Wednesday, August 2, 2017

Wisdom Wednesday: Is the ‘Anti-Statin” Trend Threatening Lives?

A wave of anti-science skepticism may put people with high cholesterol at risk if they’re convinced to quit life-saving statin medications, heart experts warn.

An “internet-driven cult” is attacking the safety and effectiveness of cholesterol-lowering statins, despite mounds of clinical trial data showing the drugs work and produce minimal side effects, said Dr. Steven Nissen, chairman of cardiovascular medicine at the Cleveland Clinic.

“We as physician scientists have to speak out,” Nissen said. “We have to regain the public’s attention around the fact that it isn’t a good thing to have high cholesterol, and a lot of heart disease is preventable by addressing risk factors like cholesterol.”

Nissen makes his case in an editorial published online July 24 alongside a new study in the journal Annals of Internal Medicine. That study found that patients who stick with statins even after suffering side effects are less likely to die or suffer a heart attack or stroke, compared to people who quit the drugs.

But as many as three-quarters of patients stop statin therapy within two years after they suffer a side effect, or “adverse event,” from the drugs, the authors of the new report said in background notes.

The new study found that patients who keep taking their statins had about a 12% incidence rate of death, heart attack or stroke, while those who quit statins had an incidence rate of about 14%, said senior researcher Dr. Alexander Turchin. He’s an endocrinologist with Brigham and Women’s Hospital in Boston.

Of more than 28,000 patients treated with statins at two major Boston hospitals, more than 70% continued taking the drugs after suffering from side effects, the researchers found. These patients did better during the next decade than those who quit, according to the report.

My Take:
This study, like most others, on statin drugs, shows a very modest benefit (less than 2%) from continuing medication. I have never argued that statin drugs don’t work (a little bit). But they work by lowering inflammation, not by lowering cholesterol.

Physician scientists do need to speak out as Dr. Nissen said. They need to admit that the sugar industry financed the original studies that were skewed to blame fat for heart disease. Harvard scientists have come forward and admitted their complicity. Even the sugar industry has confessed that they hoped sugar consumption would increase by 40% if fat got the blame for heart disease.

Fast forward 30 years and sugar consumption has increased from 80 pounds per person per year to well over 100 pounds. That’s about 20% of our caloric intake daily.

During this same period, when fat consumption was reduced and statin drug use has become the norm, heart disease has continued to rise. It is now the leading cause of death in the U.S., killing over 375,000 Americans every year.

The Bottom Line:

The ‘anti-statin’ trend is well founded and long overdue. Physician scientists should be focusing on finding better ways to reduce vascular inflammation and let go of the dogma surrounding cholesterol.

Source: July 25, 2017 National Institutes of Health

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