Familial hypercholesterolemia is beneficial!

As I have shown in my previous newsletters, there is a total lack of scientific support of the cholesterol hypothesis. We have documented that in a detailed review published six years ago in Expert Review of Clinical Pharmacology. According to the journal, our paper has been downloaded up to now by more than 340,000 readers, and according to Google Scholar, it has been cited in 186 scientific papers. In spite of that, the national guidelines in most countries still recommend cholesterol-lowering treatment of people with elevated cholesterol.

Since then, many more studies with contradictions of the cholesterol hypothesis have been published. The strongest one has recently been published in BMJ Open by Kumi et al., but obviously, the authors haven´t understood their most revolutionary finding themselves. As it is utterly difficult to publish papers contradicting something that everybody “know” is correct, I have decided to send my conclusions of their findings to as many cardiology scientists in the world as possible. I am of course preparing a paper about this issue as well, but it may probably take much time before it has been published.

Kumi et al. have analyzed the myocardial injury type in almost four million patients with acute myocardial infarction. The interesting finding was that only 0.06% of the patients had familial hypercholesterolemia and their mortality was much lower than the others. It is very interesting because in a recent review in Circulation, which included 62 studies comprising >7.3 million individuals from all over the world, the prevalence of familial hypercholesterolemia in the general population is about 0.33 %. If the cholesterol hypothesis had been true, the number of patients with myocardial infarction in the study by Kumi et al. should therefore have been more than five times higher.

These findings are in accordance with our previous review about familial hypercholesterolemia. What we found was that the cholesterol of those who die from myocardial infarction is not higher than that of those who survive; that it is only very few who die early and that the cause is that they have inherited elevated coagulation factors as well; for instance, fibrinogen, factor VIII and increased aggregation ability of the platelets

In fact, high cholesterol is beneficial, because, as we have shown, the lipoproteins participate in the immune system by adhering to and inactivating almost all kinds of microorganisms and their toxic products. In accordance, before the year 1900, where infectious diseases were the commonest causes of death, the life span of people with 50% risk of having familial hypercholesterol-emia was just as long or longer than in the general population (Sijbrands et al.).

In conclusion, do not lower FH-people´s cholesterol! Instead, analyze their coagulation factors, and if they are too high, treat them with a relevant anticoagulating drug.

Best regards

Uffe Ravnskov, MD, PhD, independent researcher, Lund, Sweden. www.ravnskov.nu