POLICOSANOL AND THE STATIN WAR
On May 17, 2006, the JAMA carried a mundane little article stating that policosanol was ineffective in reducing cholesterol (1). This rather odd, little article is remarkable in that it made international news. The NEW YORK TIMES, USA TODAY and even small city newspapers touted it as being quite the latest word and of enough importance to distribute it widely. Why? The article itself noted that there were 80 articles that had shown considerable benefit from policosanol. Considering the routine refusal of JAMA and NEJM to publish letters criticizing such articles ( I have had a dozen turned down and know some others who have had the same experience), I have to raise the question of false advertising. After all, these journals receive huge income from the pharmaceutical companies which push statin drugs as if they were water. There has been a concerted effort in recent years to attempt to put everyone in the world on one or even two statin drugs. The risks of statin drugs far outweigh any benefits that I see. Yes, statins reduce cholesterol but they also damage liver, muscle, heart muscle, peripheral nerves and the brain. Is it a coincidence that the incidence of congestive heart failure (heart muscle damage) has doubled?

The article in question involved only 143 patients who were treated for 12 weeks with Cuban sugar cane derived policosanol. Was it the Cuban source? Are the authors of the study paid ''consultants'' to the statin industry? We may never know the answers to these questions.

The evidence for effectiveness of policosanol in reducing cholesterol is at least 80 times as great as the negative study. Why did the media not at least mention some of the positive articles? The positive studies include a total of many hundreds of patients. The negative article came from Cologne, Germany. In 2002. the AMERICAN HEART JOURNAL published an article from Bonn, Germany (2). The authors reviewed the literature in placebo-controlled lipid lowering studies and found that policosanol lowered total cholesterol by17 to 20% and lowered LDL cholesterol by 21 to 29%, while raising HDL by 8 to 15%. These authors note that 10 mg of policosanol is safe, well tolerated, and ''equally effective in lowering total or LDL cholesterol as the same dose of simvastatin or pravastatin.'' Policosanol at dosages of 20 mg have been found to be safe is studies up to over 3 years. Policosanol has additional benefit in enhancing smooth muscle proliferation (the opposite of statins), decreasing platelet aggregation, and LDL peroxidation. It is of some interest that the negative Cologne study was begun in September, 2000, and finished in May, 2001. Why was it published 5 years later? All the studies on policosanol have reported that it is safe and free of adverse effects. Is the increasing evidence that statins carry serious risks a reason to have this small, negative study published and excessively publicized now?

One study of policosanol in 1999, demonstrated that policosanol was more effective and safer that pravastin (3). Indeed, in this study policosanol lowered cholesterol one and a half times that of pravastatin! And there are studies demonstrating the effectiveness of policosanol in improving the heart status of patients with coronary heart disease (4). Another study concludes that ''policosanol produces more advantageous changes in HDL cholesterol and has a better safety and tolerability than lovastatin 20 mg/day'' (5). And another study demonstrated the lipid lowering effects, and safety as well as significant lowering of blood pressure (6). And yet another concluded that ''policosanol, but not lovastatin, is a suitable alternative to manage patients with intermittent claudication because of pleotrophic properties beyond its cholesterol-lowering effects (7).

The statin war is moving into high gear. I will take policosanol, beta sitosterol, lecithin, arginine, taurine, diet and exercise any day over any statin drug! There is NO situation under which I would personally use a statin drug. Beware the PharmacoMafia's attempts to push statins on everyone. The effects may be as serious as any war!