Statins - who needs them and why?

The NYT's Tara Parker Pope investigates:

But many statin users don’t have established heart disease; they simply have high cholesterol. For healthy men, for women with or without heart disease and for people over 70, there is little evidence, if any, that taking a statin will make a meaningful difference in how long they live.

“High-risk groups have a lot to gain,” said Dr. Mark H. Ebell, a professor at the University of Georgia who is deputy editor of the journal American Family Physician. “But patients at low risk benefit very little if at all. We end up overtreating a lot of patients.” (Like the other doctors quoted in this column, Dr. Ebell has no ties to drug makers.)

How is this possible, if statins lower the risk of heart attack? Because preventing a heart attack is not the same thing as saving a life. In many statin studies that show lower heart attack risk, the same number of patients end up dying, whether they are taking statins or not.

“You may have helped the heart, but you haven’t helped the patient,” said Dr. Beatrice Golomb, an associate professor of medicine at the University of California, San Diego, and a co-author of a 2004 editorial in The Journal of the American College of Cardiology questioning the data on statins. “You still have to look at the impact on the patient over all.”

A 2006 study in The Archives of Internal Medicine looked at seven trials of statin use in nearly 43,000 patients, mostly middle-aged men without heart disease. In that review, statins didn’t lower mortality.

Nor did they in a study called PROSPER, published in The Lancet in 2002, which studied statin use in people 70 and older. Nor did they in a 2004 review in The Journal of the American Medical Association, which looked at 13 studies of nearly 20,000 women, both healthy and with established heart disease.

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Let's put it another way.

Do you like to gamble?

“What if you put 250 people in a room and told them they would each pay $1,000 a year for a drug they would have to take every day, that many would get diarrhea and muscle pain, and that 249 would have no benefit? And that they could do just as well by exercising?” asks Jerome Hoffman, professor of clinical medicine at the University of California at Los Angeles.

“How many would take that?”

How many indeed?

Finally take a look at this:


Dr Malcolm Kendrick is a controversial "cholesterol theory sceptic".

Bottom line. Insider thinks that statins might help some people. But they certainly should not be put in the tapwater!

He also is open to argument and discussion.