The medical profession has established beyond doubt that high cholesterol contributes to heart disease. What it won't accept is that low cholesterol can be dangerous too-causing violent and suicidal behaviour in some people. Matt Ridley explains why going back to fry-ups may be good for usby Matt Ridley / January 20, 1996 / Leave a comment
Published in January 1996 issue of Prospect Magazine
One day in 1987, two scientists were walking down the street in Washington, DC, when one stopped to buy the New York Times. It carried news of the latest study of heart disease, in which 2,051 people in Helsinki had been given a drug to lower their cholesterol levels, compared with 2,030 who had been given a placebo. The results of the study were only mildly encouraging. Fourteen of those on the drug had died of heart disease in five years; 19 of those on the placebo. But what caught Stephen Manuck’s eye was something else.
“Look at this bit,” he said to his companion, Jay Kaplan. “Yet another study finds more people dying violent deaths after taking the cholesterol-lowering drugs.” Ten people had died of “non-illness mortality” (medicspeak for accidents, violence and suicide) compared with four in the placebo group. The ensuing conversation was the start of a detective story which leads to the heart of human behaviour and has some disturbing things to teach us about following doctors’ advice. Very low cholesterol levels might be just as bad for us as very high ones-but in different ways. It is a message the medical profession is extremely reluctant to let us hear.
Manuck’s colleague at the University of Pittsburgh, Matt Muldoon, went back through the six large trials of cholesterol-lowering then published, and found his hunch confirmed. They were all studies in which one group of mostly middle-aged men had been given a drug or a diet, compared with another group given a placebo. In every study, more of those given the drug or diet had died violent deaths than in the control group. Only four of the six studies showed a reduction in heart-disease deaths. Taking all the studies together, cholesterol treatment reduced the risk of dying from heart disease by just 14 per cent. It raised the risk of accidents, violence, and suicide by an astonishing 78 per cent.
Two years later Muldoon added another two studies to his portfolio and found the effect still impressive. Only “secondary studies”-those in which the patients were already suffering from heart disease when the studies began-proved immune to the “violent death” effect. All primary studies showed a substantial increase in violent deaths among those taking the anti-cholesterol drug or diet. Of course, because more people die of heart disease than in accidents, the overall effect was little or no change in total mortality. The additional violent deaths almost exactly cancelled out the lives saved from heart disease. None the less, the increase in violent deaths was more than ten times as significant statistically (i.e. ten times less likely to be as a result of chance) as the fall in mortality from heart disease. And violent deaths sometimes involve innocent bystanders.