Dr Malcolm Kendrick
Dr Kendrick in an Aberdonian who works as a GP in England. He may be familiar to British readers as a so called “statin denier” as termed by a popular newspaper. Dr Kendrick and Zoe Harcombe PhD, sued the paper for libel, and after five years of litigation have finally won their case.
Dr Kendrick has been interested in the causes of ischaemic heart disease for about 20 years and published The Great Cholesterol Con about 15 years ago. This book delves into what does and does not cause coronary arterial plaque and heart attacks and recently he has also published another, The Plot Thickens.
His presentation at the Public Health Collaboration Conference in Glasgow explained what actually causes coronary plaque. He took us on a referenced revision of why previous theories, which have been accepted by many as fact, are not valid.
He spoke about the Minnesota Experiment. This has also been discussed in Gary Taubes’ books. Residents in Mental Health facilities in Minnesota were given different diets for several years and the outcomes were evaluated. In those days, indeed before neuroleptic drugs like Largactil and Haloperidol were invented, people with a diagnosis of schizophrenia could spend years of their lives in mental hospitals, so the population tended to be quite stable.
The intervention was the replacement of saturated fat with polyunsaturated fat. This was thought, by the influential Ancel Keys, to be the main cause of coronary artery disease, following the publication of his Seven Countries Study. (Although the data from 22 countries was available at the time). The patients’ cholesterol levels did indeed go down in the polyunsaturated diet group, but unfortunately the death rate went up.
Although this RCT should have led researchers to look elsewhere for the cause of coronary heart disease, the study results were simply not published, and the war on saturated fat continued, and still continues up to the present day.
The Q Risk 3 is the most up to date questionnaire that is administered by GPs or indeed yourself if you know your lipid blood results and blood pressure. It lists 20 risk factors for heart disease. These are really associations and are not necessarily causative. For example, your postcode is included.
The LDL result, when taken in isolation, shows no increase in risk. Other markers of dyslipidaemia such as low HDL and high triglyceride levels do.
The health of the Glycocalyx, which is like a shimmering brush border that lines all of our blood vessels, is key to the development of coronary plaque. If it is lush, it wafts our blood cells along, and stops them from sticking. It could be compared in some ways to Teflon. Certain things reduce the depth and function of the Glycocalyx such as: sugar, starch, alcohol, SLE, Hughes Syndrome, ageing, stress, smoking, diabetes, dyslipidaemia, and high blood pressure.
If the Glycocalyx is breached, the lining of the blood vessels can be injured, and to prevent bleeding, a vigorous platelet aggregation ensues. This is intended by nature to be helpful. The clotting cascade is controlled by just over 100 different cytokines and chemicals in the body. Endothelial progenator cells are released from the bone marrow, and these plug the holes in blood vessels. These form the basis of the plaque that covers the holes in the lining of blood vessels.
Plaque never forms in veins. It forms in arteries, especially where damage has occurred due to high turbulence, such as at forks in arteries. It is when plaques break off, and another burst of clotting ensues that heart attacks may occur.
Dr Scott Murray
Dr Murray is a Scottish Cardiologist who now works in England. His talk dealt with the practical things you can do to improve your cardiac risk and how he uses the Coronary Artery Calcification Score.
He says that a low carb or ketogenic diet is key to improving your lipoprotein type and size. Smaller and denser lipoproteins are more atherogenic than big fluffy ones. He showed pictures of healthy hearts compared to unhealthy ones that tend to have a lot of fat around them.
Taking at least 150 minutes of exercise a week including brisk walking and resistance exercise can reduce cardiac risk by 20-14%. Stopping cigarettes reduces your risk by 37%. A reduced carb diet can reduce your risk by 31-18%. Weight loss can reduce risk by 18%. Stress management can reduce risk by 41%.
Oestrogen use for women within ten years of the menopause also reduces cardiac risk. He advises you to keep thin if you possibly can.
If your CAC score is 0, your cardiac risk is 2.5%. If it is over 150, he advises a statin. These reduce plaque rupture.
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