The “standard”, if you have ever had a cardiac “event” or coronary artery disease, is to immediately place you on a statin (for the rest of your life) and, in most cases (exception: if you have ulcer issues) low-dose aspirin as a low-level anticoagulant.
Here’s the problem: It doesn’t work because it’s not targeting where the actual issue resides.
This has now been known since 2004, when this study published; the study itself was initiated in 1999. 304 patients with a history of coronary artery disease were tested and baselined. Only those with normal glucose levels were accepted into the study; clinical diabetes was an exclusionary factor. 202 of the 304 were excluded at baseline for this reason, leaving the study authors with 102 patients.
The results ought to wake you up; they’re here in this table.
The CVE+ entries are for those who had a second cardiac event during the three years of the study, the CVE- entries are for those who did not. ALL of the CVE+ entries had elevated (by double on average) insulin levels despite both groups having normal blood glucose.
Further, those who had a second event had no material difference in cholesterol levels compared to those who did not. In other words “management” of cholesterol levels was not protective. Finally, there was a material difference in statin use — in the negative sense, in that a greater percentage of those who had an event were taking a statin (and a nitrate!) than those who didn’t, and even worse, aspirin wasn’t protective either.
One cautionary note: All of these results are associative, as they must be in such a study. Even though the divergence in insulin levels was ridiculous between the two groups that does not prove causation.
But remember — while associations can provide strong evidence of a connection they are just as valuable, if not more-so, in disproving said connections. In this case it appears that both statins and aspirin are worthless when it comes to preventing a second CAD event.
Further, since all of the participants had normal glucose levels there is no intervention that targets “diabetes management” which helps in this case. Indeed the study showed that “management” of diabetes symptoms (specifically, blood glucose levels) that allows high insulin to persist may actually potentiate — that is, cause — the second heart attack and CAD event.
There is no medicine for the condition of high insulin — that is, “insulin resistance.” We can and do treat the symptom that it (eventually) produces, that is, high blood glucose, but the cause of the high glucose remains unaddressed.
There is, however, a means to improve your insulin sensitivity — that is, to move yourself either from that second column to the first one or at least get closer to it: Get all of the vegetable oils and carbohydrates (that is, grains and starches including breads, cereals and similar), with the exception of green vegetables and modest amounts of fruit, out of your diet.
Again — this study has been out since 2004. Why hasn’t your doctor — and especially, if you have one, your cardiologist — told you?
Further, if you’ve got evidence of CAD in your medical history why hasn’t your insulin sensitivity (NOT just cholesterol and glucose tolerance) been tested and monitored? Is it because there is no pill for it and that the actual means of improvement available to us require admitting that the so-called “standard recommendations” for what to eat, especially for those with heart disease, are exactly backward?