The Truth About Statins

(CBS)  A new class of prescription drugs burst on to the scene over the last 15 years called statins designed to lower cholesterol. They're now taken by more than 18 million americans. And statins are a $21 billion industry. But do all the people taking them really need to be? CBS News teamed up with BusinessWeek magazine to investigate.

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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.

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FYI: How to lower cholesterol without medication.
BusinessWeek: Do Cholesterol Drugs Do Any Good?

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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.

"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.

[niedernhofer]

If you''re taking any of the prescription anticholesterol drugs called statins, you need to know that they can be dangerous to your health. In addition to the common statin-associated side effects such as nausea, diarrhea, constipation, and muscle aching, top-selling statin drugs have been found to block the body''s production of coenzyme Q10 (CoQ10).

CoQ10, 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

[pilgrimsway-2009]

Sorry for my comments.
Do not go to this address its full of lies

http://www.debbieschlussel.com/archives/2006/12/barack_hussein.html

[alphaa10-2009]

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.

[alphaa10-2009]

seandgreen said, "ASPIRIN ... does nothing to actually LOWER cholesterol..."
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You misread andor3 comments on aspirin, which was in the context of countering inflammatory response, not reducing cholesterol.

[jacobmarley3]

I''m hoping doctors at least read the New England Journal of Medicine.

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."

[usakousagi]

ASPIRIN has it''''s place by blocking the production of thromboxane A-2, a chemical that platelets produce that causes them to clump. It HAS been researched, and does nothing to actually LOWER cholesterol. It just can''''t work that way.


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.

[mbburch06]

I hope no one reads this article and decides to just stop taking his prescription. Yes there are side effects, but the risk of not taking your medication is higher LDL and greater chance of heart attack.

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.

[prairiegirl2]

Also, congestive heart failure (weakening of the biggest muscle we have) has risen right along with the use of statins!

[andor3]

TRUTH: A common (and underreported) side effect of statins is muscle weakness or damage. The heart is a muscle and susceptible.

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.

[coppertales]

I am a 63 year old male, 5''11", 245 lbs. I am a competitive powerlifter aka weightlifter. I have had cholestrol levels around 300 for 30 years. I have taken all of the name brand statins with severe side effects. The last one being Crestor, which I took for 10 days before I became so sore and weak I could not get out of bed without help nor go to work. After stopping the drug, I was back to normal in 3 days. I have an irregular heart beat. My heart doc says I have a damaged heart muscle that is affecting the timing of the heart beat. I have passed every stress test taken in the last 10 years with flying colors. I am sure that if I had continued to take statins, I would not be alive now. All the doctors that I have told about my symptioms have replied that there is not way you could be having these problems. My heart doc just tells me to keep lifting. He is the only one with a clue.