Predicting Future Heart Attacks

Major Health Bulletin

Coronary Calcification Predicts Future Heart Attacks and Coronary Death.
Cholesterol Not Found To Be A Significant Risk Factor

By Bill Sardi

A striking report just published in the New England Journal of Medicine
indicates the accumulation of calcium in coronary arteries, and not
cholesterol, more accurately predicts a future heart attack or other heart
trouble, far more than cholesterol or other standard risk factors.

This report gives evidence of a major misdirection by modern medicine – the
creation of cholesterol phobia in the population at large. Prior studies
show use of cholesterol-lowering drugs does not reduce mortality rates for
coronary artery disease. This report follows a front-page report in Business
Week Magazine declaring cholesterol-lowering drugs to be of marginal value.

The study involved 6722 men and women, ~age 60, who were studied for a
period of 3.8 years (median). None had coronary artery disease at the
beginning of the study. Subjects who experienced an adverse coronary event
(heart attack, angina, placement of a stent, coronary death) were more
likely to be taking cholesterol-lowering drugs (~28%) than those who did not
experience such an event (~16%). Furthermore, subjects who experienced a
heart attack or angina had about the same total cholesterol (~199) as
subjects who did not (~194). Cholesterol barely met statistical significance
whereas calcium was a highly predictive factor.

Traditionally-used risk factors, such as C-reactive protein (a marker of
inflammation), triglycerides, HDL cholesterol and greater body mass, were
not predictive for a future coronary artery event.

Among subjects whose coronary artery calcium score was zero, their risk for
any adverse coronary event was only about one-half of 1% (0.0044), or less
than 1 in 200, whereas those with a coronary calcium score over 300, about
8.0% experienced an adverse event involving coronary arteries (0.0804), or
about 8 in 100, an 18-fold difference (1800%!), over the 3.8 year period.

This study shows the risk for a future heart attack is nil for those with a
calcium arterial score of zero. This data helps to explain why hundreds of
thousands of Americans experience a sudden-death heart attack with
low-to-normal cholesterol. Most heart attacks emanate in the four coronary
arteries that supply the heart with oxygenated blood. About 50% of arterial
plaque is calcium and only 3% is cholesterol.

Arterial calcium can be measured by use of a CT scan (called an Agatston
score, for Dr. Arthur Agatston, South Beach Miami, Florida cardiologist).
About 70% of white males, 52% of black males, 57% of Hispanic males and 59%
of Chinese males, have coronary calcium scores greater than zero. The
calcium arterial scores for women are about half that of males owing to the
fact they donate calcium to their offspring during pregnancy and lactation
and control calcium via estrogen throughout their fertile years.

Calcium begins to accumulate in coronary arteries in males as soon as full
growth is achieved, around age 18. Women begin to accumulate calcium in
their arteries with the onset of menopause or early hysterectomy. It was
recently reported that postmenopausal women who take calcium supplements
increase their risk for a heart attack by about 45%. [British Medical
Journal 2008 Feb 2; 336 (7638): 262-6]

In the early 1990s British cardiologist Stephen Seely noted that countries
which consume that highest amount of calcium (New Zealand, Ireland, North
America, Scandinavian countries), mostly from dairy products, have the
highest rates of cardiovascular disease. [International Journal Cardiology
1991 Nov; 33(2):191-8]

Sixty-four percent (64%) of subjects who experienced any coronary event were
current or former smokers compared to about 50% of those who did not
experience a heart attack or other adverse event. [Coronary Calcium as a
Predictor of Coronary Events in Four Racial or Ethnic Groups, New England
Journal of Medicine 358: 1336-45, March 27, 2008]

Copyright 2008 Bill Sardi, Knowledge of Health, Inc.

Thursday, March 27, 2008

News press ignores report showing cholesterol does not predict heart attacks

It’s been 30 hours since the New England Journal of Medicine issued its
online posting of articles in its most recent edition (March 26, 2008). One
report should raised eyebrows. Cholesterol did not predict future heart
attacks, coronary artery calcium did. In fact, arterial calcium was far more
predictive of a future heart attack than any other traditional measure,
including triglycerides, C-reactive protein or body mass index. But the news
media appears to be ignoring the report. The few news outlets that did cover
this story only reported on the calcium, not the cholesterol. WebMD, and the
National Institutes of Health websites called no attention to the
cholesterol finding but did report about the calcium. The Boston Globe, New
York Times, Atlanta Journal Constitution, failed to report it at all. The
American Heart Association also made no mention of the study. Is modern
medicine and the news media just going to ignore a report that could save
millions of lives? The report suggests a great misdirection by modern
medicine, with millions of cholesterol-phobic Americans misled over the
primary cause of fatal heart attacks. -Bill Sardi

Leave a Reply