A Billion Dollar Decision That's Not Good For Your Health

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

disease.

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, atrovastin 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 atrovastin or placebo, 90% of the patients had died

despite the fact that the patients who were given atrovastin 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”

http://pharmacistkeith.blogspot.com/2011/09/truth-about-cholesterol.html

http://keithabell.info/2013/10/are-your-prescriptions-making-you-sicker.html

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