What you and nearly every person over the age of 60 get following a physical is a strong recommendation from their physician to treat with a drug some putative sign of cardiovascular disease.   What I wish to convey to you is that with very few exceptions these drugs are treating symptoms rather than the underlying causal condition.  Treating signs is not effective, and thus not worth their side effects.  I have spent 11 years since healthfully.org was born looking into medical issues and the methods of pharma.  Moreover I have been reading medical literature since 1972 and came to it with a strong science background.  I am warning you about the bullshit based upon tobacco science that pharma teaches physicians, and I will also presenting to you what medical science has uncovered concerning cardiovascular disease.  It is as Prof. Peter Gotzsche wrote:  “Whatever the industry does, whatever it calls it, and whatever it says about its noble motives, it all boils down to one thing:  selling drugs.“  Deadly Medicines and Organised Crime:  how big pharma has corrupted healthcare p. 87.  His book meticulously adds flesh to how big pharma has corrupted healthcare. 

4) In what follows I will show you how much big pharma has corrupted the science behind cardiovascular disease for to sell their drugs.  I will start with hypertension (your concern Danny), then hypercholesterolemia, followed by endothelial dysfunction and end with the major causes for atherosclerosis and thus cardiovascular disease. You will arrive at where you started and know the healthful path for the first time. 

Associated with doesn't entail cause.  Firemen are often found at fires; that doesn't prove they cause fires.  Kidney damage is associated with hypertension, not caused by it.  That is because hypertension is caused by atherosclerosis (stiff, swollen arteries full of plaque that contains fibrous tissue, lipids, lymphocytes, and calcium).  When plaque leaks it can damage the kidneys.  But instead of treating atherosclerosis that causes the ischemic events, pharma treats hypertension.  It is like treating fever instead of the flu.  

Ischemia (ischemic events) occurs when there is a restriction of the blood supply causing a shortage of oxygen and glucose needed for cellular metabolism to keep the tissue alive.  It can be caused by vasoconstriction, embolism, or thrombosis.  The first two account for less than 10% of those events.  The third, arterial thrombosis is caused almost entirely by young soft plaque before a hard fibrous cap forms over the plaque.  It leaks through the endothelial cells that line the artery, and this leaked plaque can block the flow of blood to cause the destruction of tissue.  If the thrombosis-caused ischemic events occur in the heart and destroys sufficient muscle it is called a myocardial fraction (heart attack, MI); destroys sufficient neuron a stroke.  These events can block arterioles (small arteries) and result in subclinical events.  Thus an angina pain could be a small ischemic event; and some bouts of mental disorientation could be mini-ischemic events.  Often these mini-events go unnoticed.  If they occur frequently in the brain (where there are no pain receptors) it causes the second most common form of dementia, vascular dementia.  If these mini-ischemic events occur often enough in the kidney, it causes kidney dysfunction.  And the same occurs in other tissues; of note is the eyes, bowels, limbs, under the skin, but not limited to these tissues.   Leaking plaque is caused by atherosclerosis, not hypertension.  Thus as expected lowering blood pressure doesn’t significantly lower the frequency of events—though pharma claims it does.  So what are we to make of pharma’s claims?

First the FDA permits the surrogate outcome of lower blood pressure; but we take antihypertensive drugs to prevent major events.  Second to avoid negative results very, very few pharma-funded studies use as endpoints just deaths and heart attacks.[1]  This claim of benefits is based on industry funded studies (which have Positive bias by design and gross manipulation of results—see Prof. Prof. Ben Goldacre’s Bad Phama).  Even so these shoddy short-term studies by pharma (what I call tobacco science) do NOT result in a statistically significant reduction of major coronary events for beta blockers, ACE inhibitors , Angiotensin II receptor antagonists, and calcium channel blockers,  so found the prestigious Cochrane Review and Worst Pill; thus these drugs are not worth their side effects.[2]  The worst of these pharma studies (not used by Cochrane and Worst Pill in their analysis) are used to market these drugs and justify treatment guidelines.  What we know about antihypertensive drugs and pharma, this is their business model—“all about sales”.    

8) The web of deceit on causes of coronary events has been carefully woven:  hypercholesterolemia is another bystander.  High cholesterol is only very weakly associated with coronary events.  For example the Framingham Study found that the elderly with high cholesterol had less coronary events and lived longer than those with low cholesterol (Prof. Uffe Ravnskov, Ignoring the Awkward! p 36). The surrogate outcome of statins lowering cholesterol is not associated with fewer ischemic events, and their side effects are significant.  Yet Braunwald’s cardiology textbook repeatedly states the industry’s mantra that “statins are safe and effective.”  For the doctors and the public, pharma frames the discussion of cardiovascular disease.  It is all for the sales of drugs as Prof. Peter Gotzsche states.   Even those who know avoid this topic or give it lip-service rather than lose their audience.  Thus the chorus of critics of the cholesterol hypothesis is small, but their evidence convincing.  Enter in the Amazon website cholesterol myth and you will find over 50 books thereon.

So what is driving the development of atherosclerosis and thus myocardial fractions?   Endothelia cells are the gatekeepers for what enters the tissues that make up the arteries.  Thus damage to them--termed endothelial  dysfunction-- promotes the entering of substances into the artery tissue that cause atherosclerosis.  Endothelia dysfunction has 5 main causes:  1) high level of blood sugar especially the 7 times more reactive fructose (thus heart attacks are associated with diabetes and the Western diet) through the process of glycation,[3] which damages the endothelial cells.  2) Fructose is converted to fat in the liver.  Too much fructose with too little exercise results in a fatty liver.  A fatty liver mucks up the metabolic regulatory system to cause insulin resistance and thus weight gain.  Among its many effects is a higher level of blood sugars; thus through glycation damages endothelial cells.  3) A diet high in trans-fats and polyunsaturated fats (polyunsaturated fats are subject to a process of rancidification in the body and on the shelf).  Their abnormal shapes adversely affect the cell walls of the endothelial cells.  4) Carbon monoxide and other reactive chemical in the blood which can bond to the endothelial cells (similar to fructose and glucose).  5) Infectious agents through their toxins circulating in the blood damage the endothelial cells and thereby permit the penetration of pathogens into the tissue within the arteries.  Infectious agents in the artery walls have been clearly shown to be the major cause of plaque formation through an immune response to their presence.[4]  In conclusion, the five processes which damage the endothelial cells are atherogenic.   

Young immature plaque is similar to a boil, both are caused by infection.  When the young plaque leaks it can cause a thrombosis.  Evidence for the role of pathogens goes back over 100 years: “There is every indication that the production of tissue in the intima [inner layers of artery wall] is the result of a direct irritation of that tissue by presence of infection or toxins.”[5]  There are hundreds of published journal articles, see these links and, or enter into Google scholar and enter atherosclerosis + pathogens.  Similarly articles prove the other causes:  enter glycation + endothelial dysfunction, trans- fats + endothelial dysfunction, and rancid + polyunsaturated fats.[6]  Thus we can see that the Western diet with its unhealthy fats, refined carbohydrates and loads of sugars (US average is 151 pounds) which lead to metabolic dysfunction resulting in insulin resistance and fatty liver disease, and cigarettes are driving forces in endothelial dysfunction.  Thus to reduce the risk of atherosclerosis and its comorbidities, we must reduce the risk for endothelial cell damage. 

We have as problems not just the high sugar (fructose being the worst sugar), but also another example of profits before health.  Polyunsaturated fats are cheap, so too is their conversion to saturated fats by hydrogenation to improve the flavor of foods—a byproduct are trans-fats.  These fats are favored by food manufacturers, thus the widely held belief that they are healthful, and the more expensive saturated fats are unhealthful.  It turns out that the expensive saturated fats and monounsaturated fats are the best for health—see fats for the very convincing evidence.  And it get worse, the transfats made from these polyunsaturated fats through a process of hydrogenation have been proven to promote cardiovascular disease.  A number of countries have totally banned them, the US has created exclusion for business and then doesn’t inforce the labeling requirement but relies upon the food manufacturer to inform the public of their presence.  Again the saying of Prof. Gotzsche rings true:  “it all boils down to one thing, the selling of drugs” or in this case that of the cheaper polyunsaturated fats and the hydrogenated fats derived therefrom.   In a system which measures performance by profits, it is more profitable to manipulate beliefs than to do the right thing. 

Like so much else, the popular “wisdom” on diet fails—as proven by the current pandemics.  I have spent 2 years (10-2013 to 10-2015) examining the obesity and diabetes pandemics and their role in promoting cardiovascular disease.  The main cause of these conditions is diet, and thus the main fix and prevention lies with diet.  I have arrived at an evidenced based dietary fix for preventing and reversing endothelial dysfunction, insulin resistance and fatty liver disease--click on link and long version.  The regulatory and information systems are broken. 

Most of what pharma writes is through KOLs (key opinion leaders).  To be a KOL entails receiving large sums for services to pharma—not employees.  In our corporatist world, the 800 pound gorilla can do pretty much anything it wants” as Harvard Prof Marcia Angell states (a reference to the $800 billion industry).  More complete is the statement by Dr. Evens in The Guardian:  “The pharmaceutical industry is the most lucrative, the most cynical and the least ethical of all the industries. It is like an octopus with tentacles that has infiltrated all the decision-making bodies:  World Health Organizations, government agencies, parliaments, high administrations in health and hospitals and the medical profession." He is the author of "The Guide to the 4,000 Useful, Useless or Dangerous Medicines" (Sept 2012), with Dr. Bernard Debre is director of the prestigious Necker Institute; Dr. Philippe Even is a member of the French Parliament--F. Pharma.  Prof.  Angell’s  77 minute lecture confirms these quotes, at https://www.youtube.com/watch?v=ZqKY6Gr6D3Q. 

For more on hypertension, http://healthfully.org/rl/id1.html, atherogenesis http://healthfully.org/rl/id2.html and http://healthfully.org/rl/id8.html, high dose aspirin treatment http://healthfully.org/rc/id17.html and dietary treatments http://healthfully.org/rh/id12.html of atherosclerosis (the high sugar Western diet causes endothelia dysfunction which  is causally associated with atherosclerosis), and for the cholesterol myth watch the Australian Broadcast corporation at https://www.youtube.com/watch?v=Sa9ZYsW59Zo, and on my website are numerous articles on statins, the cholesterol myth, the major causes for atherosclerosis.  They can be found through the Google-internal search engine on each home page--one article on the cholesterol myth is at http://healthfully.org/rl/id5.html.