Bempedoic acid, marketed as Nexletol, is being heralded as the latest weapon in the pharmaceutical industry’s arsenal against high cholesterol and cardiovascular disease. Approved in 2020, it has been promoted as an alternative for individuals who cannot tolerate statins. But is it truly a game-changer, or just another Band-Aid for deeper systemic issues? As a holistic cardiologist, I believe the root cause of heart disease lies not in a statin deficiency—or, now, a bempedoic acid deficiency—but in lifestyle, nutrition, and addressing the body as a whole.
What is Bempedoic Acid?
Bempedoic acid is a medication that targets adenosine triphosphate-citrate lyase (ACL), a liver enzyme involved in cholesterol production. Unlike statins, which act further down the pathway and are notorious for muscle-related side effects, bempedoic acid activates only in the liver, which supposedly spares muscle tissue. This is being touted as its main advantage over statins. But while the mechanism might be different, the question remains: are we fixing the root of the problem, or just managing symptoms?
High cholesterol is often blamed as the villain in cardiovascular disease, but what about chronic inflammation, poor diet, environmental toxins, and sedentary lifestyles? These underlying causes won’t be addressed by bempedoic acid—or any pharmaceutical drug.
A Closer Look at the CLEAR Outcomes Trial
The CLEAR Outcomes Trial is being used to promote bempedoic acid as a viable solution for statin-intolerant patients. But when we dig into the numbers, the results are less impressive than the headlines suggest.
After 3.5 years, the trial showed:
– Primary Endpoint (4-component MACE): 11.7% of patients on bempedoic acid experienced a cardiovascular event compared to 13.3% on placebo. This means an absolute risk reduction (ARR) of just 1.6%. That’s right—1.6%. For every 100 people treated, ONLY 1 or 2 avoid a major cardiovascular event.
– Fatal and Nonfatal Heart Attacks: The ARR was 1.1%.
– Coronary Revascularization: The ARR was 1.4%.
While these numbers might sound meaningful in pharmaceutical marketing, they pale in comparison to what can be achieved with lifestyle changes. How about lower your risk to 0%? I think we do this at Natural Heart Doctor.
No Impact on Overall Mortality
Perhaps the most damning finding of the CLEAR Outcomes Trial is that bempedoic acid did not reduce overall mortality. In fact, there was a slight increase in death rates in the bempedoic acid group (6.2% vs. 6.0% on placebo). In other words, while it may tweak cholesterol numbers and reduce certain events, it does nothing to extend life. Shouldn’t that be the ultimate goal?
What About Side Effects?
While bempedoic acid avoids the muscle pain associated with statins, it is not without risks:
– Elevated Uric Acid: Increases the risk of gout.
– Tendon Disorders: Rare but serious injuries.
– Liver Enzyme Elevations: Indicates potential liver stress.
Is this risk worth taking for a 1.6% reduction in cardiovascular events when safer, natural options exist?
Pharmaceuticals Are Not the Solution
Bempedoic acid represents yet another attempt to treat symptoms while ignoring causes. It assumes that cholesterol is the primary problem, ignoring the fact that cholesterol is a vital molecule for hormone production, brain health, and cell repair. Demonizing cholesterol and lowering it at all costs is a misguided strategy that benefits pharmaceutical companies more than patients.
The solution is the 100 Year Heart Method.
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