NEW YORK, Jan. 17, 2008
The Truth About Statins
BusinessWeek And CBS News Examine Whether Statins Are Over-Prescribed
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Play CBS Video Video The Truth About Statins More than 18 million Americans fight cholesterol with a popular class of drugs called statins. But concerns are mounting about their safety and effectiveness. Dr. Jon LaPook reports.
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Video Are Statins Over-Prescribed? Only On The Web: Dr. Jon LaPook speaks to Dr. Christopher Cannon of Brigham and Women's Hospital about the effectiveness of cholesterol-lowering statins.
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Architect David Mullican lowered his cholesterol the old-fashioned way: with diet and exercise. (Business Week/CBS)
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(CBS)
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Interactive Heart Disease Learn more about different types of heart disease, explore different treatments and assess your own risk.
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Quiz Heartscore Quiz When it comes to your heart, can you tell the myths from the facts?
As an architect, David Mullican specializes in unique designs for beachfront homes. So when his doctor told him to take lipitor to treat his high cholesterol, he had a better idea.
"I didn't want to do a prescription medicine so I was going to try to figure out a way around it," Mullican said. "I took the prescription home with me but I never filled it."
Instead, he chose to lower cholesterol the hard way - through diet and exercise, CBS News medical correspondent Dr. Jon LaPook reports.
Our national obsession with cholesterol numbers has led to us to depend on statins as the easy way to fight heart disease - and why not?
It's hard to ignore ads. One advertisement is for Lipitor, the most popular statin on the market. But if you look into where this number - the 36 percent reduction in heart attacks comes from - you'll find out that benefit may not be as dramatic as you think.
The study in the ad split people into two groups. For over three years, one group took Lipitor, the other took a placebo. For every 100 people in the placebo group, there were three heart attacks; in the Lipitor group there were two. That means that 100 people had to take Lipitor for more than three years to spare just one person from a heart attack.
Statins do one thing extremely well. They lower cholesterol - especially bad cholesterol - and the science tells us there's one group of people who definitely should be taking it.
"In people with known heart disease, this has become a standard of care, that you really need to be on a statin," said Chris Cannon.
But what about the millions of people with elevated cholesterol who are taking statins but have no heart disease or other risk factors? Here's where the controversy heats up.
"We have no evidence that taking a cholesterol-lowering medication like a statin will prevent them from getting heart disease," said Elizabeth Nabel, director of the National Heart, Lung, and Blood Institute. Dr. Nabel oversaw government guidelines that say don't consider statins in patients with low risk factors unless their bad cholesterol is over 160. That hasn't stopped the statin craze.
Even though guidelines say don't use statins in patients with low risk factors unless their bad cholesterol goes over 160, in the real world, many doctors prescribe statins anyway.
FYI: How to lower cholesterol without medication.
"We have been perhaps driven too quickly into this sort of assumption and this model, that it's all about the cholesterol number and if we can just lower that number, everything is better," Dr. Howard Brody said.
But statins have side effects and cost money. What's more, they may give a false sense of security. Statin users may be tempted to neglect other risk factors, like high blood pressure, lack of exercise, and poor diet.
"Doesn't a guy like me want to believe that I can have a greasy cheese burger with fries, extra fries, and then if I swallow this pill everything will be great," Brody said.
David Mullican's approach paid off. He lost 30 pounds and lowered his cholesterol, without a pill.
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Michelle Obama tells how her role as the First Lady has changed her perspective.
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See all 65 CommentsCoQ10, a naturally occurring antioxidant, is synthesized in our bodies and is critical for the production of energy, especially in the tissues and organs that have high-energy requirements such as the heart, liver, and skeletal muscles. Statins block the production of CoQ10 and cause a deficiency. Anyone who takes a statin without also taking supplementary CoQ10 is at risk for serious harm.
Don''t stop taking a statin without your doctor''s order, but make a point to talk with him or her about the effects of statins on your CoQ10 level. At the very least, your doctor should want you to take a CoQ10 supplement (they''re readily available in most health food stores and pharmacies). Perhaps your doctor would even be interested in some of the nonprescription approaches to lowering low-density lipoprotein (LDL, or "bad") cholesterol levels, such as niacin (vitamin B3) and fish oils (omega-3 content).
Larry J. Frieders, R.Ph.
http://www.thecompounder.com/
340 Marshall Ave Unit 100 ~ Aurora, IL 60506
Do not go to this address its full of lies
http://www.debbieschlussel.com/archives/2006/12/barack_hussein.html
In a healthy body, lipoproteins cooperate-- the LDLs (low density lipoproteins) transport cholesterol to the cells, and the HDLs scavenge excess cholesterol for return to the liver and excretion. A cholesterol "problem" is an imbalance in this lipoprotein transport system..
Cholesterol is not intrinsically harmful. But when an excess accumulates and oxidizes, it promotes inflammation and creation of plaque on/in blood vessel walls. With significant accumulation of plaque, there is partial or complete blockage of circulation.
Although inflammation at plaque sites has other consequences, the primary danger of arteriosclerosis is blockage of circulation to vital organs.
Because statins depress the HMG CoA reductase pathway of liver metabolism (which generates cholesterol), statins effectively reduce cholesterol levels. However, by throttling this enzyme pathway, statins also reduce the body''s ability to produce CoQ10, an enzyme vital to proper heart function. A 1993 study suggested only 90 days'' use of statins reduced CoQ10 levels by an average 40 percent-- clearly enough to trigger a wave of cardiac problems. A later study found supplementation of 100mg daily of CoQ10 reversed this depletion.
Use of statins is not the only way to modify the quantity of cholesterol in the body, and most doctors have read of dietary and other interventions. The key, for most patients, is to be aware alternatives to statins exist. CBS should be saluted for pointing this out-- see FYI link above.
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You misread andor3 comments on aspirin, which was in the context of countering inflammatory response, not reducing cholesterol.
http://content.nejm.org/cgi/content/short/358/3/252
"We found a bias toward the publication of positive results. Not only were positive results more likely to be published, but studies that were not positive, in our opinion, were often published in a way that conveyed a positive outcome. We analyzed these data in terms of the proportion of positive studies and in terms of the effect size associated with drug treatment. Using both approaches, we found that the efficacy of this drug class is less than would be gleaned from an examination of the published literature alone. According to the published literature, the results of nearly all of the trials of antidepressants were positive. In contrast, FDA analysis of the trial data showed that roughly half of the trials had positive results. The statistical significance of a study%u2019s results was strongly associated with whether and how they were reported, and the association was independent of sample size. The study outcome also affected the chances that the data from a participant would be published. As a result of selective reporting, the published literature conveyed an effect size nearly one third larger than the effect size derived from the FDA data."
Aspirin shouldn''t be taken on a regular basis anyways for any form of treatment. It stays in your system and slowly releases through your stomach lining, resulting in eventual BREAKDOWN of your stomach lining. It causes ulcers at an early age in children that had parents that insisted on an aspirin at every head ache, and pain. Trust me living with an ulcer at the age of 18 is NOT fun. I had one instance where I learned since my lovely health insurance wouldn''t cover the meds I needed my throat closed up due to the acid inflamation.
PLEASE do not promote aspirin as a daily use.
Never change a drug regimen without consulting your doctor first. There are alternatives to statins. Ideally everyone would diet and exercise to keep his cholesterol in check, but as we all know this is America and most just don''t take very good care of their bodies. Statins are not a perfect solution to an unhealthy lifestyle, but they have saved thousands of lives.
TRUTH: it is not clear that statins help by lowering cholesterol. It may be their anti-inflammatory effects are the reason they show some effectiveness in reducing heart problems. But aspirin may do just as well or better with fewer side effects. You can be sure the drug companies do not want any study to confirm that.
TRUTH: although doctors are not supposed to prescribe statins in patients with low risk factors, they will go to great lengths to find risk factors to rationalize breaking these guidelines. My cholesterol was 180 for 20 years but my doctor tried to talk me into statins when he found one grandparent had heart trouble. I had the sore muscle side effect, quit the pills, and switched doctors.
TRUTH: cholesterol is GOOD. It is an essential chemical for normal body functioning, including building brain tissue and making hormones. Cholesterol has been made out like some kind of poison, like if we could get rid of it we would be better off. In fact, because cholesterol is so precious, the body recycles it--that is why there are so many varieties of ways cholesterol is found: the body sends out scavenger molecules to gather and reuse cholesterol. Maybe too much cholesterol is bad (and there is controversy about that), but it may be just that the U.S. diet has more animal products than the body is equipped to handle safely. hmmm... imagine which powerful lobbies would want to prevent that info from getting out: beef, milk, cheese, eggs. It is interesting that those products used to be advertised as healthy, but they stopped that theme.
TRUTH: people vary in size, shape, body chemistry and a million other ways. So it is absurd that there should be one "right" number for cholesterol. If that were adopted, doctors would coerce tall people into surgery to have the tops of their heads removed so they will fit the "average" height number.
46 year old male has significant MI and survives.
On a complete vegetarian diet with exercise, doubtful that total cholesterol would be below 240, maybe much higher.
Statins yes or no? I''m on them, guess I will go with doctors recommendation, but who the hell knows?
Flip a coin.
"target" level of 150.
Blew us both away after 7 yrs of taking statins and 6 wks of the oils finally showed me a "light at the ...", the pharmacist too. So he told me to double the in take of the oils with the meds and we should find out next week on my 6 week follow up what that has done. Those of us that need help to lower cholesterol, I personally think they need to do some more tests, only this time use people with "risk factors" to see if they actually work before they get every doctor in the country to prescribe them. I think it just makes more work for the blood labs!
Thanks for your time.
Dan
On the other hand, they do have nasty side effects: muscle weakness and damage, mental confusion and amnesia, and a host of other things. There have been studies of the side effects, but they have a hard time because drug companies do not want to fund them and will seek to prevent them--like the study in this article, the results could devastate their profits.
In the end, if you ask doctors or drug makers, they will often praise statins. If you ask people who take them, you often get a different story.
People should take responsibility for their lives rather than blame drug companies, the FDA and health professionals trying to help them, for their own unwillingless to get on a bike and eat less.
We should not be looking for a magic pill to cure everything, but rather looking to ourselves to be healthy. It starts by not eating that bag of chips and drinking a 40 oz soda.
Mike Moore (Sicko) can complain about healthcare, but the bottomline is he can''t even care for himself and be healthy. He is morbidly obese likely with both diabetes and obestiy. He is part of the problem with healthcare. If you want to lower healthcare premiums and avoid medications in general (which do have side effects), try exercising and staying healthy.
That being said, however, it''s appalling that drugs like these are approved by the FDA with so little regard to the side effects and effects of long term use. The word of the FDA is absolutely no comfort to patients, since they have long since become nothing but a marketing arm for pharmaceutical companies.
The perversion of government agencies by big business has been coming on for a long time, we''re just all starting to be hit in the face by how far they''ve fallen. FDA, EPA, FCC, doesn''t matter, they''ve all quit doing the jobs they were created for.
As you''ll notice, Dr. Graveline himself has fairly impressive credentials.
Lipitor: Thief of Memory
by Dr. Duane Graveline
ISBN-10: 1424301629
ISBN-13: 978-1424301621
"When Dr. Duane Graveline, former astronaut, aerospace medical research scientist, NASA flight surgeon, and family doctor is given Lipitor to lower his cholesterol, he temporarily loses his short-term memory. Urged a year later to resume the drug at half dose, he lost both short-term and retrograde memory and was finally diagnosed in a hospital ER as having transient global amnesia (TGA). This is the "scary, appealingly written" account of his search for answers that his medical community didn''t have -- the how and why of his traumatic experience, and what needs to be done to prevent the devastating side effects to body and mind from the escalating use of the statin drugs."
ANY MEDICAL TREATMENT CAN HAVE ADVERSE EFFECTS. A story like "I know this one guy who started taking Zocor and died the next week" is not scientific evidence. Try reading some of the thousands of controlled, scientific studies on these medications and then form an opinion.
Again I say, read: www.spacedoc.com
These drugs are NOT safe. Even if I believed that they are prevening anything, they are NOT safe...so should not be used.
Maybe people shoul dsign waivers saying they won''t sue when they end up with muscle issues, cant remember what they had for lunch, or are convined to a wheelchair (but have low cholesterol). I guess from what I have seen first-hand, you''d have to hold a gun to my head and I still would not swallow this garbage.
I''ll bet my former pastor who is now convined to a wheelchair, can hardly speak and can only slightly move his arms wishes he read about the dangers (real, serious ones, not RARE!) before going on Lipitor.
I hope this *** is banned soon. I hope this investigation opens up the whole statin can of worms and it all gets pulled.
People will be better off. Look at the studies...so few heart attacks were supposedly prevented compared to the placebo. NOT worth the risks in my warped mind.
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