Cholesterol and statins: “Do not stop your treatment without seeing your doctor”, say cardiologists … and Michel de Lorgeril

February 2, 2009 – “Do not interrupt your treatments before seeing your doctor or cardiologist”, proclaims the Association des cardiologues du Québec (ACQ) to people who have been prescribed statins or other drugs to reduce their rate cholesterol.

The president of the ACQ, the D^r Dominique Grandmont, published a statement to counter the comments made by the French cardiologist Michel de Lorgeril, during recent interviews he granted in Quebec – including one in HealthPassport.net – to promote his latest book¹.

Joined in Grenoble where he lives, Michel de Lorgeril recommends that patients who would be tempted to stop their treatment to discuss it first with their doctor “hoping that the latter will have as a culture of the subject a little more than the sales pitch. industrial, ”he says.

For Michel de Lorgeril, it is important to debate cholesterol and statins urgently. “The question should be studied again by medical and scientific experts free from any conflict of interest and independent of the pharmaceutical industry,” he insists.

According to him, cholesterol is not responsible for cardiovascular disorders and drugs to reduce cholesterol, including statins, are used “for nothing, with exceptions”. (See our interview on this subject, Cholesterol and statins: Michel de Lorgeril persists and signs.)

There is “no scientific argument to say that stopping cholesterol treatment increases the risk of cardiovascular complications,” he adds.

The French cardiologist maintains that “doctors prescribe too many statins to people who do not need them and that they hide the side effects, some of which can be serious”.

The words of D^r de Lorgeril would have prompted “several patients” to stop taking their statins recently, while others are seriously questioning, according to Dr.^r Grandmont. This is confirmed by two other doctors, the D^rs André Carpentier and Paul Poirier², for whom Michel de Lorgeril would have succeeded above all in “confusing the message” rather than clarifying it.

Responsible or not, cholesterol?

Accusing the D^r de Lorgeril to make “spectacle medicine” by proposing “half-truths and absurdities […] without scientific rigor ”, the D^r Grandmont maintains that cholesterol is “indeed involved in the genesis and progression of atherosclerosis”.

For his part, the D^r André Carpentier brings certain nuances. “For some, high cholesterol, or LDL, can lead to an increased risk of disease, while others will not or may not. “

According to him, cholesterol is one risk factor among many others and it is all of these factors that are taken into account when it comes time to decide whether or not to prescribe statins.

“We have official recommendations – or guidelines – to guide us, but the decision to prescribe always depends on a person’s absolute risk of developing cardiovascular disease. “

According to Michel de Lorgeril, these recommendations would be “biased” because they were set by doctors potentially “in conflict of interest”.

An assertion categorically denied by D^r Paul Poirier, who was part of the group of Canadian experts who set the recommendations, in the country, with regard to cholesterol-lowering drugs. “It is true that pharmaceutical companies sometimes exert pressure, but the committees remain independent,” he assures us.

He nevertheless concedes that he has already received honoraria from the pharmaceutical industry for having taken part in conferences, an amount he says he has given to charities.

Too many statins prescribed

In the debate he raises, D^r de Lorgeril argues that doctors are too quick to prescribe statins and not enough to encourage their patients to make lifestyle changes, such as healthy eating and more physical activity.

“There may be general practitioners who have the trigger and who more easily prescribe statins in primary prevention³ », Agrees the president of the ACQ, Dominique Grandmont.

In the same breath, if he says he agrees with the prevention message of D^r of Lorgeril, he has caveats about its application in the field.

“You could say there are too many prescriptions, but people look for easy solutions first and are generally reluctant to make long-term lifestyle changes. “

“But in secondary prevention³, we cannot achieve such significant reductions in cholesterol levels without statins and, on this, Michel de Lorgeril goes too far when he says that these drugs are prescribed unnecessarily, ”concludes Dr.^r Grandmont.

Martin LaSalle – PasseportSanté.net

1. De Lorgeril M, Cholesterol, lies and propaganda, Axis Mediascience, September 2008.
2. The D^r André Carpentier is an endocrinologist and researcher specializing in blood lipids at the Center hospitalier universitaire de Sherbrooke. The D^r Paul Poirier is Assistant Professor of Pharmacy at Laval University and Director of the Cardiac Prevention / Rehabilitation Program at the University Institute of Cardiology and Pulmonology at Laval Hospital in Quebec.
3. The term “primary prevention” refers to prevention carried out before the disease occurs. Secondary prevention is that which is applied after a person is sick, to prevent a recurrence.