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Cholesterol Guru Saved Us

It seems almost unbelieveable that barely 25 years ago there was still controversy raging in the medical literature about whether cholesterol played a central role in the development of heart disease.

The first attempt to summarize where the science stood was the Consensus Conference on Lowering Blood cholesterol to Prevent Heart Disease in 1984. One of the chief architects was Basil Rifkin, the head of the National Institutes of Health, division of Atherogenesis who passed away this week at 73. Dr Rifkin and his pals were the first to take a stand and declare that the total evidence from a bunch of small studies and population surveys showed that high cholesterol levels were killing our people in increasing numbers. They also made the important statement that we should attempt to reduce the level of cholesterol in the blood of all Americans because even average levels in this country were way too high by historic standards. For instance they were less than half as high in Asian countries with mostly fish and vegetable based diets where heart disease was almost unheard of. They further called, rather cautiously for treating those with levels above 240 with diet and in some cases niacin and cholestyramine, the only drugs available at the time (this was some 5 years before the availability of the first statin drug).

It was a bold move at the time and was welcomed by those of us who needed support to get people to change their carnivorous and sedentary habits. We have learned a lot since then, not the least of which is that very low cholesterol levels are achievable with modern drug therapy and lifestyle change and can dramatically reduce risk of heart attack and stroke by as much as 90%!! Dr. Rifkin and the NIH deserve a lot of credit for saving a lot of us from ourselves.

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