CardioBrief

It’s only a very small moment within the enormous ongoing debate over health care reform, but a recent exchange in the US Senate over cholesterol remedies highlights the potential pitfalls when politicians talk about medicine.

As reported by David Herzenhorn in the New York Times, New York’s Senator Charles Schumer “said his doctor had directed him to take Lipitor… and then, after his cholesterol levels had dropped, suggested that he try a less expensive, generic medication instead. But he switched back after his cholesterol levels went back up. ‘I’m taking Lipitor even though it’s more expensive.’”

Iowa’s Charles Grassley then recommended that Schumer “try a more natural remedy: red yeast rice. ‘I’ll bring the pills for you tomorrow,’ he told Mr. Schumer.”

Finally, Florida’s Bill Nelson said: “Grapefruit might do the same thing for you.”

Schumer got in the last word: “‘How about a pastrami sandwich? How would that do?”

Comment: It’s probably best not to make too much out of this passing exchange, but it may be worth noting that only Schumer’s comments (pastrami sandwich excepted) would pass muster with most cardiologists. Although red yeast rice contains the same ingredient found in lovastatin, it has not been proven to be either safe or effective and, as Herzenhorn accurately notes in his story, the FDA has issued warnings about red yeast rice products in the past.

It wouldn’t surprise me if some critics of Grassley’s crusade against conflicts of interest in medical decision making and education use his remarks as ammunition against him. But because Grassley is wrong about red yeast rice doesn’t mean he’s also wrong about everything else. But it is fair to hold his feet to the fire and demand that “natural” remedies like red yeast rice supplements undergo the same kind of rigorous scrutiny as other medications.

It should also be noted that grapefruit is good for you (or at least a whole lot better than soda and candy) but it’s no substitute for a statin, and people who take warfarin need to be careful.

Finally, it’s unlikely that this little episode sheds any real light on the larger issue of health care reform.

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