying from a heart attack by a whopping 350%! That’s 10 times the effectiveness of statin drugs and with none of the toxicity, side effects, and potential for dementia and diabetes that can happen with the drugs.

When the authors of the study looked for a “potential explanation for the apparent failure of statin therapy,” they listed problems such as elevated Lp(a), small dense LDL, homocysteine, fibrinogen, and infections as factors in heart disease. Statin drugs don’t change any of these risk factors. And as to why the calcium score was so effective, they had this to say, “The first [reason] is that accumulation of cholesterol within a plaque could not be effectively halted with statin therapy, and that expansion of calcification was an indicator of continued plaque growth.” Basically, it means that the reason these patients had a heart attack was because the plaques in their arteries continued to expand and the statin drugs could do nothing about it. There are two morals to this story.

One, don’t rely on statins. They are nowhere near as effective as a regular exercise program, a healthy diet, stress reduction, hormonal restoration, and supplements such as QuickStart, which I describe in my book, Bursting With Energy.

Secondly, if you have a family history of coronary artery disease and want to know what your risk is, don’t measure your cholesterol. As this study shows, even your LDL cholesterol levels are a useless marker for heart attack risk.

Instead of cholesterol, ask your doctor to order a coronary calcium score. If it’s less than 30, relax, and don’t worry. Your risk is negligible. If it is greater than 30, repeat the test a year later, if it increases by more than 15%, it’s time to work with a doctor versed in heart disease prevention. You can find that doctor at www.acam.org.

Yours for better health,

Frank Shallenberger, MD