Cholesterol Wake Up Call

A wake-up call for Baby Boomers. That’s what many newscasters were calling the recent emergency heart surgery performed on former President Bill Clinton. But the underlying message was not: “Wake up and get heart healthy.” It was: “Wake up and take your drugs.”

Coincidentally, just one week before President Clinton was admitted to the hospital, a major new study on heart disease risk – reported in The Lancet – delivered just the opposite message: “Wake up and get heart healthy. No medication necessary.”

The Lancet study revealed specific details about heart disease risk that we wrote about years ago.

According to White House medical reports, President Clinton was taking the cholesterol-lowering statin drug Zocor when he left office in 2001. But after he lost weight and his cholesterol dropped, he stopped taking the drug. Naturally, this detail was pounced on by mainstream doctors who crowed, “See what happens when you don’t take your pills?”

ABC news stated that some cardiologists predict that Clinton “will have to take a much higher dose of a cholesterol-lowering drug for the rest of his life.” No surprise there. After a heart bypass, statin therapy is mainstream medicine’s recommended standard of care. But in a Newsday report, Dr. Valavanur Subramanian, chairman of cardiovascular surgery at New York’s Lenox Hill Hospital, noted that two of the three arteries used in Clinton’s operation were mammary arteries, taken from his chest. Dr. Subramanian described these arteries as “extraordinarily resistant to cholesterol buildup.”

So you have to wonder; if the new arteries resist cholesterol so efficiently, then why put him on a high dose of statins?

The answer: Well… because that’s just the way they do it! But that’s only the start. According to Dr. Subramanian, Clinton’s doctors will probably also recommend taking a daily aspirin, along with a diuretic drug (to prevent buildup of fluid), and a beta blocker (to help regulate heartbeat). That’s an impressive and potentially quite dangerous drug cocktail, especially when you add up the known side effects.

The new study is titled INTERHEART, and the editors of The Lancet call it possibly the most “robust” study ever conducted on heart attack risk factors. About 15,000 heart attack patients were matched with the same number of subjects who had not experienced any heart problems. The subjects were recruited from all over the world, and were examined by more than 260 researchers who gathered data on a variety of heart disease risks for about a decade.

Here’s a “surprise”: the expected number one risk factor for heart attacks, either high cholesterol or elevated levels of LDL (the “bad” cholesterol), have not showed up among the top causes of heart attacks. According to INTERHEART, the factor that rates as the number one risk of heart attack is an unacceptable ratio of apolipoproteinB (apoB) to apolipoproteinA1 (apoA1). Apolipoprotein is cholesterol’s protein component. ApoB is the protein found in LDL, and apoA1 is found in HDL. The ideal apo ratio is one apoB to two apoA1. In other words, elevated LDL alone (the condition statins are used to treat) was not found to be a major factor in heart attack risk. It’s all about the APO ratio.

The INTERHEART study was launched more than a decade ago when the importance of other factors that put the heart at risk were not yet widely known; factors such as triglycerides, homocysteine and C-reactive protein. Hopefully an INTERHEART II study is underway that will take these elements into consideration. In the meantime, the factors that the INTERHEART team found to be most important after APO ratio were (from greater to lesser risk): cigarette smoking, diabetes, high blood pressure, excessive abdominal fat, stress, inadequate intake of fruits and vegetables, and lack of exercise.

In the conclusion to the study, researchers wrote that the relative risk for heart attack can be lowered by about 80 percent just by doing three things: eating plenty of fruits and vegetables, getting regular exercise, and avoiding smoking. Note that this list does not include statin drugs.

This is the REAL wake up call for Baby Boomers.

In a recent telephone poll of more than 1,200 adults called at random, nearly 70 percent said they were careful about what they eat either most or all of the time. But another poll of nearly 2,500 adults revealed that only 15 percent eat the recommended minimum of five servings of vegetables each day. And 60 percent of those surveyed said that eating only one to four servings of vegetables daily is adequate for a healthy diet. Only 12 percent said they eat five servings every day. In addition to five vegetables per day, the USDA recommends two to four daily servings of fruit. The recommended servings of both fruits and vegetables are expected to rise when the USDA releases its updated guidelines next year.

How would you answer those same poll questions? Do you believe your diet is healthy? Are you eating enough fruits and vegetables?

In the second survey, 80 percent of the participants said they expected to live at least into their 70s, and more than 40 percent expect to reach their 80s. But their chances for doing so probably aren’t realistic unless they start filling their shopping carts with fewer chips and crackers and more fresh produce.


  1. “Lessons Learned – Clinton’s Case Highlights Potential Dangers of Quitting Statins” ABC News, 9/7/04,
  2. “A Time-Tested way to Mend his Ailing Heart” Delthia Ricks, Newsday, 9/7/04,
  3. “Effect of Potentially Modifiable Risk Factors Associated with Myocardial Infarction in 52 Countries (the INTERHEART Study)”
    The Lancet, Vol. 364, No. 9438, 9/11/04,
  4. “Chill Out!” CBS News, 8/29/04,
  5. “New Test may Better Predict Heart Attacks” The Associated Press, 8/31/04,
  6. “Poll: Americans See Themselves as Healthy” The Associated Press, 9/8/04,
  7. “Americans Don’t Eat Healthy” The Associated Press, 8/23/04,
Author: Life Enthusiast Staff