Intensive
Therapy Means You Will Die Sooner
with Good Looking Numbers
I am
outraged that no serious action is being
taken by medical doctors to stop the
conscious killing of patients by the
pharmaceutical companies. Responsible
physicians need to stand up—we swore an
oath to protect our patients—to keep
their welfare as our highest
priority—not to safeguard the earnings
of any industry. Research over the past
four decades has consistently shown that
intensive drug treatment will lower
risk factors, such as
cholesterol, blood sugar, and blood
pressure; but will also cause patients
to die sooner, albeit, with better
looking numbers. So far, any changes in
medical practices resulting from all
this bad news have been imperceptible.
In fact, most of my colleagues, without
taking a single dime, readily come to
the defense of the drugs they prescribe,
and their manufacturers—the others take
a bribe.
In
general, people who have elevations of
cholesterol, blood sugar, and blood
pressure, known as risk factors, have a
greater chance of having heart attacks
and strokes in the future. These
elevated numbers are the signs of
disease, not actual disease. During my
forty years in the profession (I started
medical school in 1968), I have never
seen a patient die of high cholesterol,
high blood sugar, and/or high blood
pressure. These people die from rotten
arteries, manifesting as strokes and
heart attacks. Drugs won’t heal the sick
arteries. The reason pharmaceutical
companies sell drugs that treat the
signs of diseases is
they can. The reason they don’t
sell drugs that cure the
underlying diseases is they can’t.
To
compound matters, medications cause
“warning messages” to disappear, leading
many people to a false sense of
security. As a direct result, they fail
to take appropriate actions to improve
their diets and lifestyles—measures that
would make real differences. During
patient interviews (a history I take
when people come to my 10-day, live-in
program), I often notice that the
“disease portion” of their data sheet is
left blank, while their medication list
is extensive. I ask, “Why have you left
this section about your diseases blank,
when you are taking three medications
for high blood pressure, two for
diabetes, and a statin?” Their answer:
“I don’t have these problems anymore,
since I started taking these drugs.”
They believe they have been cured
because the “warning messages” are gone.
But this deduction is contrary to
common sense and the results of
extensive scientific research.
Aggressive Treatment of Diabetes Kills
Diabetic
medications are approved for market
based upon their ability to lower blood
sugar levels, not based on any
improvements in the quality or quantity
of the patients’ lives. A popular
diabetic medication, Avandia (rosiglitazone),
given at a dosage of 4 mg twice daily,
on average, decreases hemoglobin A1c by
1.5 percentage points, reduces fasting
plasma sugar by 76 mg/dL (4.22 mmol/L),
and reduces insulin resistance by 25%.1
Urinary protein excretion also decreases
significantly. Logically, these
improved
numbers
should mean healthier patients, but they
don’t. On May 21, 2007 the New York
Times reported, “…patients taking
Avandia had 66 percent more heart
attacks, 39 percent more strokes and 20
percent more deaths from
cardiovascular-related problems.”2,3
That same day the FDA issued a Safety
Alert on Avandia. Paradoxically, this
study funded by Glaxo, was called “the
DREAM study,” (an acronym for Results of
the Diabetes REduction Assessment with
ramipril and rosiglitazone Medication).
In reality, the nightmare for patients
continues as this toxic drug is still
marketed aggressively to patients and
their doctors.
On
February 6, 2008 the National Heart,
Lung, and Blood Institute (NHLBI),
stopped the ACCORD study
(Action to Control Cardiovascular Risk
in Diabetes) when results showed
that intensive treatment of diabetics
increases the risk of dying compared to
those patients treated less
aggressively.4 Patients in
the intensive group were sometimes
taking four shots of insulin and three
pills daily, and checking their
blood-sugar levels four times a day. The
goal of intensive treatment was to make
the patients’ blood sugar numbers as
close to “normal” as possible, as
measured by a hemoglobin A1c. (This test
reflects long-term sugar control).
Those with the “better numbers” died
more often.
The DREAM
and ACCORD studies are not the first
time aggressive treatments with insulin
and diabetic pills have been reported to
harm and kill people. Since 1972, the
Physicians Desk Reference (PDR)’s
descriptions of every diabetic pill have
included two paragraphs in heavy black
print that begin with: “Special
Warning on Increased Risk of
Cardiovascular Mortality.” Even more
scandalous, three major studies
published between 1996 and 2000 have
shown more weight gain, higher
cholesterol, triglycerides, and blood
pressure; and more heart disease,
stroke, and/or death with “aggressive”
treatment compared to less treatment.5-7
Diabetic Treatments
Increase Heart Disease
Unfortunately for the
patient, the doctors, and
the drug companies,
“anti-diabetic
treatments”—pills and
injected insulin – are
actually
“anti-diabetic-patient” in
the sense that they commonly
hurt the customer. Consider
the results of these major
studies:
-
The Diabetes Control
and Complications Trial
(DCCT) is the
largest study done to
show the effects of drug
therapy on diabetics.5
Six and a half years of
treatment with intensive
insulin therapy for
type-1 diabetics
resulted in more weight
gain, as well as higher
cholesterol, LDL (bad)
cholesterol,
triglycerides and blood
pressure compared to
people treated less
aggressively. As
expected from the rise
in cholesterol, there
was an increase in the
risk of heart disease
and stroke for the
intensively treated
patients.
-
The Veterans Affairs
Cooperative Study in
Glycemia Control and
Complications in NIDDM
study showed an increase
in cardiovascular events
in those receiving
intensive therapy.6
In this research paper
diabetic patients with a
history of a heart
attack were studied, and
those treated with
insulin or diabetic
medications had an
increased risk of death.
-
In a large European
study, The TRACE
Study Group,
investigators found
diabetic patients with a
history of heart attacks
treated with diabetic
pills and/or insulin had
almost twice the death
rate as those diabetics
treated with diet alone.7
Diabetics treated
without medications
(diet only) had the same
death rate as people
without diabetes.
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Aggressive Treatment of Cholesterol
Kills
Worldwide,
the number one prescribed medications
are statins for lowering cholesterol.
Doctors have been so seduced by
provocatively dressed, attractive, young
female “drug reps,” and the “science,”
that many have come to believe that,
“these drugs are of such great public
benefit that they should be put into the
drinking water for everyone to consume.”
In truth, their benefits have been
established only for people with very
high risks, such as patients with a
history of previous heart surgery, heart
attacks, and/or strokes.8
Hardly mentioned are the serious side
effects, including death, and the fact
that these drugs are approved for market
based upon their ability to lower
cholesterol levels, not based on any
improvements in the quality or quantity
of the patients’ lives.
Vytorin, a combination of
Zocor (a statin which blocks cholesterol
synthesis) and Zetia (which blocks
intestinal absorption of cholesterol),
rocketed to the third best-selling
cholesterol-lowering medication soon
after its introduction in 2004. In
2007, Vytorin was a $4 billion-a-year
treatment, but sales should be slightly
off for 2008. After withholding the
results from the public for nearly two
years, on January 14, 2008, the company
Merck/Schering-Plough Pharmaceuticals,
announced, under pressure from the US
Congress, that even though patients
taking Vytorin dramatically lowered
their cholesterol levels, they achieved
no improvement in survival, compared to
Zocor alone; and doubled the thickness
of their arteries (intimal-media
thickness).9 This
thickening is associated with an
increased risk of stroke and heart
attacks. Not coincidentally, Zocor, ran
out of its patent protection in June of
2006. For damage control, one week after
this report on Vytorin,
Merck/Schering-Plough Pharmaceuticals
ran full two-page ads in newspapers
worldwide.
Aggressive Treatment of Hypertension
Kills
Anti-hypertension drugs are approved for
market based upon their ability to lower
blood pressure levels, not based on any
improvements in the quality or quantity
of the patients’ lives. Over the past 22
years, multiple studies have shown that
aggressive treatment of hypertension
with a goal of making the numbers look
normal (110/70 mmHg or less), increases
the patient’s risk of heart attack,
stroke, brain damage, and/or death.10,11
The phenomenon is known as the “J-shaped
curve of mortality.” Meaning: lowering
the pressure to a certain point is
beneficial (that is the first part of
the “J” shape), but beyond that point of
reduction, the patient is harmed (the
second part of the “J”). This harm is
found with both systolic (top number)
and diastolic (bottom number) pressure
changes. Based on solid research,
diastolic blood pressure should not be
reduced below 85 mmHg by medications.12
In June of
2006 an extensive review of the data on
22,576 patients with heart disease and
hypertension was published. When treated
with medications, the incidence of heart
attacks, death, and/or stroke was three
times higher for patients with a
diastolic blood pressure of 60 mmHg
compared to a pressure of 80 to 90 mmHg.10
Another study of the elderly found a 14%
increase in strokes in those whose
diastolic pressure was lowered by only 5
mmHg with medications (starting average
of 177/77 mmHg).13
Furthermore, the brain function in the
elderly is impaired by intensive
treatment of blood pressure with
medication.14 This loss of
intelligence may be permanent in some
cases.
Why
Does Intensive Therapy Kill?
You might
expect the results of pharmaceutical
treatments for chronic disease to be
neutral, because the therapies are
directed at risk factors rather than the
underlying illnesses. Not so—the more
intense the treatments, the worse the
outcomes. Medications have serious,
sometimes fatal, side effects—but this
is only a small part of the answer.
The most
important reason intensive therapy kills
is that drug treatments, which focus on
the signs and symptoms of disease, are
counterproductive to the body’s efforts
to stay alive under adverse conditions.
We are designed to live optimally under
conditions of clean air, water, and food
(a starch-based diet). If these ideal
surroundings are not met then
adaptations must be made to survive.
For example, when people smoke
cigarettes they cough and produce mucous
in an effort to remove the toxic smoke
from their lungs. These adjustments
also serve as signs of the on-going lung
injury. If cough-suppressing medication,
for example, codeine syrup, were used
intensive to completely suppress the
cough, then more of the toxic chemicals
from the smoke would be
retained—hurrying the person’s demise.
In
addition to serving as signs of disease,
elevation of the blood pressure and
blood sugar (and maybe cholesterol) also
serve as part of the corrective
adaptations that the body makes in
response to the burdens caused by the
unhealthy Western diet. In the case of
hypertension, the blood pressure
increases in order to improve
circulation. The Western diet reduces
the flow of blood to the tissues by
creating blockages (atherosclerosis),
spasms of the arteries, and the clumping
of blood cells. The net effect is an
increase in (peripheral) resistance to
the flow of blood. To compensate, the
blood pressure rises in order to restore
adequate perfusion to the tissues. A
rise in blood pressure is the correct
response for the body to make under
these circumstances.
The
pharmacological, medical answer to
elevated blood pressure is to poison
various parts of the cardiovascular
system: beta blockers are given to
weaken the heart muscle, calcium channel
blockers prevent normal contraction of
the arteries, anti-angiotensin drugs
block the actions of adrenal hormones,
and diuretics inhibit the kidneys’
ability to conserve water and minerals.
Rather than improving the circulation,
these drugs cause the opposite: a
further decline in perfusion
pressure—counteracting the body’s
efforts to deliver adequate oxygen and
nutrients to the tissues.15,16
The result, as would be expected from
worse circulation, is more damage, seen
as an increase in the risk of strokes
and heart attacks, and loss of brain
function (dementia).
Resistance
to the actions of insulin develops in
response to the burdens of the Western
diet. This adaptation is made in part to
stem excessive weight (fat) gain. One of
the primary jobs of insulin is to store
fat in the fat cells. After the
accumulation of the first 30 pounds of
fat, the body seems to say “that’s
enough,” and puts the brakes on by
reducing the effectiveness of insulin—in
other words, insulin resistance
develops. With weaker insulin activity,
the blood sugar rises. Injections of
insulin partially override this natural
resistance causing weight gain to
accelerate. Medications, like Byetta
injections and sulfonylurea pills, cause
the pancreas to release more insulin
with effects similar to insulin shots.
Artificially lowering blood sugar with
these drugs also prevents excess
calories (sugar) from being eliminated
through the kidneys (glucosuria),
further hindering the body’s attempts to
make overdue corrections by losing its
excess fat. The net result of all this
intensive therapy is accelerated
accumulation of body fat, which means a
sicker patient at more risk of death and
complications. (In addition to causing
obesity, intensive therapy results in
many other biochemical changes that are
counterproductive to survival.)
Lowering
cholesterol with drugs, like statins,
does little or nothing to heal the sick
arteries. To make matters worse, Zetia (ezetimibe),
an ingredient in Vytorin, appears to
further damage a patient’s arteries.
Zetia works by blocking the absorption
of cholesterol (an animal-synthesized
sterol) by the intestines. This drug at
the same time blocks the absorption of
plant-derived sterols in every
person taking Zetia.17
Unlike cholesterol, plant sterols cannot
be synthesized within the body;
therefore, they must be obtained from a
diet of starches, vegetables, and
fruits. Plant sterols are essential for
our health, and more specifically, they
are vital ingredients for healthy
arteries. These sterols lower total and
LDL (bad) cholesterol by a variety of
mechanisms, and reduce oxidative
stresses and inflammation, which lead to
atherosclerosis.18
Doctors, It Is Time to Prescribe the
Miracle Drug: Food
The facts
are indisputable: The intensive
pharmaceutical treatment of signs of
chronic diseases is a failure—causing
great mental, emotional, physical, and
financial harm to patients. Since
doctors are the gatekeepers of
treatment, they have the opportunity and
duty to change medical care. We must
stop prescribing treatments that don’t
work.
The reason
pharmaceutical companies don’t sell
drugs that cure the underlying
diseases is they can’t. All
common chronic diseases are caused by
diet and lifestyle. There is little
profit in selling sweet potatoes,
broccoli, and a pair of walking shoes.
Doctors willing to step in front of the
crowd and practice lifestyle medicine
will reap great rewards. Foremost, they
will fulfill their professional dream by
helping their patients regain their lost
health and appearance, get off all
unnecessary medications and avoid all
unwarranted surgeries.
References:
1) Lebovitz HE, Dole JF,
Patwardhan R, Rappaport EB, Freed MI;
Rosiglitazone Clinical Trials Study
Group. Rosiglitazone monotherapy is
effective in patients with type 2
diabetes. J Clin Endocrinol Metab.
2001 Jan;86(1):280-8.
2) http://www.nytimes.com/2007/05/22/business/22drug.html?pagewanted=print
3) Nissen SE, Wolski K.
Effect of rosiglitazone on the risk of
myocardial infarction and death from
cardiovascular causes. N Engl J Med.
2007 Jun 14;356(24):2457-71
4) BMJ 2008;336:407,
doi:10.1136/bmj.39496.527384.DB
5) Purnell JQ. Effect
of excessive weight gain with intensive
therapy of type 1 diabetes on lipid
levels and blood pressure: results from
the DCCT. Diabetes Control and
Complications Trial. JAMA. 1998
Jul 8;280(2):140-6.
6) Colwell JA, Clark CM
Jr. Forum Two: Unanswered research
questions about metabolic control in
non-insulin-dependent diabetes
mellitus. Ann Intern Med. 1996
Jan 1;124(1 Pt 2):178-9.
7) Gustafsson I,
Hildebrandt P, Seibaek M, Melchior T,
Torp-Pedersen C, Kober L, Kaiser-Nielsen
P. Long-term prognosis of diabetic
patients with myocardial infarction:
relation to antidiabetic treatment
regimen. The TRACE Study Group. Eur
Heart J. 2000 Dec;21(23):1937-43.
8) Abramson J, Wright
JM. Are lipid-lowering guidelines
evidence-based? Lancet. 2007 Jan
20;369(9557):168-9.
9) Lenzer J. Unreported
cholesterol drug data released by
company. BMJ. 2008 Jan
26;336(7637):180-1.
10) Messerli FH, Mancia
G, Conti CR, Hewkin AC, Kupfer S,
Champion A, Kolloch R, Benetos A, Pepine
CJ. Dogma disputed: can aggressively
lowering blood pressure in hypertensive
patients with coronary artery disease be
dangerous? Ann Intern Med. 2006
Jun 20;144(12):884-93.
11) The July 2004
McDougall Newsletter: http://www.nealhendrickson.com/mcdougall/2004nl/040700pubp.htm
12) Kaplan NM. What is
goal blood pressure for the treatment of
hypertension? Arch Intern Med.
2001 Jun 25;161(12):1480-2.
13) Somes GW, Pahor M,
Shorr RI, Cushman WC, Applegate WB. The
role of diastolic blood pressure when
treating isolated systolic
hypertension. Arch Intern Med.
1999 Sep 27;159(17):2004-9.
14) Paran E. Blood
pressure and cognitive functioning among
independent elderly. Am J Hypertens.
2003 Oct;16(10):818-26.
15) Cruickshank, J.
Benefits and potential harm of lowering
blood pressure. Lancet. 1:581-4,
1987.
16) Strandgaard S.
Autoregulation of cerebral blood flow in
hypertensive patients. The modifying
influence of prolonged antihypertensive
treatment on the tolerance to acute,
drug-induced hypotension.
Circulation. 1976;53:720-7.
17) Sudhop T, Lütjohann
D, Kodal A, Igel M, Tribble DL, Shah S,
Perevozskaya I, von Bergmann K.
Inhibition of intestinal cholesterol
absorption by ezetimibe in humans.
Circulation. 2002 Oct
8;106(15):1943-8.
18) Devaraj S, Jialal I.
The role of dietary supplementation with
plant sterols and stanols in the
prevention of cardiovascular disease.
Nutr Rev. 2006 Jul;64(7 Pt
1):348-54.
2008
John McDougall All Rights Reserved
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