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129 of 137 people found the following review helpful
5.0 out of 5 stars A tribute to proper science, 6 Feb. 2007
This review is from: The Great Cholesterol Con ~ The Truth About What Really Causes Heart Disease and How to Avoid It (Paperback)
Despite monumental efforts, cardiovascular disease is still the leading cause of disability and death in many countries. The Great Cholesterol Con by the British physician Dr Malcolm Kendrick will be a very discomforting piece of literature for many of his colleagues. For in this groundbreaking work, Dr Kendrick shows painfully clearly that the medical establishment has been chasing the wrong enemy for over four decades, while the real villain has been staring them right into their faces.

In the first chapters, Dr Kendrick uses plain textbook biochemistry to show that there is no such thing as a `cholesterol level', that there is no thinkable way for the bogyman LDL to cause arterial plaque, that the idea that the `good' HDL could reverse plaques by breaking out incorporated LDL is a perfect example of magic thinking and that the ingestion of saturated fat can not have any influence at all on the amount of any lipoprotein floating around in the blood stream. He presents statistics from the WHO ("Not the pop band, but the World Health Organisation") that show that countries with the lowest saturated fat intake invariably have a much higher cardiovascular heart disease mortality than the countries with the highest saturated fat intake.

After describing in detail why statin therapy probably does more harm than good in the general population, Dr Kendrick explains the observation that people with inherited super high LDL levels (familial hypercholesteraemia or FH) indeed do have a substantially increased risk of dying of cardiovascular disease. In the land of FH, children aged ten die of massive heart attacks (although others live happily to be 104...) Even to those who clearly understand that the cholesterol hypothesis must be utter bonkers, made up in the minds of the worlds most gifted fairyologists, this has always been a hard nut to crack. To many doctors, the excess pathology in the FH population is the kind of Aha experience that overrules all the contradicting evidence. Children aged five get massive heart attacks, aha! Astatinate, astatinate! Aha!

To speak with Dr Kendrick: "And Aha to you too!" Once again, it's not what it looks like. Actually, it's a hell of a lot more complicated than so. To begin with, many individuals with FH not only have elevated levels of harmless LDL, they also have higher levels of lipoprotein a, most often called Lp(a). This is ordinary LDL, with a slightly different protein coat. Lp(a) - which is never measured in ordinary cholesterol tests - is the only cholesterol containing vehicle that actually is atherogenic. Extremely so. It is a potent clotting factor. Once incorporated in clots, it makes them as robust as concrete, keeping them out of reach for natural clot dissolving agents. Secondly, many hypercholesteraemiacs (but not all of them) suffer from a whole range of other clotting abnormalities. These people should be identified and subsequently treated for their life threatening clotting disorders, not for their elevated LDL levels.

Then what is it that really causes this dreaded `killer of the Western world'? Well, a huge part of the cause is in our brain, or more precisely, in our nervous system. Perceived stress - especially the prolonged stress brought on by social dislocation, lack of control, insufficient reward - disrupts the HPA-axis: an intricate and highly complicated set of hormonal feed back loops that allows us to properly deal with life's challenges. By constantly pushing the HPA-axis over the edge, we are effectively giving ourselves various degrees of `Cushing's Disease,' a malady characterised by chronic overproduction of the stress hormone cortisol. Cushing's Disease, invariably ruins the cardiovascular system. This is well documented. The sub clinical form - which is induced by such apparently unrelated stressors as smoking, cocaine or steroid abuse, discrimination and spinal cord injury - is no less dangerous. Kendrick explains exactly how this works. His model also for the first time explains the distribution of cardiovascular heart disease in time and place. Why did the Fins once have the world's highest heart disease mortality? Did anybody know that Finland endured the greatest forced relocation in the recent European history?

Once you have read the first lines, you will read the whole book, probably right on the spot. It is extremely information dense, so it definitely helps that Malcolm Kendrick is one of the better writers of our time, gifted with an ultra dry Scottish wit. I challenge everybody in the field - cardiologists, GP's, lipid researchers, health insurers, nutritionists and journalists - to carefully read this book and shoot at its flaws.

I expect a deafening silence. It requires a great deal of courage to admit that one plus one is two, when you have always maintained it is three.

Melchior Meijer
Medical reporter
The Netherlands
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Showing 1-1 of 1 posts in this discussion
Initial post: 3 Nov 2011 15:01:19 GMT
Mr Nigelson says:
Wish that I could write so passionately and articulately as you do. Compelling argument, insightful summary, brilliant.
Not even your mother tongue I would guess from your name?
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