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Do Cholesterol Drugs Do Any Good?

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#1 stocks



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Posted 25 July 2008 - 09:15 PM

The ad proclaims that "Lipitor reduces the risk of heart attack by 36%...in patients with multiple risk factors for heart disease."

The dramatic 36% figure has an asterisk. Read the smaller type. It says: "That means in a large clinical study, 3% of patients taking a sugar pill or placebo had a heart attack compared to 2% of patients taking Lipitor."

Now do some simple math. The numbers in that sentence mean that for every 100 people in the trial, which lasted 3 1/3 years, three people on placebos and two people on Lipitor had heart attacks. The difference credited to the drug? One fewer heart attack per 100 people.

So to spare one person a heart attack, 100 people had to take Lipitor for more than three years. The other 99 got no measurable benefit.

When Wright and others explain to patients without prior heart disease that only 1 in 100 is likely to benefit from taking statins for years, most are astonished.


#2 Rogerdodger



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Posted 26 July 2008 - 10:58 AM

Heart disease: US doctors back statins for children as young as 8 ...
With NO study of long term damage to these children!!!

The move by the American Academy of Paediatrics has triggered a furore, because there is little long-term data on the risks and benefits of statins in children and, as yet, no evidence that the drugs can prevent heart attacks when they are adults.

Get on the money train!!

Most people who take statins suffer no side effects from the cholesterol-lowering drugs. A small but significant number, however, develop mild to crushing muscle pain. In rare cases, the drugs can lead to permanent muscle damage, kidney problems, and death. Doctors disagree about the frequency of statin-induced muscle pain; clinical trials put the number at around 3 percent, though some doctors estimate that as many as 10 to 15 percent of statin patients are affected to some degree


If the only risk factor you have is high cholesterol, you may not need medication because your risk of heart attack and stroke is probably already low.


Researchers who studied 500,000 residents of Denmark, about 9 percent of that country's population, found that people who took statins were more likely to develop polyneuropathy.10 Taking statins for one year raised the risk of nerve damage by about 15 percent--about one case for every 2,200 patients. For those who took statins for two or more years, the additional risk rose to 26 percent.


PS: Another study found over 50% of internet quoted health links were incorrect!
(and many of the "correct" are debatable!)
What's a guy to do?

...over half of the links (22 out of 40, 55%) that the students viewed were, in fact, inaccurate on the whole.


Conclusions Despite the popularity of publications warning of the potential harm associated with using health information from the Internet, our search found few reported cases of harm. This may be due to an actual low risk for harm associated with the use of information available on the Internet, to underreporting of cases, or to bias.


Edited by Rogerdodger, 26 July 2008 - 11:07 AM.

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Posted 26 February 2009 - 06:40 PM

More statin madness

I’ve had a number of people email me about a new study appearing in the Archives of Internal Medicine purportedly showing that statins really do provide benefit to those who take them regularly. As you can see from the heading of an email piece I pasted above, even Medscape is all over this article and blasting it out to physicians all over the world.

I’m sad to say that this is the same kind of paper I would have been taken in by 20 years ago before I really understood how to read the scientific literature critically. In fact, I would have used it myself to justify giving statins to all kinds of people, and I’m sure other physicians are doing so right now. But I would have been in error to base my prescribing on this paper, and all the other docs out there giving statins like they were candy are in error as well.

What they’re saying here is that statins have been shown to reduce mortality from heart disease in those who have elevated LDL, which is true. But this decrease in deaths from heart disease is compensated for by an increase in deaths from cancer and other causes, so there really isn’t a gain. You’re still dead. Just maybe not from heart disease, but what difference does it make. Are you going to spend $200 per month for the rest of your life and stay on medications that may make you feel lousy and lose your memory just so you can die of something other than heart disease?

The randomized controlled studies clearly show very little benefit to statin therapy in terms of decreasing all-cause mortality, the one statistic that really counts. The controversy arises because the statinators simply don’t want to believe what these carefully performed trials tell them. They by gosh want statins to work. And they’re going to keep looking and fiddling with the data until they get a study that tells them what they want to hear whether the data is valid or not.

It’s pitiful that they are so desperate.

Don’t fall for the false promise of this or any other version of an observational study. These kinds of studies do not prove causality. Nor do they prove that a drug regimen works. The patients in this study who religiously took their statins had better all-cause mortality than those who didn’t. But, as we saw above, adherers always have better all-cause mortality than non-adherers. In this case, was it that the adherers lived longer or was it that statins conferred some sort of benefit. We can’t tell. But we do know that in the real studies, the randomized control trials, statins didn’t do squat, so my vote would be that what we’re seeing here is an adherer effect and not a statin effect.

My advice is to continue to regard statins with a jaundiced eye. So far, we haven’t seen any evidence that justifies the expense and the side effects of these drugs.


#4 maineman



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Posted 26 February 2009 - 08:03 PM

in the 20 years I've been prescribing statins (which cost 9 bucks for a 90 day supply at Wal Mart and other places) there has been a dramatic decline in stroke, heart attack and peripheral vascular disease. Patients who came to them late (e.g. after a cardiovascular episode) have been disease free since taking them. Who knows, maybe I only have healthy patients? No. I am very conservative about meds, but I use statins, blood pressure pills and encourage patients to treat their diabetes strongly. In fact, here's the key to health: lower cholesterol, blood sugar and blood pressure. Don't smoke. That's it. Statins are good. mm
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    Mark S. Young

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Posted 27 February 2009 - 08:20 AM

Have you noticed any drop in mental acuity among your statin takers?
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#6 maineman



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Posted 03 March 2009 - 03:21 PM

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Posted 11 March 2009 - 11:14 AM

Lower intelligence, memory problems, nightmares, depression, suicide...

Statins are the new NHS wonder drug for cutting cholesterol. But do they have sinister side-effects?

The research challenges the medical convention that lowering your cholesterol is always a good thing - indeed, they suggest statins may affect intelligence, cause depression and even raise the risk of suicide.
The studies add to a growing body of evidence that having low cholesterol levels may prove as dangerous as having high readings.

But cholesterol is also produced by the brain, where it is used to release vital chemicals called neurotransmitters that carry messages between brain cells. Now a study by Iowa State University suggests that statins inhibit this vital process.
When brain cells are deprived of cholesterol, they are five times less effective at releasing chemical messengers, says the research, published in the highly respected journal Proceedings Of The National Academy Of Sciences.
'If you deprive cholesterol from the brain, then you directly affect how smart you are and how well you remember things,' says Yeon-Kyun Shin, the biophysics professor behind the study. 'This may lead to depression and irrational acts.' He believes this is directly caused by disruption in the neurotransmitter release in the brain.

Shin's findings reinforce another new study, which found that men with a combination of low cholesterol and depression are seven times more likely to die prematurely from suicide, accidents and other unnatural causes than men with only depression.
Scientists who followed nearly 4,500 Vietnam veterans over a 15-year period say the disturbing findings may be due to low blood cholesterol reducing levels of the brain's feel-good chemical messenger, serotonin.

Low serotonin is linked to depression, anger, sleep loss and other problems, says Dr Joseph Boscarino, of the American Geisinger research institute, who did the research.
'While it's generally understood that having low cholesterol is a good health sign, combined with other factors, it could actually put a person at risk,' says the report.
In fact, there is a significant body of evidence to show that low cholesterol may be as dangerous as high cholesterol.



The idea that low cholesterol could be bad for you isn't the only health message that's been revised. Here are some others:

EGGS: Only last month, research backed by the British Nutrition Foundation put cholesterol-rich eggs firmly back on our healthy menus. For years, eggs had been associated with an increased risk of heart disease; this has been shown to be wrong.

BACKS: Conventional wisdom held that a bad back should be treated with bed rest. But experts changed their minds, and now stress the importance of movement and exercise.

TONSILS: A tonsillectomy was once almost a childhood rite of passage but are now so discredited that children who do need their tonsils removed can't get the operation.

NUTS: For ten years, pregnant and breastfeeding women were advised not to eat peanuts if there was a family history of allergies. But last December, the Food Safety Agency said it was no longer backing the policy because 'current evidence' does not support it.

MAGGOTS AND LEECHES: These were banned from mainstream therapy after the NHS was formed in 1948. But, in recent years, maggots have been used to keep wounds clean, and leeches to help healing after surgery.

NYMPHOMANIA: This was regarded as a mental illness until the Sixties. These days, women who don't have a strong sex drive are thought to be 'unwell', suffering from Female Sexual Dysfunction.

#8 stocks



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Posted 11 May 2009 - 08:45 AM

Cholesterol Contrarians Question Cult of Statins

But a cluster of cholesterol contrarians has emerged to challenge the conventional wisdom. These physicians argue that while statins are an appropriate and valuable medication for certain patients - particularly those with pre-existing heart conditions - their value to the general population is questionable. Furthermore, they argue, these powerful drugs create more serious side effects than the public or most doctors realize.

"There is a disparity between the published evidence and the public perception," argues Beatrice Golomb of the University of California, San Diego, who is conducting an ongoing study of the side effect of statins. She has authored a paper, to be published later this year, concluding that the coronary health benefits of statins are "fully offset" by the harm they do elsewhere the body.

"I don't think most doctors understand this — including the ones who do work in this area," she said.

"We're basically saying that most of the people who are taking statins are not going to benefit from them," agreed James Wright of Vancouver. "We think the benefits don't outweigh the harm in primary prevention — that is, for people who don't have evidence of occlusive vascular disease."

As director of the Therapeutics Initiative, an independent group based at the University of British Columbia that looks at evidence-based drug therapy issues, Wright has long been skeptical of the push to put more and more people on statins. An estimated 13 million Americans, and nearly as many outside the U.S., use these drugs, which are meant to be taken every day for the rest of your life.

Goldstein, the medical director of the Fountain Medical Court in Bonita Springs, Fla., argues that Western society suffers from "cholesterol-phobia" — a condition in which healthy people fixate on their LDL level after being bombarded with advertisements warning of potential danger.


Edited by stocks, 11 May 2009 - 08:52 AM.

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Posted 23 November 2009 - 07:05 PM

Statins treat lab values

Here in a short interview is everything that is wrong with mainstream medicine today. We have two influential doctors at the pinnacle of their academic and clinical prowess – no doubt on the payrolls of multiple pharmaceutical companies – who are absolutely full of themselves blathering on about expensive treatments that have no true scientific grounding. And their BS is being disseminated to practicing doctors everywhere. Instead of ‘Lipids for Dummies’ this interview should have been called Dummies for Statins.

Watch and just shake your head.

These guys aren’t really talking about reducing the risk for heart disease or early death; they’re discussing how to use extremely expensive medications that are not particularly benign to treat lab values. As I’ve written countless times, statins can quickly and effectively treat lab values, but there is little evidence they treat much else. So if you want to have lab values that are the envy of all your friends, statins are the way to go. But if you want to really reduce your risk for all-cause mortality, you might want to think twice before you sign up for a drug that will cost you (or your insurance company) $150-$250 per month, make your muscles ache, diminish your memory and cognition, and potentially croak your liver.


#10 Echo



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Posted 24 November 2009 - 01:15 AM

Stocks, there is always controversy about anything in life (except death and taxes). Well founded scientific studies that are randomized, placebo-controlled and prospective have consistently found benefit to statin therapy for cardiovascular (CV) events reduction with a fairly linear relationship found between the LDL cholesterol level and the risk of CV events. Across multiple nations, across a wide variety of cholesterol starting values and using methods even other than statins to reduce LDL cholesterol. Hundreds of thousands of patients. All very well documented. Statistically significant. You are presenting a very distorted few on the topic. To be clear, there are far more people having unstable angina, non-fatal heart attacks, strokes, needing angioplasty, stents and bypass surgery, than people dying of a cardiovascular event. SO, it is harder to show a benefit for death, but even the benefit for death is clear. 3 vs 2 out of 100 may not sound like much, but when you are talking about the #1 cause of death in the US, that's an important benefit. Add to that the reductions in unstable angina, non-fatal heart attacks, strokes, needing angioplasty, stents and bypass surgery and you start to see a significant health policy benefit. The second important point is that the higher the risk of the patient for CV events, the higher the benefits. Risk factors incl, hypertension, diabetes, hyperlipidemia, smoking and bad family genetics--history of CV events at age less than 55 in the family. There are other risk factors, but those 5 are a great start. So here's are rough breakdown: High risk and you already had a first event: No brainer--statin benefits are highest in this group. High risk and you've never had an event: Fairly good evidence to support taking it on risk vs benefit. Lower risk and you've already had a first event: Fairly good evidence to support taking it on risk/benefit. Lower risk and no first event: Here it is reasonable to try to lower cholesterol without meds if you can. There is absolutely NO QUESTION that there has been a substantial trend downward in CV events over the past 10 years largely due to the efforts of front-line doctors to better control hypertension, diabetes, and high cholesterol combined with less smoking. NO QUESTION. This is largely due to the availability of excellent drugs and medications with cleaner action and less and less side effects and NOT due to better eating and exercise habits in the US. By and large, the benefits are despite worsening diet and exercise habits with increasing obesity, sedentary lifestyle consumed in front of the TV, VCR, DVD, TIVO, internet, email, texting, twittering, etc. Doc