Cardiologist Refutes Relationship Between Cholesterol Levels And Heart Attack

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The original research that led to putting so many Americans on statins may be flawed.

Ernest N. Curtis, M.D.

Everybody has atherosclerosis to one degree or another, It is simply a biological fact of aging.

People taking statins may be surprised to learn that, according to a California cardiologist, cholesterol levels have nothing to do with whether a person develops heart disease or has a heart attack.

“Everybody has atherosclerosis to one degree or another,” states Dr. Ernest N. Curtis. “It is simply a biological fact of aging.”

The idea that cholesterol causes disease comes from a set of closely related theories known as the Lipid Hypothesis, the Cholesterol Theory, and the Diet-Heart Theory. These theories claim that too much cholesterol in the blood is the major causative factor in atherosclerosis, also known as hardening of the arteries. The Diet-Heart Theory maintains that too much saturated fat and cholesterol in the diet raises the cholesterol level, causing atherosclerosis and leading to the two most dreaded complications of atherosclerosis--heart attack and stroke.

However, many doctors and patients have a seriously mistaken view of what atherosclerosis actually is. Cholesterol is not deposited on the inner surface of the arteries and built up over time like sludge in a pipe. Actually, the process is initiated by a proliferation of smooth muscle cells from the middle layer of the wall of the artery. These sheets of cell form a firm plaque which rigidifies that portion of the arterial wall. Nothing is deposited upon or sticking to the inner lining of the artery. Some have hypothesized that the breakdown of cells within plaque gives rise to the cholesterol that is often found there, which is to say that cholesterol is a result of the plaque, and not the cause.

During his cardiology training over thirty years ago, Dr. Ernest N. Curtis saw hundreds of patients with coronary heart disease and heart attacks. He was struck by the fact that most patients with fairly advanced atherosclerosis had such a wide variety of cholesterol levels. Dr. Curtis began to question what he had been taught on the subject and to research the origins of the Cholesterol Theory.

“If one takes the occurrence of heart attacks and strokes as an index of the severity of atherosclerosis then there are some statistics that argue strongly against a role for cholesterol. For example, men suffer heart attacks at a rate 3-5 times that for women. Yet women on average have higher cholesterol levels than men. If you examine the statistics closely you will see that the incidence of heart attacks is spread pretty evenly throughout the entire range of cholesterol levels.”

In working his way back to the original studies on cholesterol, he was surprised to find that evidence for the truth of these theories was so weak as to be virtually nonexistent.

Cholesterol is a major structural component of every cell in the body and especially vital to the cell membrane that encloses and protects every cell. The bile salts required for proper absorption of fats and fat-soluble vitamins are made from cholesterol as are many of the hormones without which we could not live. If the human body manufactures 80-90% of the cholesterol in our system, then how could humans survive and advance if manufacturing a toxic substance in the arteries?

As he worked forward through the evolution of these theories, he noticed a persistent pattern that included employment of dubious data and statistics, unscientific reasoning, and statistical manipulation designed to make trivial differences seem significant. A number of these practices bordered on outright scientific fraud. One distinguished researcher, George V. Mann ScD, M.D., professor of Biochemistry at Vanderbilt School of Medicine, called the Diet-Heart Theory “the greatest scientific fraud of the 20th century---perhaps any century.”

Dr. Curtis’ book, "The Cholesterol Delusion", traces the development of the Cholesterol Theory from its origins and shows how each step in its evolution used dubious data and statistics, unscientific reasoning, and statistical manipulation to promulgate a fallacious theory that supports cholesterol as a deleterious element in the body. The book is helpful for those whose cholesterol levels are high and for whom statins have been prescribed.

Dr. Ernest N. Curtis received his B.A. In Biological Sciences from the University of California, Berkeley and his M.D. from the University of California, Irvine. After a Residency in Internal Medicine and Fellowship in Cardiology, he entered private practice in Long Beach, California where he has practiced for the last 32 years. Visit the author at


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