My next-door-neighbor is a lawn guy. I see him all the time from my office window, puttering around in his yard … seeding, fertilizing, watering if we haven’t had rain for awhile, and of course, mowing and trimming. Not surprisingly, he’s got a healthy lawn, which anyone can tell from the rich, green color of the grass.
I’m not a lawn guy. Never have been. I spent most of my adult life living in apartment buildings, where the lawn (if there was one) was the landlord’s problem. We rent a house now, so I’ve finally got the lawn, but I still have no desire to put any work into it. I pay a guy to ride his lawnmower around the place, and that’s the extent of my involvement. No seeding, no fertilizing, no watering. The grass isn’t just grass; it’s a motley mix of grass, clover and weeds, with a corresponding mix of hues. During dry spells, there are brownish patches.
So as you might expect, my lawn isn’t going to win the local association’s “Most Beautiful Lawn” award anytime soon. (Yes, they have one.) That doesn’t matter to me, but I wouldn’t mind having a nice, healthy lawn. So after comparing my neighbor’s lawn to mine, I’ve figured out a solution: I’m going to hire a company to spray-paint my grass the same color as his. Then my lawn will be just as healthy.
The company I have in mind is Merck. I’m picking them because they apparently believe that since people with high HDL are less prone to heart disease, they can prevent heart attacks by developing a drug that artificially jacks up HDL. Riiiiiight. Paint the grass green, and the lawn is healthy. And if I have a mechanic tinker with my Mitsubishi so it produces exactly the same amount of exhaust as a Maserati, it’ll do 180 on the highway.
What’s amazing is that Merck is jumping in where Pfizer already failed, as the Wall Street Journal reported in this article:
It’s been nearly three and a half years since Pfizer abruptly pulled the plug on its $800 million effort to develop torcetrapib after the HDL-cholesterol raising drug was linked to a higher risk of death in a 15,000-patient study.
The disastrous outcome contributed to Pfizer’s stunning decision in September 2008 to sharply curtail early-stage research for drugs for cardiovascular disease, a franchise the company has owned for more than a decade with the blockbuster statin Lipitor and the blood pressure pill Norvasc (now generic).
Pfizer ended its clinical trial three years early because the death rate among the subjects taking torcetrapib plus a statin was 60% higher than in the group that only took a statin. (Since the patent on Lipitor will run out soon, Pfizer was hoping to create a new miracle combo drug.) The higher death rate, by the way, included a higher rate of fatal heart attacks. Gee, you’d almost think something was wrong with the Lipid Hypothesis.
And here’s the interesting part: the drug did exactly what it was supposed to do. In early phases of clinical testing, Pfizer breathlessly reported that the miracle combo boosted HDL by 44 to 66 percent, while lowering LDL by 41 to 60 percent. Wowzers! … high HDL, low LDL. Your doctor would read your drug-induced cholesterol score and happily sign a declaration that you’ll probably live to be 100. Then a couple of years later, your family could take that declaration, fold it up neatly, and put it in the pocket of your burial suit.
The point is, high HDL and low LDL don’t confer benefits in and of themselves. It’s far more likely that they’re markers for good cardiovascular health, not the cause. (In the case of low LDL, it’s not even a good marker. See this post for more on that topic.) Pushing markers up or down with drugs is nothing more than treating a lab score. And as Pfizer found out, the drugs can produce nasty side effects that far outweigh any benefits.
My HDL on my last lab test was 64. Combined with a score of 70 for my triglycerides, it makes for an impressive lab result. But it’s not those numbers that are keeping me healthy; it’s the diet that produced those numbers. A diet rich in natural fats raises HDL. A diet low in sugar and starch reduces triglycerides. A diet rich in natural fats and low in sugar is also a diet that’s more likely to keep blood sugar under control, and less likely to produce the inflammation that can damage arteries.
As I’ve said before, I don’t expect pharmaceutical companies to abandon the drug business and start recommending a change in diet. That’s not why they exist … and some of the drugs they’ve produced have been modern wonders.
Unfortunately, it’s the cholesterol-manipulating drugs that have been raking in the big bucks for the past 20 years, so of course Merck is going to jump on the HDL bandwagon. Prepare yourself for the press releases coming down the pike over the next few years. First you’ll see headlines about how Merck’s new drug raises HDL by 90%. Then you’ll read about clinical results that are “inconclusive.” Finally, Merck will quietly put out a release giving the pharmaceutical version of “The operation was a success, but unfortunately the patient died.”
Then I’ll hire some of their former employees to paint my lawn.
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