I feel compelled to do a post today in response to medical news that is all over the news wires today about statin drugs, that’s the class of drugs that lower your cholesterol levels. The LA Times Headline says “about 70 million Americans could take statins under new guidelines”
Let me just read the first few paragraphs of the article,
“The number of Americans taking cholesterol-lowering statin drugs is set to double under new guidelines unveiled Tuesday by the American College of Cardiology and the American Heart Assn.
The goal of prescribing statins to as many as 70 million people is to reduce the incidence of heart attacks and strokes in the United States, not merely to get patient’s LDL cholesterol – the “bad” kind that’s most closely linked to disease risk – into an ideal range, experts said.
The new game plan for statins represents a stark shift from approaches embraced by cardiologists and primary care physicians for most of the past decade. Now, doctors will be urged to treat a wider range of healthier patients, including those likely to suffer stroke or heart disease as they age.
The new guidelines distinguish between patients who would benefit most from high-dose statin therapy and those who can take a lower dose less likely to cause side effects, such as muscle fatigue, a slight rise in blood sugar and, in rare cases, hemorrhagic strokes and a toxic breakdown of muscle tissue called rhabdomyolysis.
Cholesterol is essential for digestion, hormonal balance and cell function, but at high concentrations can gum up arteries. Statins reduce cholesterol by blocking the liver’s production of the waxy substance. Americans spent $21.3 billion on cholesterol-lowering medications in 2010, including statins marketed under such brand names as Crestor, Lipitor and Zocor.
Under the new guidelines, physicians should prescribe statin medications to all patients with high odds of suffering a heart attack or stroke in the short-term — that is, those who have had such an event already, patients with Type 2 diabetes, and those with exceptionally high levels of LDL cholesterol linked to familial risk.
But the guidelines also recommend that patients with a 7.5% risk of suffering a stroke or heart attack over the next decade be prescribed statin medication as well.”
Not surprising the Wall Street Journal reports “AstraZeneca Applauds the Release of New US Guideline for Management of Blood Cholesterol”
It’s not surprising because according to WebMD AstraZeneca’s Crestor was the number 1 most prescribed drug last year with 23.7 million prescriptions and total sales of $5.3 billion dollars. These new guidelines are expected to double the number of prescriptions for the statin drug class having a major positive impact on AstraZeneca’s bottom line.
Another amazing development, in a story reported in Endocrinology Update on Nov 4 past American Medical Association president Professor Kerryn Phelps advised the public via her Twitter account to consider stopping their statins. She twitted her comment while watching ABCs series called Heart of the Matter Part 2: Cholesterol Drug War which claimed that the medical profession and the public had been duped into believing that statins were essential for preventing death from heart
One of the studies that they used to come up with these guidelines is a meta analysis by the Cochrane group that added up results from 18 different trials to conclude that statins reduced deaths from all causes in people with low risk of heart disease. Their conclusion was that if 1000 people took a statin over 5 years, 18 of them would avoid a major cardiovascular event. The British Medical Journal in October of this year argues that the “events” in the trials included procedures to improve blood flow to the heart and who knows if the person would have had a heart attack if this hadn’t been done? It also says that the side-effects of statins such as increased risk of developing diabetes (about 10%) and muscle pain (50% more common) were not adequately reported. It further points out that all of the randomized trials in the Cochrane review were funded by the manufacturers of the statins being studied. Interestingly, another Cochrane review unrelated to this story showed that industry-sponsored studies are more likely to find positive results than non-commercial trials.
Let me review with you some articles that have been published in the last few months about the risks associated with statins.
Oct 25, 2013 the Men’s Journal had an article called Statin’s Latest Side Effects. In this article they pointed out that in a trial of more than 46,000 adults, statin users had a 27 percent greater risk of developing vision-skewing conditions than non users. According to Dr Daniel Briceland, spokesperson for the American Academy of Ophthalmology “The lens epithelial cells are very sensitive to changes in oxidative stress” Since statins interfere with oxidation processes the eye cells might not regenerate properly to clear away cataracts. According to Dr Paul Thompson, chief of cardiology at Harvard Hospital in Connecticut, “We know that statins inhibit a process that dissolves collagen and other fibrous tissue, so it could be that this interferes with the eye’s ability to repair damaged tissue.”
According to the Chicago Tribune Oct 30, 2013, when Mevacor also known as lovastatin, the first statin drug, was being developed, animal studies suggested that cataracts might be a side effect. On May 21, 2010 a British study reported in the British Medical Journal online showed that statins increased the risk of cataracts and the risk returned to normal within a year of stopping the statin medication.
A new study reported in JAMA Ophtamology online on Sept 19, 2013 showed that cataracts are more common in statin users than non users.
Diabetes, according to Renal and Urology News, atorvastatin had no significant affect on a combined endpoint of cardiovascular death, myocardial infarction also known as MI and stroke among diabetic patients on hemodialysis. After 11.5 years of follow up in both groups, daily atorvastatin or placebo, 90% of the patients had died despite the fact that the patients who were given atorvastatin during the trial had an average reduction in LDL cholesterol levels by 42%. In the New York Times October 22, 2013 Dr Hosam Kamel, the vice chairman of the American Medical Directors Association, a group representing physicians in nursing home practice, said there was scarce scientific evidence supporting the use of statins in 70 to 80 year olds in their care. He said that the results don’t conclusively establish the benefits of using statins for seniors and he went on to say there is evidence of harm linked to statin use in seniors including muscle aches, liver toxicity, gastrointestinal distress, and growing evidence of impaired memory, heightened risk of diabetes and increased risk of cancer.
According to Dr Rita Redberg, cardiologist at the University of California San Francisco Medical Center and editor in chief of JAMA the side effects associated with statin use was not reported in studies. According to her summary of the evidence for using statins to prevent heart disease, heart attacks will be prevented in only 1 or 2 out of every 100 healthy people with high cholesterol who take statins for 5 years while 1 person out of those 100 will develop diabetes and older people are much more vulnerable to the side effects of the medications. She also says there is some evidence that low cholesterol is associated with higher mortality at an older age.
Back in 2009 I appeared on KSCO Radio’s The Wellness Hour with Bernie Owens. (link is coming soon) Back then on that show I laid out the facts about cholesterol and statin drugs as I saw them using the drug manufacturers own research to back up my opinions.
I pointed out back then that inflammation was a better predictor of cardiovascular events than cholesterol. In fact I stated on that show that cholesterol had NOTHING TO DO WITH HEART DISEASE, that it was actually a warning sign.
I laid out how, when you actually look at a lot of the research on statin drugs and look at the raw numbers, not the conclusions at the beginning and end of the articles but the raw numbers, many times there wasn’t any real significant, statistical difference in outcomes of cholesterol lowering from the placebo groups.
I showed that statin drugs actually do 2 things.
– it’s true they lower cholesterol but
– they are actually anti-inflammatory as well and it was this property that produced the positive cardiovascular benefits.
I showed that lowering cholesterol numbers actually caused many other problems ranging from issues with muscles because of co Q 10 depletion, low testosterone, low vitamin d, increased risk of cancer, and increase risk of Alzheimer disease. So it is really refreshing now to have a well-known cardiologist back up some of what I said back then.
See my blog post, “Truth About Cholesterol“
See Also “Are Your Prescriptions Making You Sicker?“
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