Effectiveness of statins is called into question (L.A.Times)

[mike r]

http://www.latimes.com/news/science/la-he-statins-20100809,0,934659.story

August 9, 2010
Effectiveness of statins is called into question
The drugs clearly help patients who have already had a heart attack. But their use has skyrocketed in patients hoping to prevent a first heart attack. In those cases, the benefits are dubious.
By Melissa Healy, Los Angeles Times

As the world's most-prescribed class of medications, statins indisputably qualify for the commercial distinction of "blockbuster." About 24 million Americans take the drugs — marketed under such commercial names as Pravachol, Mevacor, Lipitor, Zocor and Crestor — largely to stave off heart attacks and strokes.

At the zenith of their profitability, these medications raked in $26.2 billion a year for their manufacturers. The introduction in recent years of cheaper generic versions may have begun to cut into sales revenues for the brand-name drugs that came first to the market, but better prices have only fueled the medications' use: In 2009, U.S. patients filled 201.4 million prescriptions for statins, according to IMS Health, which tracks prescription drug trends. That's nearly double the number of prescriptions written for statins in 2001, four years after they arrived on the American pharmaceutical landscape. But in recent months the drugs' touted medical reputation has come under tough scrutiny.

Statins were initially approved by the Food and Drug Administration for the prevention of repeat heart attacks and strokes in patients with high cholesterol who had already had a heart attack. And used for that purpose — called "secondary prevention" — the drugs are powerful and effective medications, driving down patients' risk of another heart attack or stroke by lowering their levels of LDL (or "bad") cholesterol. Then physicians came to believe statins could also reduce the risk of a first heart attack in people who have high LDL cholesterol but are nonetheless healthy. This use of statins — called "primary prevention" — has driven the growth in the market for statins over the last decade. Today, a majority of people who use statins are doing so for primary prevention of heart attacks and strokes. It is this use of statins that has come under recent attack.

"There's a conspiracy of false hope," says Harvard Medical School's Dr. John Abramson, who has cowritten several critiques of statins' rise, including one published in June in the Archives of Internal Medicine. "The public wants an easy way to prevent heart disease, doctors want to reduce their patients' risk of heart disease and drug companies want to maximize the number of people taking their pills to boost their sales and profits."...

[arikara]

1. I have no doubt that statins will go down

as one of the biggest hoaxes perpetrated by the medical system. There is lots of alternative information out there but of course none of that counts with the believers, so when an article in business week came out 2 years ago I gave it to my Mr's physician. To his credit, he actually read it and commented on it the next time we saw him, and he isn't so pushy with the statins anymore.

a couple of the excerpts...

<snip>

no benefit in people over the age of 65, no matter how much their cholesterol declines, and no benefit in women of any age. He did see a small reduction in the number of heart attacks for middle-aged men taking statins in clinical trials. But even for these men, there was no overall reduction in total deaths or illnesses requiring hospitalization—despite big reductions in "bad" cholesterol. "Most people are taking something with no chance of benefit and a risk of harm,"

<snip>

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. Or to put it in terms of a little-known but useful statistic, the number needed to treat (or NNT) for one person to benefit is 100.

<snip>

http://www.businessweek.com/magazine/content/08_04/b4068052092994_page_2.htm

[azul]

2. Wait, there is more.

Side effects. Memory loss. Glucose and fat metabolism disruptions.

I went to a seminar on ageing and nutrition recently and got directed to some information on how the brain needs plenty of cholesterol and fatty acids to make connections and function well, and how statins block this metabolism: make you forget stuff perhaps to dementia, but remember an insatiable hunger.

http://www.spacedoc.net/

http://people.csail.mit.edu/seneff/statins_think_twice.html


The effort to get at the metabolic effects is up against rally big special interests now a days.

[arikara]

3. Oh I know

don't forget about damage to muscle. Muscle pain is why we've fought against the Mr being on statins. Because he's had heart attacks the docs get very demanding on the subject. They don't get that lowering cholesterol at the cost of destroying muscle makes no sense as the heart is a muscle too. I have an elderly friend who was healthy but has totally gone downhill since starting statins. Now her memory is terrible and she's depressed all the time. Unfortunately she's of the old school where the doctor is god so she won't stop the pills.