Dr. Ovadia Lied About Statins! A Cardiologist Reacts to the Viral Statin Video — Transcript

Full transcript

1. 0:00He lied about LDL cholesterol, and he
2. 0:02lied about statins. He is a
3. 0:05cardiothoracic surgeon. There's nothing
4. 0:07wrong with being a cardiothoracic
5. 0:09surgeon, but he is not trained in
6. 0:11lipidology or cardiology. Cardiothoracic
7. 0:14surgeons are amazing at what they do,
8. 0:16and I work with some of the most amazing
9. 0:18cardiothoracic surgeons in the world at
10. 0:20two of the largest tertiary care
11. 0:22academic centers in Ohio, but they are
12. 0:24not trained in the chronic management of
13. 0:26lipids or cardiovascular disease. They
14. 0:29rearrange your insides, and they never
15. 0:31see you again. I'm Dr. Allo. I'm a
16. 0:33double board certified cardiologist. I
17. 0:36teach at two medical schools, and I
18. 0:38wrote the lipidology and cholesterol
19. 0:39textbook that cardiologists read to
20. 0:42learn how to treat and prevent heart
21. 0:43disease. Let's take a look at what he
22. 0:45said in this video. It has gone viral,
23. 0:48and it's reached hundreds of thousands
24. 0:49of people. Let me correct this so it
25. 0:51doesn't keep spreading. I hate being the
26. 0:54chief misinformation officer, but
27. 0:55somebody has to do it.
28. 0:57>> I'm a heart surgeon, and I don't
29. 1:00automatically prescribe statins for high
30. 1:02LDL cholesterol. When most people hear
31. 1:05that, including many doctors, they
32. 1:08assume I'm being reckless. But here's
33. 1:10what LDL actually is. LDL is not a
34. 1:14toxin. It's a transport particle.
35. 1:16>> Yes, LDL carries cholesterol. That's its
36. 1:20job. But when there's too much of it,
37. 1:22LDL particles get into the artery wall
38. 1:24and build plaque. The European
39. 1:26Atherosclerosis Society reviewed more
40. 1:28than 200 studies and more than 2 million
41. 1:31people. Genetics, population studies,
42. 1:34and randomized trials all point the same
43. 1:36way. The more LDL and the longer you
44. 1:39have it, the more heart disease. Every
45. 1:4239 points you lower LDL means about a
46. 1:4422% drop in major cardiovascular events.
47. 1:48>> Elevated levels alone do not equal
48. 1:51arterial plaque or cardiovascular
49. 1:54disease.
50. 1:55>> The research says otherwise. The PESA
51. 1:58study looked at middle-aged adults with
52. 2:00no traditional risk factors and nearly
53. 2:02half of them already had plaque in their
54. 2:04arteries. LDL was the strongest risk
55. 2:07factor they could change. About 11% of
56. 2:10people with an LDL between 60 and 70 had
57. 2:13plaque. Between 150 and 160, it was 64%.
58. 2:18>> In certain specific situations, people
59. 2:22who have already had a heart attack or
60. 2:24certain extremely high risk profiles,
61. 2:27they can provide some measurable risk
62. 2:30reduction.
63. 2:31>> It's not just for people who already had
64. 2:33a heart attack. The benefit of lowering
65. 2:36LDL grows the longer you do it. For
66. 2:39every 39 points lower, risk drops about
67. 2:4112% in the first year and about 29% by
68. 2:45year seven. That's why young people with
69. 2:47high LDL benefit the most over a
70. 2:50lifetime and 10-year risk calculators
71. 2:52miss them because those scores are
72. 2:54driven mostly by age.
73. 2:56>> But here's what statins do not fix, the
74. 2:59underlying metabolic dysfunction, the
75. 3:02chronic inflammation and the insulin
76. 3:05resistance that are actually driving
77. 3:07heart disease in the majority of
78. 3:10patients that I see.
79. 3:12>> The underlying cause, the root cause of
80. 3:14atherosclerosis is LDL cholesterol.
81. 3:18There's no question about it. This is
82. 3:19not debatable in the medical literature.
83. 3:22Brian Ference and colleagues in 2017
84. 3:24published a very large analysis with
85. 3:26more than 20 million person years of
86. 3:28follow-up showing that LDL cholesterol
87. 3:31meets the criteria for causation. In
88. 3:33other words, LDL cholesterol by itself
89. 3:36causes atherosclerosis. All of the other
90. 3:39things he mentions, like inflammation,
91. 3:41metabolic dysfunction, and insulin
92. 3:43resistance can contribute to it and
93. 3:45speed it up for sure. And you can add
94. 3:47other things, too. If you have high
95. 3:49blood pressure, if you're obese, if you
96. 3:51smoke, if you don't eat fruits and
97. 3:53vegetables, if you're sedentary, or if
98. 3:55you have poor social determinants of
99. 3:57health, all of those things speed it up.
100. 4:00But, make no mistake about it. If your
101. 4:02LDL cholesterol is below the threshold
102. 4:04for creating plaque, you will not create
103. 4:07plaque. People with hypo beta
104. 4:09lipoproteinemia walk around their entire
105. 4:12lives with an LDL cholesterol between 5
106. 4:14and 20, and they essentially never get
107. 4:16heart disease. Even if they smoke, even
108. 4:19if they have insulin resistance, even if
109. 4:21they're overweight, even if they don't
110. 4:22do anything right. We now have the tools
111. 4:25to completely prevent heart disease, yet
112. 4:28we're choosing not to. So, you don't
113. 4:30have to choose between fixing your
114. 4:32metabolism and lowering your LDL. You
115. 4:34can do both. In the Jupiter trial,
116. 4:37people without heart disease had 44%
117. 4:39fewer vascular events on a statin.
118. 4:42>> Many patients experience side effects,
119. 4:45such as muscle ache, fatigue, brain fog,
120. 4:49and the response varies widely from
121. 4:52person to person.
122. 4:53>> In 2026, the Cholesterol Treatment
123. 4:55Trialists published a study in The
124. 4:57Lancet. 23 double-blind trials with more
125. 5:00than 154,000
126. 5:03people. Of the 66 side effects on statin
127. 5:06labels, 62 happened just as often on the
128. 5:09sugar pill. Muscle symptoms were real,
129. 5:11but rare. In placebo-controlled
130. 5:14double-blind trials, the serious side
131. 5:16effects people worry about, like real
132. 5:18muscle damage or liver problems, showed
133. 5:20up in fewer than one in a thousand
134. 5:22people a year. And in trials where
135. 5:24people served as their own control,
136. 5:26switching between a statin and a placebo
137. 5:28without knowing which was which, about
138. 5:3090% of the symptoms they felt on the
139. 5:32statin showed up on the placebo, too.
140. 5:35That makes statins incredibly safe,
141. 5:37incredibly reliable, and very, very well
142. 5:40tolerated, with some of the best
143. 5:42outcomes we've ever seen. They don't
144. 5:44just prevent heart disease. Started
145. 5:46early enough in life, they can nearly
146. 5:48eliminate it. And if you do feel side
147. 5:51effects, tell your doctor. There are
148. 5:53other statins and other options.
149. 5:55>> Here's what I tell my patients instead
150. 5:58of just chasing a single lab number. In
151. 6:00the end, LDL is just one piece of a much
152. 6:04larger picture. Heart disease risk is
153. 6:06multifactorial.
154. 6:08Treatment decisions should focus on your
155. 6:11overall metabolic health, not a single
156. 6:14lab value.
157. 6:15>> He's right about one thing. LDL isn't
158. 6:17just a lab number. It's the actual cause
159. 6:20of atherosclerosis. It's the one lab
160. 6:23value all of us should be tracking,
161. 6:25monitoring closely, and knowing inside
162. 6:27out. If you could track only one thing
163. 6:30to predict your risk of dying of heart
164. 6:31disease, it would be your LDL
165. 6:33cholesterol. Lowering LDL is one of the
166. 6:36most studied and most proven things in
167. 6:39all of medicine. We've known that
168. 6:40cholesterol drives plaque for more than
169. 6:42100 years, and decades of trials show
170. 6:45that lowering LDL cuts heart attacks and
171. 6:47strokes. The lower it goes, the bigger
172. 6:50the benefit. So, if your LDL is high,
173. 6:53don't let anyone talk you out of
174. 6:55treating it. It doesn't matter if you're
175. 6:56metabolically healthy, if you're young,
176. 6:58or if you exercise. A high LDL builds
177. 7:01plaque anyway. 200 years ago, people ate
178. 7:05whole food, moved all day long, and were
179. 7:07rarely overweight. Life expectancy was
180. 7:10still under 40. A healthy lifestyle
181. 7:12alone was never the answer. Since the
182. 7:15late 1960s, deaths from heart disease
183. 7:17have dropped by more than half, [sighs]
184. 7:19even while obesity and chronic disease
185. 7:21went up. Cath labs, stents, heart
186. 7:24failure medicines, surgery, and less
187. 7:26smoking all helped. But lowering
188. 7:28cholesterol, above all with statins, is
189. 7:31one of the biggest reasons. And with
190. 7:33today's medicines, we can get LDL below
191. 7:3620. In the trials, the people with the
192. 7:38lowest LDL had the fewest heart attacks
193. 7:41and strokes, and we still haven't found
194. 7:43a floor. He and I agree that metabolic
195. 7:45health is important, but even if you're
196. 7:47completely healthy, a high LDL will
197. 7:50still build plaque. Telling people that
198. 7:52being metabolically healthy and active
199. 7:54protects them from a very high LDL is
200. 7:57simply wrong. The research is very
201. 7:59clear. In the PSA study, nearly half of
202. 8:02middle-aged adults with no traditional
203. 8:04risk factors, no smoking, no diabetes,
204. 8:07already had plaque. At an LDL of 60 to
205. 8:1170, 11% had plaque. At 150 to 160, it
206. 8:15was 64%.
207. 8:17In a pooled analysis of more than 36,000
208. 8:20young adults, an LDL of 100 or higher
209. 8:24meant a 64% higher risk of coronary
210. 8:26heart disease later in life. And the
211. 8:29REACT study, published this year,
212. 8:31scanned the arteries of more than 16,000
213. 8:34adults with no known heart disease. In
214. 8:36their 30s, one in three men and one in
215. 8:39five women already had plaque. So,
216. 8:42here's what actually moves the needle.
217. 8:44Reduce your saturated fat intake,
218. 8:47increase your fiber intake, and take
219. 8:49your medications if you need them. Then,
220. 8:52do cardio, lift weights, reduce stress,
221. 8:54and improve your sleep, and don't smoke.
222. 8:57If you want to text me all day and all
223. 9:00night, and go on Zoom with me live every
224. 9:02week, join my community. The link is
225. 9:04below. And I made a full video on the 15
226. 9:07biggest lies about statins. Watch that
227. 9:10one next.