Author: Dr. Gary Huber, DO
Why are 13 million of our friends and neighbors all taking a drug that may or may not be helping them? Protecting your heart from a heart attack has little to do with lowering LDL.
To the 13 million of you out there that are already on a statin to lower cholesterol, may I have your attention? The rest of you may want to pay attention as well. Why are 13 million of our friends and neighbors all taking a drug that may or may not be helping them? In case you haven’t heard, there is a big debate over these drugs and it has spilled out of the medical journals and onto your daily newspaper. BusinessWeek magazine printed a cover story dated January 17th, 2008, and I strongly suggest you read it in it’s entirety. Allow me summarize some of it’s content.
Dr. James M. Wright is a professor at the University of British Columbia and he also serves as the director of a government-funded group called the “Therapeutic Initiative”. The sole purpose of this group is to read all the medical literature and figure out how well different drugs work for their intended purpose. That makes Dr. Wright opinion more valuable than most. So if we take these statin drugs in an effort to reduce heart attacks and prolong life then we need to look at how well they are working. Dr Wright states that “he found no benefit in people over the age of 65”. He found “no benefit for women of any age”. He did observe a small reduction in the number of heart attacks for middle-aged men taking statins, but even in this group he found no overall reduction in total deaths or illnesses requiring hospitalization. His conclusion is that “most people are taking statins with no chance of benefit and a risk of harm”.
So what drugs are we talking about? Lipitor, Mevacor, Zocor, Crestor, Pravachol to name a few. Lipitor should be on everyones lips as the famous Dr. Jarvik can be seen on TV promoting this drug. Surely we can trust the benevolent advise of a man that was a pioneer in artificial hearts. Well . . . he was paid $1,350,000.00 over two years by Lipitor to act as their pitchman. And speaking of “acting”, there is presently a congressional committee investigating Lipitors ad campaign for fraud, as there seems to be a strong suspicion that a stunt double was used, and that Dr Jarvik was not rowing across a lake as the ad implied. Small point? Or is it just another day in the life of deceptive advertising used by drug companies. After all they did manage to collect a mere $27.8 BILLION dollars in sales in 2006 and that’s just from STATIN sales. This is big business folks.
The article also talks about a term “NNT” which stands for “number needed to treat” which is quickly becoming the new standard for evaluating the efficacy of drugs. It represents “how many people need to take a drug in order for one person to benefit”. For example if we look at beta-blockers for treatment of congestive heart failure. Studies show that 24 people need to take the drug for seven months to prevent ONE hospitalization for heart failure, thus the NNT = 24. Several scientific papers have recently pegged the NNT for statins at 250 or possibly higher. Dr. Jerome R. Hoffman offers this analogy, “What if you put 250 people in a room and told them they would each pay $1000 a year for a drug they would have to take every day, that many would get diarrhea and muscle pain, and that 249 of them would have no benefit? And that they could do just as well by exercising? How many would take that?”. An estimated 10 to 15% of statin users experience side effects including muscle pain, cognitive impairment, and sexual dysfunction. A more recent study out of the University of Iowa reports that statins also reduce the needed cholesterol formed in the brain that aids neurotransmitter function. The result is declining memory and reduced cognitive ability.
Shall we move our discussion to ethics? Why not. The National Heart, Lung, and Blood Institute launched the National Cholesterol Education Program (NCEP) in November of 1985. The goal of NCEP was to reduce illness and death related to coronary heart disease by reducing the number of Americans with high cholesterol. The NCEP’s 2004 guideline update recommended lower targets for bad cholesterol prompting more physicians to use more statins on more patients. But 8 out of the 9 experts on this NCEP panel had financial ties to the drug industry. How convenient.
Adding insult to injury, there have been recent articles discussing Zetia’s effect on blood vessels. It seems to cause arterial thickening, which is counterproductive to it’s intended effect. It is making heart disease worse.
My own 2 cents worth is that we have become “cholesterol obsessed” in this country. We are focused on a NUMBER and trying to equate that to good health. We ignore bigger issues like homocysteine and cardiac CRP. Homocysteine is a normal byproduct of our metabolism but if we don’t break it down then it accumulates and causes inflammation to arteries, which is creating the hot beds where cholesterol can accumulate. We don’t focus on our CRP or inflammation of our bodies that is a function of oxidative stress. If we eat right and exercise, then we have done more to protect our arteries than any drug could ever hope to accomplish. Cholesterol only becomes a problem when we ignore the overall health of our blood vessels. It is the rust that accumulates when we fail to protect our vessels with proper nutrients. Focus on health rather than obsess about disease.
There will always be those few that need drug assistance to maintain their health but it is truly the few, not the majority. Spaniards have LDL levels similar to Americans but less than half the rate of heart disease. The Swiss have even higher cholesterol levels but their rates of heart disease are also lower. Australian aborigines have low cholesterol but high rates of heart disease. Why? Look at ALL the factors in your life. The picture is not as simple as high cholesterol = need for statin. Profitable maybe, but not that simple.
Since this post in 2008 many more studies have shed even more light on the topic. Please see our more current articles as this story progresses. There are more details but the story remains largely the same. Statins are a valuable drug for a small select audience but in general they are over prescribed to people who have no need for them, cause multiple side effects and significant expense, and for some lead to diabetes, low testosterone, and loss of quality of life. I suggest a more intelligent application of statins rather than the current “good for everyone” mentality.