Inaccuracies in Recent Article Concerning How To Avoid a Heart Attack

To the Editor: 

As a cardiologist working at the National Heart, Lung, and Blood Institutie (NHLBI), I feel compelled to address several serious inaccuracies in the article entitled Secrets to Healthy Living in the Ozarks – How to Avoid a Heart Attack/Stint (sic) published in the Douglas County Herald on June 29, 2018.  My major concern is that these inaccuracies may convince some of your readers to stop taking important medications proven to reduce the risk of heart attacks, strokes and peripheral artery disease, and the possible need for stents.  

First, it is grossly incorrect to state that “clogging rarely occurs in the peripheral vascular system;” in fact, peripheral artery disease affects 8.5 million Americans. The article also makes a concerted effort to dismiss the findings introduced by the NHLBI-funded Framingham Heart Study and confirmed in countless other studies over the past six decades that cholesterol is a major risk factor for heart attack and stroke. The article ignores these findings and claims that because cholesterol increases with age and is a major component of our cell walls, cholesterol lowering drugs are harmful, causing memory problems and increasing blood vessel thickening.  In fact numerous studies, including several funded by the NHLBI, have shown that intensive lowering of LDL (“bad”) – cholesterol reduces the amount of atherosclerotic plaque in the coronary, neck and peripheral arteries, leading to major reductions in the risk of heart attacks, strokes, and peripheral artery disease.  Occasionally, patients report memory issues with statins, the most commonly used cholesterol-lowering medication.  However several large, carefully designed studies have concluded that memory problems are not increased with these drugs. 

Finally, the article’s conclusion that you should “ask your doctor to help you develop a plan to wean yourself off medications that contribute to cardiovascular complications” appears to be targeting cholesterol-lowering medications.  Although I agree with the author’s premise that a healthy diet is important for preventing cardiovascular disease, it is equally important that people realize that high LDL-cholesterol increases the risk for heart attacks and other major cardiovascular events, and that cholesterol-lowering medications, alongside a heart-healthy diet and regular exercise, play a major role in reducing this risk. 

Jerome L. Fleg, M.D. 

FACC, FAHA

Medical Officer, Division of Cardiovascular Sciences

National Heart, Lung, and Blood Institute