Monday, February 05, 2007

Statin Briefs

Lancet, Jan 20, 2007
Are Lipid-Lowering Guidelines Evidence-Based?
To sum it up: No studies have shown statin cholesterol-lowering drugs to be effective for women at any age, nor for men 69 years of age or older, who do not already have heart disease or diabetes. More than 50 adults have to take a statin drug for 1 patient to avoid a fatal heart attack, and that figure only applies to high-risk patients. Cholesterol treatment guidelines need to be revised.

This is London, UK, Jan 23, 2007
To sum it up: Dr. Malcolm Kendrick has published a book, The Great Cholesterol Lie; who likens the lipid-hypothesis and heart disease to an amazing beast. "The closer you look the more you find that the cholestrol hypothesis is an amazing beast. It is in a process of constant adaptation in order to encompass all contradictory data without keeling over and expiring."

HeartWire Jan. 27, 2007
Dr. James M Wright of the University of British Columbia, Vancouver
"If you take a male who is 50 years old, a smoker, with high blood pressure, who eats the worst diet in the world . . . then if I were an honest physician, I would tell him that maybe he should be taking a statin. And if he asked how much would that reduce his risk, I would have to tell him that it would only reduce his risk by 2% over the next five years. If he understood that information, he would say, You're expecting me to take a pill everyday for five years? And it's going to cost me two dollars a day? You're crazy! I'm not going to do it."

So, if physicians were truly honest with their patients, the doctor says, "I think there probably would be very few people being treated for primary prevention with a statin drug."

World Review Nutrition Dietetics, 96: 1–17, 2007
To sum it up: Dr. Harumi Okuyama says the direction of modern medicine needs to move away from the lipid-hypothesis of coronary heart disease. Once cases of genetic/familial high cholesterol are removed from population statistics, he claims that high cholesterol is not found to be a causal factor for coronary heart disease. High total cholesterol is not positively associated with high coronary heart disease mortality rates among general populations more than 40–50 years of age. He notes that the rate of heart attacks differs by approximately 4 to 8-fold at the same total cholesterol level in some populations.

He continues that while Western countries have accepted the lipid-hypothesis of heart disease and the use of statin drugs, "little benefit seems to result from efforts to limit dietary cholesterol intake or to total cholesterol values to less than approximately 260 mg/dL." He believes it is urgent we change the direction of current medical practice away from statins.

1 comment:

  1. When I read this post I thought how unfortunate it is that the by far best risk marker, HbA1c is so religiously ignored by the statin pushers. Knowing that it could have nothing to do with the $20 billion in annual sales, I just can’t figure what it IS? I wanted to site one of the studies that illustrate this fact so I performed a google search:

    HbA1c all cause mortality

    What you may find interesting is that your blog entry from 11/17/06 came up fourth!

    Results 1 - 10 of about 114,000 English pages for HbA1c all cause mortality. (0.12 seconds)