Chlesterol, Malcolm Kendric and epithelial's

Discussion in 'Ask The Experts' started by Guerilla9, May 20, 2014.

  1. Guerilla9

    Guerilla9 Elite Member

    Id be interested to get your opinions on the publications of Dr Malcolm Kendrick with regards to LDL/HDL ratios & levels and their effect on CVD. Most of which fly in the face of conventional belief on the subject.

    In addition, He makes a case for the higher CHL levels and their effect on epithelial cells within the blood vessels. Do you agree that these epithelial cells are a major factor in controlling debris within blood vessels? and are there any studies into what controls their production and apparent reduction as we age other than a link to CHL?


    @Dr Angell

    @Dr Waktare
    Last edited by a moderator: May 25, 2014
  2. Irish Beast

    Irish Beast Beast

    @Guerilla9 - Can you make sure you tag one of the Docs as they don't check the forum regularly so rely on email notifications

    Have you got a link to the publication? 
  3. Guerilla9

    Guerilla9 Elite Member

    Hes not responsible for the studies used in his book "the Great Choleserol Con" and advisor to the BMC as I understand it.
  4. Dr Waktare

    Dr Waktare Consultant Cardiologist


    Haven't heard of him before, but found him on Google. A quick scan of what he is saying suggests that his views are shall we say wayward. Doesn't mean he doesn't have a point of view, and certainly I didn't see stuff that suggests that he is an "out and out nutter". What I would say is that there is a strong national and international consensus on this, and I can't recall when such a medical consensus last shifted. Bug cause infections, MMR doesn't cause autism and...

    High cholesterol and high LDL to HDL ratios cause coronary heart disease - period. Is that all there is too it - far from it. It is a complex issue, with both the exact way the lipids circulate and other factors (like smoking) interact playing in to it. Also the causation isn't 100%. Not everyone with high cholesterol gets CHD, just like everyone has a great aunt who smoked 40 a day and lived to 90.

    Do pharmaceutical companies attempt to "big up" the benefits of their drugs - undoubtedly. They are commercial organisations out to make a profit. Their conduct in the past was very underhand. It has got a lot better in the recent past, mainly due to much tighter scrutiny by people like the Cochran Collaboration (who Dr Kendrick starangely feel are "in on it").

    GP's do also have an incentive to over-prescribe statins. However there is almost certainly less harm coming to patients if there is 30% over-use than if there is 30% underuse, and overall we are probably still underusing statins.

    In respect of endothelial cells (you called it epithelial, but I assume you meant endothelium), fats actually make up the larger part of your cell walls. However I can't see a logical reason why having more circulating would make things better - you need enough (which is very little) and having more won't make things better. I don't know the detail of his arguments as I haven't read his book (and am not inclined to). By way of an analogy, think of having a bath - you need enough water to wash. Having the bath fuller doesn't mean that you are able to wash any better. However it does create dangers of getting your floor wet. To take an extreme example, you need sodium (the stuff that makes up half of common salt), but can actually survive fine on a trivial amount of around per day (around 1% of our average intake). If you take in a lot too much, you put yourself in danger of getting high blood pressure. So in this example, sodium is vital to the body's functioning, but the body copes fine with a very wide range of intakes.

    All in all, I am a beleiver in open debate, and I think that in cases there is over-use of statins. However overall I would look at Dr Kendrick's book as a sense check to challenge over-use but not a credible argument that the basic premiss of our present understanding is wrong...

    Hope that helps.
  5. Irish Beast

    Irish Beast Beast

    Thats a fantastic response Johan, thanks for taking the time to respond!

    @Guerilla9 - Tagged so you don't miss the response
    Last edited by a moderator: Jun 7, 2014
  6. Guerilla9

    Guerilla9 Elite Member

    Fantastic response! Thankyou for your time.
  7. francesco totti

    francesco totti Elite Member

    I read that book 2 years ago at my local library- a good read.
  8. Dr Angell

    Dr Angell Senior Member

    I think @Dr Waktare has nailed this one to be honest. I agree that I think there is a debate to be had with regards to over-prescription of statins or at least, making sure the right people get them and not just blanket prescriptions but how much credibility there is to the anti-statin movement remains to be seen.