Wednesday, June 06, 2012

Should Statins Be Given To Healthy People?

This study (and accompanying editorial) are recommending that everyone over 50 take statins. (The study is free, you need to register though):

The Effects Of Lowering LDL Cholesterol With Statin Therapy In People At Low Risk Of Vascular Disease: Meta-analysis Of Individual Data From 27 Randomised Trials, The Lancet, 17 May 2012
"In individuals with 5-year risk of major vascular events lower than 10%, each 1 mmol/L reduction in LDL cholesterol produced an absolute reduction in major vascular events of about 11 per 1000 over 5 years. This benefit greatly exceeds any known hazards of statin therapy. Under present guidelines, such individuals would not typically be regarded as suitable for LDL-lowering statin therapy. The present report suggests, therefore, that these guidelines might need to be reconsidered."
This would be a coup for drug makers.

Do statins really provide benefit for someone at low risk of heart disease? One of the study's coauthors, Colin Baigent, admits:1
"Once you get down to very low levels of risk, the benefits are very small."
If you're thinking of giving statins to healthy people, why study diseased people? (60% of these participants had vascular disease.)
"Why combine people who have heart disease with people who don't? It's really misleading," says Kausik Ray, a cardiologist at Saint George's University of London. In 2010 Ray and his colleagues published a meta-analysis of 11 statin clinical trials involving 65,229 subjects without cardiovascular disease and concluded that statins do not reduce the risk of death in healthy people. (By including people who had vascular disease, the Lancet meta-analysis overestimated statins' benefits.)"
Documented side effects include strokes, muscle damage, diabetes, liver problems, kidney failure, and cognitive impairment. How well did this study account for side effects?
"According to Rita Redberg, a cardiologist at the University of California, San Francisco, and chief editor of the Archives of Internal Medicine, prior to the start of one of the trials included in the analysis, potential subjects were given statins for several weeks to see how well they tolerated them. If any individuals experienced side effects, they weren't invited into the trial. This type of prescreening is "not clean science," says Vinay Prasad, an internist at Northwestern University Feinberg School of Medicine, because it makes drugs look safer than they really are."
Any corruption in the research?
"Almost all of the trials included in the meta-analysis were funded in part by pharmaceutical companies. ... A 2003 study published in the British Medical Journal suggests that trials funded by drug companies are more likely to report favorable results about their products than are trials funded by independent organizations."
Rita Redberg, chief editor of the Archives of Internal Medicine, said:
"There are a lot of people taking statins who are not getting any benefits from them, and they're subject to a lot of adverse events."
They're going to be putting statins in the water soon.
1 All quotes are from the Scientic American article, The Stats on Statins: Should Healthy Adults Over 50 Take Them? I was surprised to see a major publication address the untoward aspects of this study.


Anonymous said...

They've got to be kidding! Healthy people?? Everyone I know on these has muscle pain. Crestor is the worst. Seriously this study was bought and paid for by BigPharma.

Laurie Endicott Thomas said...

In China in the early 1970s, some counties with a population of a couple of hundred thousand went for three years without a single person under 65 dying of a heart attack. However, people of Chinese ancestry who live in the United States get heart attacks just like the rest of us if they eat like the rest of us. And some people seriously expect me to believe that the solution is to get everyone in the US to take statins?

eml256 said...

Read em and weep (for all those greatly injured by statins){
Statin Drugs Given for 5 Years for Heart Disease Prevention (Without Known Heart Disease)

In Summary, for those who took the statin for 5 years:
98% saw no benefit
0% were helped by being saved from death
1.6% were helped by preventing a heart attack
0.4% were helped by preventing a stroke
1.5% were harmed by developing diabetes*
10% were harmed by muscle damage
In Other Words:
None were helped (life saved)
1 in 60 were helped (preventing heart attack)
1 in 268 were helped (preventing stroke)
1 in 67 were harmed (develop diabetes*)
1 in 10 were harmed (muscle damage)