Can’t I Just Take a Pill to Get My Cholesterol Down?

“Can’t I just take a pill to get my cholesterol down?”

A middle aged man said this to me recently in the office.  He has cravings for double chocolate ice cream sundies 3-4 times a week.  He has known heart disease with a previous stent placed in one of his coronary arteries.  His bad cholesterol, LDL, was elevated and his belly was quite large.

Normally as cardiologists we try to reduce the LDL cholesterol to well below 100mg/dl.  Ideal is somewhere between 50-70.  Studies show that people in cultures that have very little or no heart disease, the LDL cholesterol is exceedingly low.  Just as it is in all newborns.   It can be as low as 35-50mg/dl.

Eating saturated fat from animal products has been show to be a key reason that people have high LDL cholesterol levels.  Many other things play a part in getting heart disease but improper eating is very crucial.  A large belly has been shown to cause elevated insulin levels that can help lead to heart disease.

So what can we say to someone who:

1.  Has had a heart attack

2. Has a high LDL

3.  Is already on medications

4.  Wants to take a pill rather than giving up his ice cream.

You know the analogy I like to use relates to a car.  I often say, “If you have a car that runs on regular gasoline and you’ve been putting kerosine in it and of course its not working the way it should.   What do you think is going to eventually happen to your car?

Of course, no one would do this with a car.  Everyone understands that an automobile has to have the proper oil, care, and fuel to make it run properly.  So why don’t people understand this about their bodies?

Heart disease is 90% preventable- 90% of all CAD, Coronary Artery Disease, can be prevented with proper diet, exercise, and relaxation techniques.

A health care crisis is upon us.  Yet, very few people are interested in taking the steps needed to prevent illness.  Andrew Weil, M.D. a guru of integrative medicine suggests that we need to really examine the medical system to get away from a disease management system and really embrace prevention (http://www.mydigitalpublication.com/publication/?i=29055)

I would agree.  Consider the costs of just knee replacement therapy.  Each year over 50 billion of dollars are spent on orthopedic surgeries related to Osteoarthritis, frequently caused by obesity (http://www.ajmc.com/supplement/endocrinology/2009/A235_09sep_Osteoarthritis/A235_09sep_Bitton_S230toS235). Knee replacement surgery is a big part of this cost.

Obesity is preventable.  Yet, it means that people have to take responsibility for their health care.

Last year, I highly recommended a yoga class to 50 of my patients who suffered from obesity.  I spent nearly 10 minutes talking to each and every patient.  I gave them literature and a phone number to call.

Did you know that not 1 patient even called the phone number?

Sad but true.

The number of people who were willing to spend $15 on a relaxation CD was none.  Yet, I would venture that most of those people were willing to spend $15 eating out.

Perhaps we can create a pill that will make people want to exercise.  This would be a good prescription to write.

I would then have a pill that could lead to prevention.