Different truth about Statins - Atrial Fibrillati...

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Different truth about Statins

MiniMeGreen profile image
87 Replies

If you are on Statins, especially in terms of so called "primary prevention" you should read this and preferably also some of the sources and then make an educated decision.

LINK REMOVED

By the way the absolute results/benefits in secondary prevention are not much better.

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MiniMeGreen
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mav7 profile image
mav7

As you mention, the use of statins is a personal decision by the individual and their doctor.

Important for readers to note the background of the author of the subject article.

(excerpts)

Aseem Malhotra is a controversial British cardiologist,[1] public health campaigner,[2] author, and advocate against the use of COVID vaccines.

His views on diet and health have been criticized by the British Heart Foundation as "misleading and wrong", and his public questioning of the need ever to use statins has been condemned as a danger to public health.

en.wikipedia.org/wiki/Aseem...

MiniMeGreen profile image
MiniMeGreen in reply tomav7

I have been pro vaccination, hence the 4 jabs, but not so sure any more. Look for the videos of Dr. John Campbell on youtube, e.g. from May 24th 2023 and 19th November 2023 regarding Covid-19 vaccine. He explains the issues very well.

mjames1 profile image
mjames1

Like Mav7 said. Credibility of author should be taken into consideration.

Jim

Auriculaire profile image
Auriculaire in reply tomjames1

Just like the credibility of pro statin authors who get funding from Pharma?

Peony4575 profile image
Peony4575

Sometimes when a stent is placed it can alter blood flow in the heart and cause another previously clear artery to block. This happened to my partner within 12 months of his first stent and was nothing to do with statins or cholesterol it was due to turbulence and required a second stent after which he has been fine for many years on top dose Atorvastatin and with low cholesterol . Statins are not thought to work just by lowering cholesterol but they also lower inflammation thought to be a big factor in developing heart disease . I don’t personally take a statin although I have been offered one along with every man and his dog . Did not find the article, the author or the publication compelling I am afraid and as with everything would advise anyone to do a lot of research before reaching any medical decision

Ppiman profile image
Ppiman in reply toPeony4575

That advice is sound but we aren’t medically trained and the internet is a minefield of poor and skewed information - and misinformation. The BHF, NICE and the NHS all speak very positively indeed about the useful effects and safety of statins.

Shouldn’t we trust those with knowledge rather than unknown internet sources?

Steve

Peony4575 profile image
Peony4575 in reply toPpiman

Yes Steve agree

secondtry profile image
secondtry

I don't take statins and my wife does following a mini stroke.

The author of the study you quote has been questioned in a number of replies here. I wouldn't regard him as a quack. He has had invitations to lecture all around the world with the most recent to the Indian Parliament.

MiniMeGreen profile image
MiniMeGreen in reply tosecondtry

Well, I think a maverick can also be correct on one issue but err on another. Though given the fact that my AF was diagnosed 3 days after my 4th mMRN dose and I'm by far not the only one, leads me to question whether that was only a time relationship.

On statins however, he is not the only one and they do have very serious side effects which are preferably ignored or downplayed by the main profiteers. It reminds me very much on Yudkin and the sugar (White Pure and Deadly) and the tobacco industry.

Auriculaire profile image
Auriculaire in reply toMiniMeGreen

Malhotra is a big advocate of healthy diet and other lifestyle interventions to deal with heart disease. Not much dosh to be made for Pharma in that so par for the course that his reputation will be blackened.

Ppiman profile image
Ppiman in reply toAuriculaire

I take your point and know you are a big believer in the power of a good diet. It should be the starting point for all of us, for sure, along with burning lots of energy each day rather than sitting down. That said, I suspect more money is made selling dubious, unresearched and untested dietary "products" whether "health" foods, "nutraceuticals", supplements, weight-loss diets and much more than anything else - countless billions must pass from the gullible public to these sellers annually.

Steve

Blearyeyed profile image
Blearyeyed in reply toPpiman

Quite true. Well said. I'd actually love to see the figures to compare and contrast the amount of people whom are hospitalised from adverse effects to nutraceuticals and inappropriate physical treatments with those whom have adverse effects that can be attributed to a prescribed medication.I think it would be quite an eye opener.

People also seem to ignore the fact that the majority of anti statin practitioner's specify that they are only talking about choosing a non statin approach if the patient is generally healthy and hasn't been prescribed the statin for use as a treatment for secondary prevention , or as primary prevention in a high risk patient. In those cases , the majority of anti statin medical advocates actually recommend that those patients should take the statins prescribed.

Ppiman profile image
Ppiman in reply toMiniMeGreen

It would be helpful to those interested if you linked such claims to peer-reviewed evidence. I can find nothing to show that statins "have very serious side effects" only that "statins are generally very well tolerated with a very low risk of serious adverse outcomes". The most severe side effect, rhabdomyolysis, is extremely rare, occurring "in 1 in 23 million individuals".

ahajournals.org/doi/10.1161....

Steve

Auriculaire profile image
Auriculaire in reply toPpiman

If you put in searches like " statins link to diabetes " or "statins heart failure" you will find peer reviewed research papers in Pub Med linking statin use to these serious problems. Given that diabetes is actually a much greater danger in terms of heart disease than raised cholesterol ( correlations with raised HbA1c are more reliable than those with raised total cholesterol )it seems counterproductive to prescribe a statin especially for women. The side effect of new onset type 2 diabetes is worse in women and epidemiological studies in Scandinavia have shown that raised cholesterol in elderly women is not a health problem in terms of all cause mortality or even morbidity including cardiovascular morbidity. So you have a population of healthy elderly women but hey let's give them a drug which they don't need to lower cholesterol (which they do need )and risk them turning into T2 diabetics. Makes perfect sense. Only for those benefitting financially.

Ppiman profile image
Ppiman in reply toAuriculaire

Statins and diabetes: "We should be cautious about the findings ... evidence ...suggests that patients on statins live longer or more healthily than those not taking a statin, despite developing type 2 diabetes." Professor Peter Weissberg, BHF Medical Director.

bhf.org.uk/what-we-do/news-...

Statins and heart failure: "...prevention of new-onset HF can be achieved by statin treatment. " academic.oup.com/eurheartj/...

"statin-associated cardiomyopathy ... responds safely to statin treatment discontinuation and CoQ10 supplementation".

pubmed.ncbi.nlm.nih.gov/314...

"...data ... suggests patients with heart failure using statins had a 16% lower risk of developing cancer and a 26% reduced risk of cancer mortality ...".

hcplive.com/view/statins-li...

Steve

Blearyeyed profile image
Blearyeyed in reply toPpiman

Thanks so much for adding these links , I hope people whom are already feeling anxious about taking Statins because they haven't needed much prescribed medication before will take the chance to read them. I good debate is all well and good but it does need to be tempered with consideration and quality information. Other wise people whom are genuinely scared about starting new treatments can be made more anxious and put off using medications which are necessary in their medical situation by very negative stories.

Ppiman profile image
Ppiman in reply toBlearyeyed

It’s good of you to reply so kindly. Thank you.

Steve

Susie3012 profile image
Susie3012 in reply toBlearyeyed

If your cholesterol is high then you should take a statin. Your risk of stroke and heart disease is much higher with elevated cholesterol levels. I’m a retired nurse and have read countless articles of research which does nothing but increase your anxiety. Statins are safe and side effects are minimal. If you weigh up the risk benefits of statins you will see that they save countless lives. My cholesterol soared after the menopause and I take 40mgs of Atorvastatin now. It’s halved my cholesterol to 4 which I’m very happy about. I have no side effects from the drug. I’d rather take it than run the risk of a stroke or heart attack.

Please don’t worry about it, just take it and be safe.

Auriculaire profile image
Auriculaire in reply toPpiman

BHF - another outfit that gets lots of Pharma money. "Statin associated cardiomyopathy " - so not a figment of my imagination then. The Japanrse have done a lot of research into this.

There are other studies that show that statins promote cancer. On putting in a search I found on the same page a study which found that statin use for 4 years doubled the risk of being diagnosed with colorectal cancer and another that showed that those on a statin at time of diagnosis had 40% less chance of dying of it. Well I think it would be better not to be diagnosed in the first place. However these are all observational studies which might have unknown confounders.

In the end it comes down to whether you believe the heart disease / cholesterol theory and want to reduce your cholesterol. I don't. The anti inflammatory argument doesn't interest me either as there are lots of non drug ways to reduce inflammation in the body as well as supplements like resveratrol .

Ppiman profile image
Ppiman in reply toAuriculaire

There are none that are proven with any scrutiny and rigour, unlike the statin work.

Statistics always need context to be meaningful. “Doubled the risk” is near meaningless.

Steve

Blearyeyed profile image
Blearyeyed in reply toAuriculaire

I think the point is that in certain studies like the one you mentioned about Statin associated Cardiomyopathy , the group were proving that it is possible but not that it was inevitable , or that it is a risk for the majority of patients using statins.Many of the pieces of research we see , thankfully, find or prove a thing can occasionally happen , often rarely, and they do so in order to increase the way that doctors can test patients to rule out the various possibilities for a condition happening . They aren't there to suddenly create headline news to be claimed as high risk possibilities for everyone using those medications, but merely evidence of possible or rare side effects.

As you say , the Japanese have done a lot of research on statin use , particularly in the older community. Including , a very interesting meta-analysis work which proved that statin use reduced the risk of all types of late onset Dementia which is contrary to the comments that are often discussed on this forum.

So the question is , if you are willing to agree with the conclusions of one Japanese study showing the possible and rare risks of statins for one small subgroup of people , would you also be willing to believe a much larger study showing the possible benefits of statins for a much larger proportion of the general population as well.

It proves the fact that if you are going to choose to voice studies to further your argument you do need to be ready and willing to read all the available material out there and not just voice ones that prove your cause, or dismiss a piece of work without checking it's real funding basis as propaganda funded by and created by Big Pharma if a study does not align with your particular point of view.

To be frank , the majority of doctors and medical practitioner would not continue to give out or endorse preventative medications to their patients if the risks outweighed the benefits and their was a high probability that those medications could do the person harm, no matter how much Big Pharma or Government money was behind it. It would be totally contrary to the principles they have pledged to honour in the work as physicians.

You can't just cherry pick studies no matter what side of debate you are on. You need to be willing to read a lot of the more academic works available and occasionally admit that your original opinions could be wrong if the weight of research available and the majority of advice from all sides of health care ( conventional and alternative) differs from your point of view.

I base my decisions on reading a wide variety of sources and varied research papers and peer reviews. If the majority of the information out there from various sources proved that a type of treatment being used was risky or inappropriate I would support peoples replies when they question it.

I would rethink using it whilst also weighing up the benefits and risks for me as an individual based on my own medical history.

For let us remember, in certain cases , the cure or preventative treatment for an illness we might unfortunately have can sometimes feel as bad as the illness itself , but the need to take it to extend or save our lives inevitably means we may need to take our medicine despite the side effects.

In the case of statins and the links between cholesterol risks and plaque formation the majority of information is favourable for their use as a preventative medication , particularly in the secondary prevention group . And that is even true within the recommendations of groups of medical practitioners that endorse anti statin lifestyle changes for those whom are not at high risk of cardiovascular disease.

And don't forget , just because a natural or herbal product or supplement may not be prescribed, it is still a new chemical being ingested and processed by the body which it is not used to and can equally cause side effects and health issues even if it was bought over the counter from a health practitioner.

Auriculaire profile image
Auriculaire in reply toBlearyeyed

Except that high cholesterol is not an illness. "Desirable" cholesterol levels have been lowered more than once and the last lowering was done by a committee in the States which was not truly independent as the majority of members had financial ties to statin manufacturers. Doctors are guided in their prescribing practices by this kind of recommendation and that of regulatory bodies like the FDA ,NICE , MHRA EMA etc. They do not have the time to read vast amounts of research and make up their minds for themselves though some do. I believe that the revolving door of employment whereby public officials in these bodies (whose purpose should be to protect the health of the public ) get jobs with Pharma companies after doing a stint in the public sector is a vector for corruption and there should be laws preventing it. Use of statins for primary and secondary prevention are very different. In secondary prevention there is actually a disease not just a blood level of cholesterol going above an arbitrarily decided number. In primray prevention many doctors look only at total cholesterol and if it is above the magic number recommend a statin without breaking down the cholesterol levels into ldl and hdl. As far as women are concerned there does not seem to be much awareness that hypothyroidism ( vast majority of sufferers are women) can cause high cholesterol levels and treating this condition would not just improve the overall health and well being of the patients but would bring their cholesterol levels down as well ,thus negating any need for a statin. But basically as far as statins are concerned I look at the way they work - by interrupting a key metabolic pathway in the liver. They do not just interfere with the production of cholesterol (which is actually an essential substance that our bodies need) but with other substances as well that the body is producing for a reason- like Coenzyme Q 10, vitamin K , dolichols and the substrate for steroid hormones. For example reduced cholesterol in the skin will interfere with vit D production due to lowered levels of 7 dehydrochesterol . If statins are reducing dementia development then there needs to be a determination as to whether this is due to their cholesterol lowering properties or their anti inflammatory effect. If the latter then again there are other ways of reducing inflammation in the body and dietary approaches are in my view always preferable to pills.

pusillanimous profile image
pusillanimous in reply toPpiman

My sister has been diagnosed with diabetes at age 84, she has never taken a statin in her life , but she has familial AF (myself and 4 sisters all have it), but she did have a hyperactive thyroid (often linked to AF and diabetes). There are so many causes for various conditions, to try and isolate offenders is virtually impossible.

Ppiman profile image
Ppiman in reply topusillanimous

You’re so right and that is at the heart of it so. These are very long term chronic conditions with roots that likely lie in a complex interaction of genetics and behaviour.

I hope your sister is coping well with life. When we first married, we became friends with our neighbour’s mother who was then in her mid nineties and was insulin dependent but otherwise very slim and healthy.

Steve

Auriculaire profile image
Auriculaire in reply toPpiman

I believe aha stands for American Heart Association. They get loads of Pharma dosh so of course they are going to say statins are the greatest thing since sliced bread.

Ppiman profile image
Ppiman in reply toAuriculaire

Oh now there's a quotation I have yet to see but take your word for it. O! but the cynical life has its advantages, seeing things that others fail to see... ;-)

Steve

Ppiman profile image
Ppiman

The internet is a wonderful source of nonsense as well as sense. Sorting between the two is nigh on impossible at times. Malhotra is famed for spouting both sense and nonsense. Even the Daily Mail had an unusual moment of unadulterated straight-forwardness riled by this doctor's views on statins:

dailymail.co.uk/health/arti...

Steve

HGates profile image
HGates in reply toPpiman

I’m not sure what this link is supposed to show? One doctor is unhappy with another doctor’s opinion & has roped in the dreadful GLP (famed for recent repeated failures in court) to try & crowdfund a case? This new form of campaigning lawfare is a blot on the U.K. landscape….in my opinion.

Ppiman profile image
Ppiman in reply toHGates

I've edited my post to take out the link, although it wasn't saying much different from dozens of other links to this doctor's extreme viewpoints on such as covid vaccines and statins. Some of his views are off the rails and he has posted much on social media that is genuinely dubious, with some of it considered scurrilous.

Steve

Auriculaire profile image
Auriculaire in reply toPpiman

See my reply to Minime. As for the respect of the mainstream medical community the history of medicine shows us that mavericks who actually get it right are largely blackened and often persecuted by those who stick to the consensus. Semmelweiss.

Ppiman profile image
Ppiman in reply toAuriculaire

I am sure you are right on a few occasions, but, generally, peer-review prevents such things happening largely, I should think. Semmelweiss was early nineteenth century when doctors and medicine were rather different then.

Mind you, a recent Times article showed that specialists' attitudes to themselves, their colleagues and their patients still need to change.

thetimes.co.uk/article/toxi...

Auriculaire profile image
Auriculaire in reply toPpiman

Semmelweiss is just an old illustration of an ongoing problem. The Aussie who discovered that stomach ulcers could be caused by H .pylori and cured with antibiotics was pilloried by his peers though luckily medicine did not have the power in the late 20th century to get him locked in an asylum. However the attempt in California to pass a law to strike off all doctors who spread " misinformation" is a sinister attempt at medical censorship. As mavericks can be right who decides what is misinformation? It is thoroughly unscientific- there is no such thing as settled science and anybody who says there is does not understand what science is. As I have said many times here the medical consensus changes .

frazeej profile image
frazeej in reply toAuriculaire

I think the H. pylori Aussie may have been better received at the time if he said "some" ulcers can be cured with antibiotics. At the time of his discovery, a group of H-2 antagonists (Tagamet, Zantac, etc.) were tremendously successful in treating ulcers, and in fact in many cases effected a "cure", as opposed to just treating symptoms. The very idea that a histamine blocker could cure a bacterial disease was at the time (and still is) preposterous, and thus the researcher's finding were subjected to widespread scrutiny. Well, in fact, as time goes by, it turns out that the antibiotics were not the "miracle cure", as some ulcers were stubbornly resistant to such treatment. Similarly, the ideas of 100% cure with H2 antagonists went by the boards. Thoughts now are that ulcerative GI disease may be a little more complicated than previously thought, and both "theories" of causation are deemed credible.

This is how science works. It evolves over time. However, that does not mean that every ridiculous idea put forth by investigators as gospel truth should be accepted as such.

JimF (receiving pension from BIG PHARMA)

Auriculaire profile image
Auriculaire in reply tofrazeej

And you do not think that the manufacturers of Tagamet and Zantac were not among the cheerleaders of those ridiculing the new theory? The " cure" - was it contingent on taking the meds for life or could they be stopped without the ulcers returning? If a proportion of ulcers were due to H.pylori and a proportion of those could be cured with antibiotics it would still eat away at the income received for H2 antagonists. Your last sentence applies just as much to what is promulgated by the medical consensus especially when you look at drugs that have been known from the beginning to be dangerous by the manufacturers but have been pushed to the public by unscrupulously hiding these dangers ie Vioxx and with the help of corrupt FDA officers ie Oxycontin and later have been taken off the market or prescription severe curtailed.

frazeej profile image
frazeej in reply toAuriculaire

Auriculaire: It's pretty obvious that you and I are going to be on opposite sides of the fence on this (and many other issues). You can blame BIGPHARMA for every ill that comes down the road, and I can say that the whole homeopathic, natural foods, herbal supplements, oriental remedies, righteous living, etc. is one of the biggest frauds ever perpetrated on society. On this issue we will remain permanently divided!

As an aside, I attach an article on the various "therapies" offered for the cure of H. pylori infections, and the relative merits of same.

ncbi.nlm.nih.gov/pmc/articl....

These are all compounds discovered, manufactured, and sold (at a profit-capitalism you know) by BIGPHARMA. I guess this is a bad thing too? Manipulation of the public by the corrupt FDA? Perhaps the ulcers can be cured better with a select diet of roots, berries and bark? Or perhaps, not.

I would be happy to continue this conversation; I could tout the pharma success stories, and you could counter with the failures (of which there are many), but I think the moderators (wisely) would "cut us off at the pass".

But anyway, I don't know if you are in the U.K. or the states (as I am), but, have a good day next Thursday, be it Thanksgiving.....or not!

JimF

Auriculaire profile image
Auriculaire in reply tofrazeej

I don't actually think Pharma are responsible for all the ills going. I do not believe in homeopathy and never bothered to take the homeopathic stuff my orthopaedic surgeon prescribed when I got new hips. I do take my Apixaban . But then I did get my first afib episode after a totally unnecessary treatment with Cipro. I have an asthma treatment - asthma provoked by desensitising jabs . How can healthy living possibly be a fraud? Not keen on the word righteous- smacks too much of religious belief. How many people end up with ulcers because of poor diet and stress caused by the rat race of capitalism? I live in France where we are castigated by our nasty ultra capitalist President for being lazy and preferring time to relax with our families round the table with good food and wine and meals that take 3 hours rather than working harder to make more money to spend on crap from China.

Blearyeyed profile image
Blearyeyed in reply tofrazeej

Happy Turkey Day to you ......or whichever meat free alternative you may be consuming during the Thankful season!Gobble, Gobble from the UK , Bee🦃🌽🏈👪😆😆😆

frazeej profile image
frazeej in reply toBlearyeyed

Thank you Bleary, and the same to you! Turkey it will be, a lovely Butterball breast, for just the grandson and me! Note the extra emojis for this house: 🦃🌽🏈🍷🍺

Blearyeyed profile image
Blearyeyed in reply tofrazeej

Oddly , as I am an English person living in Wales we have a family tradition of eating a Thanksgiving meal on your Thanksgiving.It started when I was teaching my daughter's about American traditions when they were little , and it also meant I had a use for all the pumpkin innards from Halloween!

We also usually do a Day of the Dead day too.

At the moment I'm just finishing off some pompom turkeys to use for a table game .

I think the rest of my family would appreciate your emojis and will be indulging in those too on tomorrow, although I can't drink anymore myself.

Have fun with your grandson , Bee

Autumn_Leaves profile image
Autumn_Leaves in reply tofrazeej

That sounds like a lot of fun! No Thanksgiving celebrations for me but I will have a St Andrew’s Day 🏴󠁧󠁢󠁳󠁣󠁴󠁿 dinner next week centred around my very own plant-based haggis recipe with neeps and tatties.

frazeej profile image
frazeej in reply toAutumn_Leaves

Enjoy St. Andrews Day! My dear mother (RIP) was Canadian born but of Scottish descent. She would have gone well out of her way to enjoy the haggis with you! She also always wore something orange on St. Patricks Day (a big thing here in the states), for her statement/celebration of the Battle of the Boyne! Enjoy your haggis!

JimF

Autumn_Leaves profile image
Autumn_Leaves in reply tofrazeej

Huge Scottish contingent in Canada! I have a lot of family connections there myself, and some in the US too. I only get the chance to make my haggis dish twice a year, on St Andrew’s Day and Burns Night, of course. I’d certainly have liked to offer your mum a wee taste!

Ppiman profile image
Ppiman in reply tofrazeej

Me too. Where would I be without Big Pharma? Or any of us for that matter…

Lovely to read!

Steve

Auriculaire profile image
Auriculaire in reply toPpiman

Malhotra is not the only anti statin cardiologist. They exist in other countries too. There is even an association where they publish articles and links to their peer reviewed studies. What they have in common (unlike many of the statin pushers) is a healthy distrust of Pharma and no financial ties with industry. Some like Michel de Lorgeril have written books about the cholesterol / heart disease myth and the dangers of statins in which they pull to pieces many of the clinical trials done on statins especially the early ones which showed more benefits but were done before clinical trial rules were tightened up. I do not regard Malhotra's viewpoints as extreme at all. What is more there is new research coming out regularly about problems with the covid vaccines. Research done by medical scientists who have perfectly good credentials. I am sure you never read any of it because you don't want to shake your convictions that they are"a good thing" . I would be interested to know what exactly you consider to be scurrilous social media.

MiniMeGreen profile image
MiniMeGreen in reply toAuriculaire

You are absolutely right! I'd add

Robert H. Lustig, M.D., M.S.L. Professor emeritus of Pediatrics, Division of Endocrinology at the University of California, San Francisco (UCSF) and author

Dr. Jason Fung - specialist physician, nephrologist and author

and Dr. Pradip Jamnadas, MD, MBBS, FACC, FSCAI, FCCP, FACP.

There are some more, it's certainly possible to find the right information if one is willing. However, it takes some reading or listening.

frazeej profile image
frazeej in reply toMiniMeGreen

Let's see. Two self promoted websites (Robert Lustig and Jason Fung), and a YouTube video! Well, this certainly stacks up well when compared to peer reviewed articles in accredited medical journals! Yeah......right. Yup, you sure can find the "right" info if you search long enough! Keep searching!

JimF

MiniMeGreen profile image
MiniMeGreen in reply tofrazeej

Nobody hinders you to ingest a statin of your choice ad libidum. Live long and prosper.

frazeej profile image
frazeej in reply toMiniMeGreen

Agreed! Live long and prosper.......however you like! My motto for years!

Ppiman profile image
Ppiman in reply toAuriculaire

I read widely when time permits of all sides of arguments, most especially regarding mRNA and statins as I take both.

I believe that social media, perhaps YouTube in particular, offers opportunities for scurrilous money-making by passing on health misinformation.

Steve

Auriculaire profile image
Auriculaire in reply toPpiman

Well I don't think you will find much better examples of scurrilous moneymaking than Merck's fraudulent marketing of Vioxx or the opioid prescribing scandals in the US. Purdue made lots of money addicting people to Oxycontin helped by a corrupt FDA official . Tens of thousands died with both drugs and untold misery was caused by addiction. The scandal was so great with the opioids that the pendulum has swung the other way and people who would genuinely benefit from opioid treatment are left in pain. Perhaps you could point out a scandal of similar amplitude concerning "misinformation" .

Ppiman profile image
Ppiman in reply toAuriculaire

Merck. as with Pfizer, deserved the full force of the law but your argument is a non sequitur, surely.

Also, without excusing the companies involved, no one takes an opioid without the knowledge that morphine and its derivatives are highly addictive. The patient leaflet is very clear on this. Also a great deal of pressure is often put on doctors to prescribe opioids by patients who demand stronger pain relief. I have examples of this in my own family.

Steve

Blearyeyed profile image
Blearyeyed in reply toPpiman

Very good point in a lot of cases pain relief addiction is a complex problem of which both the patient and the clinician have equal responsibility. Although, in relation to Oxycontin , people and doctors really weren't warned about just how addictive it would become so quickly even after short term use for a injury or post surgery problem , or how strong the rebound pain of withdrawal could be which compounded people's issue with trying to stop it after they had begun. In cases like that even generally responsible patients were blind sided.

The example of the history of Oxycontin is very different to the history of statins or most mainstream preventative prescription medications for chronic health problems , I'm sure you would agree.

Ppiman profile image
Ppiman in reply toBlearyeyed

The link below provides an interesting set of data and a timeline that tracks the use of opioids for many decades. This quotation stood out for me:

"... the number of people who admitted to using OxyContin for non-medical purposes increased dramatically from approximately 400,000 in 1999 to 1.9 million in 2002 and to 2.8 million in 2003.

By 2009, about 1.2 million emergency department (ED) visits were related to misuse or abuse of pharmaceuticals, an increase of more than 98% since 2004 and more than the number of ED visits related to use of illicit drugs such as heroin and cocaine. Most prominent among these prescription drug-related deaths and ED visits were opioid pain relievers (OPR), especially OxyContin. "

The use and abuse of opioids is a complex area and I doubt it's possible to lay blame easily.

fda.gov/drugs/information-d....

Steve

Auriculaire profile image
Auriculaire in reply toBlearyeyed

"Not really warned" . The opposite happened and OxyContin was actively and fraudulently marketed by Purdue Pharma to doctors as not being addictive for which they were convicted in 2007 for criminal misbranding. Doctors started people on the drug assuring them it was safer than conventional opioid.

Ppiman profile image
Ppiman in reply toAuriculaire

I haven't followed this as you seem to have done but it seems that the original FDA approved data sheet and patient information did make clear the addictive potential; indeed, it's hard to imagine any doctor not realising that an opioid carries an addictive risk given the very long history of addiction with this class of drugs. It seems amazing that any medical company or doctor could claim an opioid as "not being addictive".

Steve

Auriculaire profile image
Auriculaire in reply toPpiman

Most people are not suspicious like myself. They believe what their doctors tell them . The heart of the scandal over Oxycontin is that it was marketed by Purdue Pharma to DOCTORS as being non addictive under the guise of it's extended release formula. Rather than try to produce evidence of it's safety ie non addictiveness with clinical trials ( evidently a non starter as it is highly addictive) Purdue got on board a corrupt FDA official Curtis Wright IV who approved the drug. The first approved label for OxyContin contained the text " delayed absorption as provided by OxyContin is believed to reduce the abuse liability of a drug" . This text was exploited by Purdue in their marketing and they were convicted in 2007 for criminal misbranding. But in the 12 years since approval it was prescribed by thousands of doctors to patients in chronic pain who were assured when started on it that this was a new drug that they would not get addicted to.Wright left the FDA 2years after approving the drug and went on to get a very cushy number with Purdue at more than twice his FDA salary. That's the way the revolving door works and why the regulatory bodies are not to be trusted. Similar thing has happened recently with FDA officials who approved the Moderna jab have got jobs at Moderna. And don't come back and say that's capitalism and we've got no better system . It's corruption and there should be laws to stop it .

MiniMeGreen profile image
MiniMeGreen in reply toAuriculaire

I would add the Thalidomide case at least.

Ppiman profile image
Ppiman in reply toAuriculaire

I still struggle to believe any doctor would ever believe a medical rep telling them that an opioid was "not addictive", which is very different indeed from their saying it could "reduce the abuse liability". What it seems no one fully recognised was the abuse potential for this and other opioid drugs outside of the prescribed medical usage. The number of people taking this for the wrong reasons seems to be huge.

Steve

Auriculaire profile image
Auriculaire in reply toPpiman

That has always been a problem with medically prescribed opiates and opioid. Look at codeine . Opiates provoke a "buzz" as well as killing pain. I have personal experience of this as a friend of mine who did the hippie trail as far as Kabul in the early 70s came back with a large quantity of morphine . I snorted some every day for 3/4 weeks. I did not get addicted and don't remember much in the way of withdrawal symptoms. As far as addiction goes when taking opiates for pain relief the first step is having to take larger and larger amounts to get the same level of pain relief. Whether you struggle to believe it or not doctors in America did overprescribe this drug and Purdue were fined millions for their fraudulent marketing.

How many people read the patient leaflet? Bob D here boasts that he never reads them. I know my mother never ever read them. If the doctor gave it that was good enough. She ended up in hospital unconscious because her stupid doctor over prescribed Fentanyl patches despite warnings in the info for doctors that extra care had to be taken with the elderly , the underweight and the opiate naive. My mother was all three. It is possible that people never got a patient leaflet. I remember when I used to frequent floxie forums many of the American floxies complaining that they never got the patient leaflet for FQs which have black box warnings. Again they had trusted their doctors. Well that trust ended when their doctors gaslighted them telling them that the side effects they were suffering couldn't possibly have been caused by the drug even when they were actually listed in the leaflet.

Ppiman profile image
Ppiman in reply toAuriculaire

That wasn’t quite what I said but never mind. Your life sometimes seems to have been one long problem with the medical fraternity. You’ve certainly had some bad experiences and your mother. too. It’s not good enough for sure.

As for ignoring the patient leaflet, well, you’re likely spot on there but the original drug data sheet and patient leaflet seem to have been clear regarding potential addictiveness.

As for abusing drugs - caveat emptor. Long term mental issues and even psychoses are a common enough result for some who do.

Steve

Auriculaire profile image
Auriculaire in reply toPpiman

My mother's doctors were a shower and that is being polite! I have had good experiences too! The 3 major ops I have had here have all been successful and made my life better. I have a good GP - by far and away the best I have ever had and a cardiologist who I actually don't like very much but as he's never suggested I take a statin I'm disinclined to find another.As for drug abuse it can be lots of fun - when you are young.

Ppiman profile image
Ppiman in reply toAuriculaire

I know that for far too many, the fun ends badly. Our psychiatric hospitals (and city streets) are a testament to that.

The French healthcare system seems to be putting our benighted NHS in the shade.

Steve

Auriculaire profile image
Auriculaire in reply toPpiman

Things are going downhill here too . There are medical deserts where people can't get a GP and we might find ourself in one when our GP retires. I am having to wait 6 months!!! for an appointment with my gastroenterologist and it took me 6 weeks to get an appointment with my dentist. But I had a very good experience at the A& E of my local hospital 3 weeks ago. 5 hrs from arrival to leaving -examination, ECG, blood tests and CT scan and all the results plus a prescription. Only 10 mins in the waiting room and then lying down comfortably till it was time to leave.

Ppiman profile image
Ppiman in reply toAuriculaire

I hope you are fully over whatever it was that took you there. That sounds marvellous treatment.

Steve

Auriculaire profile image
Auriculaire in reply toPpiman

Unfortunately not. I had vertigo come on during an afib attack. When I went back into NSR it went away but returned during the night and got worse with balance problems .I feared a TIA . The doctor who examined me said she did not think it was that and the scan showed nothing. It has improved a lot but it is still there with certain head movements . I can walk ok it is mainly when lying down. It is probably vestibular neuritis and just a coincidence it started during an afib attack but I am not totally convinced as the TIA I had in 2019 did not show on the scan either. The pills don't make much difference .

Ppiman profile image
Ppiman in reply toAuriculaire

Bad luck and especially so as you can't be sure what is happening. I have a friend with AF who gets dizzy spells but these seem more to be BP related or vestibular.

Steve

Autumn_Leaves profile image
Autumn_Leaves in reply toPpiman

You’re absolutely right about the “recreation” use of OxyContin and similar opioids. The first time I became aware of it was in people with a history of substance abuse who would obtain it by any means, whether on prescription or buying the pills directly from someone who had no prescribing qualifications whatsoever. The abuse of prescription drugs is nothing new. I remember in the 90s when Temazepam was known as “wobbly eggs” and people were injecting it.

Ppiman profile image
Ppiman in reply toAutumn_Leaves

What people do with prescription drugs (at least what I have read some get up to with them..) has amazed me. I feel that the problems with pain relief drugs is that they don't work all that well if the pain is chronic and severe. I do tend to believe that the over-prescribing is more patient driven than is being allowed for by some writing in here. Doctors have a big role to play of course, but patient "power" is underestimated.

Steve

Mugsy15 profile image
Mugsy15

Whether you give credence to the author of this report or not, a full and rigorous independent parliamentary review into Statins is long overdue. No-one on either side of the debate should fear the truth.

frazeej profile image
frazeej in reply toMugsy15

Parliament review statins??? Seriously, that sounds like Donald Trump reviewing Covid therapies!

JimF

Mugsy15 profile image
Mugsy15 in reply tofrazeej

Hahaha yes you do have a point! 😂

Ppiman profile image
Ppiman in reply toMugsy15

The facts, insofar as science can uncover and confirm them (i.e. for now…), is in favour of statins. This has been shown from enormous, international, blinded and peer-reviewed studies.

The questioning of orthodoxy is reasonable given the history of some pharmaceutical companies’ sharp practices but with regard to statins, in particular, seems not to be based on rational thought (thus far).

Steve

Mugsy15 profile image
Mugsy15 in reply toPpiman

There are a growing number of eminent members of the medical community questioning the findings of those numerous studies. Or more accurately, questioning the way the findings have been presented within the studies. Often the conclusions drawn have been shown to be at odds with the actual results. I find Dr Paul Mason on YouTube and elsewhere to be most persuasive as he has looked at these studies with rigour and precision. However I accept that there are good people on the other side of the debate and I'd very much welcome a major review of all the evidence by a wholly independent body. Given that GPs are basically pushing just about everyone to be on these drugs sooner or later in life, we all need to know the whole truth about them.

Ppiman profile image
Ppiman in reply toMugsy15

I can’t think that GPs would be persuading any other than the patients NICE has asked them to, indeed is paying them to (a dubious practice, in my view), i.e. those whose eventual cardiovascular health might be helped by a lowered cholesterol level over the years before old age hits. The idea is that, in the longer term, morbidity and health care requirements are reduced.

I’ll look into that doctor’s video - thanks for the information.

Steve

Mugsy15 profile image
Mugsy15 in reply toPpiman

I agree, although I've read many times that GP practices receive funding for the patients with whom they have the Statin conversation. I can't say first hand that I know that to be true. Also, a large part of the questioning of received wisdom about Statins revolves around lowering cholesterol. Is this the good thing we've all been led to believe? This medical 'fact' is increasingly being questioned, and having listened to Paul Mason and many others I can certainly see why it needs to be. Perhaps have a look at his YouTube video 'Why your doctor thinks Cholesterol is bad' as a start point.

MiniMeGreen profile image
MiniMeGreen in reply toMugsy15

Actually it's because lowering cholesterol doesn't help as people with higher cholesterol live longer. The problem is sugar mainly fructose and mostly the insulin resistance.

It all started with Ancel Keys and his fat is bad hypothesis built on cherry picking in the 7 countries cholesterol study.

Ppiman profile image
Ppiman in reply toMugsy15

They receive funding only by following NICE guidelines. It's a questionable practice I feel, but the doctor's staff have extra work to do to trawl their patient records to identify those whom NICE think could be a suitable candidate for statins. Only those who will benefit are covered by the NICE payments. The idea is to reduce the burden of cardiovascular disease on individuals and the NHS in future years. That sounds laudable to me.

There can be no arguing that most people do die of cardiovascular conditions or that have those have been decades in the making. How much genetics and environmental factors contribute is still not clear but the evidence is that lifestyle and pharmacological interventions work to reduce morbidity and improve overall quality of life in the years prior to death.

Steve

Belle11 profile image
Belle11

A Mediterranean diet is more effective than statins for heart disease prevention, and lacks the adverse side effects of statins (muscle damage and diabetes), according to the NNT (number needed to treat)

"The NNT offers a measurement of the impact of a medicine or therapy by estimating the number of patients that need to be treated in order to have an impact on one person. The concept is statistical, but intuitive, for we know that not everyone is helped by a medicine or intervention — some benefit, some are harmed, and some are unaffected. The NNT tells us how many of each." thennt.com/thennt-explained/

Here are the links for statins for people with different heart histories thennt.com/?s=statins&x=0&y=0

And for a Mediterranean diet thennt.com/nnt/mediterranea...

MiniMeGreen profile image
MiniMeGreen in reply toBelle11

Thanks for the link, very useful 👍

Popepaul profile image
Popepaul in reply toBelle11

Thank you for the link,both useful and informative.

Ppiman profile image
Ppiman in reply toBelle11

Some of those stats seem really weird. The influence of statins on diabetes, for example, is far from clear and yet is presumed proven in their information.

I suspect that the idea of a Mediterranean diet is something of a myth since it is a vast generalisation and is something that - even if a reality - is a lifelong aspect of people’s lives.

Steve

Belle11 profile image
Belle11 in reply toPpiman

Changes in diet can affect cardiovascular risk at any age. Research on olive oil intake, one of the components of a med diet, found that "people who consumed the most olive oil — a little more than half a tablespoon per day — had a 19% lower risk of death from any cause over a 28-year period, compared with those who rarely or never consumed olive oil. Higher olive oil consumption was also associated with lower risks of death from cardiovascular disease, cancer, neurodegenerative disease, or lung disease. Among people who replaced butter, margarine, or mayonnaise with olive oil, the death rate was as much as 34% lower than that of people who didn’t substitute olive oil for those fats. ound that people who consumed the most olive oil — a little more than half a tablespoon per day — had a 19% lower risk of death from any cause over a 28-year period, compared with those who rarely or never consumed olive oil. Higher olive oil consumption was also associated with lower risks of death from cardiovascular disease, cancer, neurodegenerative disease, or lung disease. Among people who replaced butter, margarine, or mayonnaise with olive oil, the death rate was as much as 34% lower than that of people who didn’t substitute olive oil for those fats." health.harvard.edu/staying-...

It seems that olive oil lowers cholesterol "A 2019 analysis summarized the findings of 27 studies on the effect of olive oil on cholesterol. It concluded that olive oil consumption decreased total cholesterol, LDL, and triglycerides and increased HDL more than other plant oils. Link to analysis in this article medicalnewstoday.com/articl...

Other aspects of a Mediterranean diet include plenty of fruit and veg, lots of fish, nuts etc - all heart healthy.

We each have to make our own decisions. I consume plenty of olive oil and don't have a high cholesterol. I'm sticking with my mostly Mediterranean diet.

Keano99 profile image
Keano99

I think you have to trawl through the numerous studies on Medscape, BHF etc., to form a balanced view on this. My cardiologist, who is very unbiased wrt this, says statins do stabilise any plaque that has formed, so worth considering even if you’ve changed your diet/stress levels anyway….and would tend to recommend them to get your cholesterol down to the recommended level/s if you have any irregularity with your arteries…….

Ppiman profile image
Ppiman in reply toKeano99

I would guess that it's hard to know a doctor well enough, except as a personal friend, to decide whether he or she is biased. The cynics would have us believe that doctors like your cardiologist do precisely what Big Pharma tells them.

Also, for a non medic and medical statistics expert, I guess it would be impossible to question the findings of the major studies meaningfully. That's what NICE and other national health bodies do before they arrive at their recommendations. Of course, cynics would have their own explanations but not being medical statisticians, either, would their views be any better informed? Of course not.

In the end, we must trust to the experts and make sure that the right checks and balances are in place to prevent error and corruption. Looking at the workings and make up of NICE, it seems to me that they can be trusted.

Steve

Keano99 profile image
Keano99 in reply toPpiman

Well yes, you never know. But I changed cardiologists to one that I felt was less inclined to be as you suggest….

MiniMeGreen profile image
MiniMeGreen in reply toPpiman

I would like to get your opinion on the following papers:

2020 Jefferson Sponsorship bias in clinical trials growing menace or dawning realisation?

ncbi.nlm.nih.gov/pmc/articl...

The debate swings between the conclusions drawn by the influential Oxford-based Cholesterol Treatment Trialists’ Collaboration on the basis of their series of individual participant's data meta-analysis42 on one side, and evidence from observational studies on the other.43,44 The Cholesterol Treatment Trialists' director insists that the benefits of statin use in primary prevention of cardiovascular disease outweigh their harms (the incidence of which they estimate at 1 in 10,000 users).45 These observations seem to be contradicted by numerous large surveys, and observational studies report that users quit mainly because of harms.

2019 Diamond et al Formal comment on “Systematic review of the predictors of statin adherence for the primary prevention of cardiovascular disease”

journals.plos.org/plosone/a...

We have therefore written a commentary which provides a broader perspective on the benefits versus harms of statin therapy. Our perspective of the literature is that non-adherence to statin treatment for primary prevention of CVD is justified because the meager benefits are more than offset by the extensive harms.

2014 Kristensen et al The effect of statins on average survival bmjopen

bmjopen.bmj.com/content/5/9...

Results: 6 studies for primary prevention and 5 for secondary prevention with a follow-up between 2.0 and 6.1 years were identified. Death was postponed between −5 and 19 days in primary prevention trials and between −10 and 27 days in secondary prevention trials. The median postponement of death for primary and secondary prevention trials were 3.2 and 4.1 days, respectively.

Conclusions: Statin treatment results in a surprisingly small average gain in overall survival within the trials’ running time. For patients whose life expectancy is limited or who have adverse effects of treatment, withholding statin therapy should be considered.

2018 Demasi Statin wars have we been misled about the evidence?

pubmed.ncbi.nlm.nih.gov/293...

What is already known?

Statins are among the most widely prescribed drugs in the world and have cemented their place in preventative cardiology.

An aggressive and myopic focus on lowering LDL-cholesterol, a surrogate endpoint of heart disease, has led to the overprescription of statins to millions of healthy people at low risk.

What are the findings?

Dissenting views about statins have been publicly derided and effectively silenced by proponents who are often funded by statin manufacturers.

Doctors and patients cannot have an informed debate about statins because the raw data are being kept hidden, and it is now a matter of urgency that the data are released.

2019 Hansen et al Postponement of Death by Statin Use a Systematic Review and Meta-analysis of Randomized Clinical Trials

link.springer.com/article/1...

Results

The median modeled outcome postponement was 10.0 days (interquartile range, 2.9–19.5 days). Meta-analysis of 16 trials provided a summary estimate of outcome postponement for all-cause mortality of 12.6 days, with a 95% postponement interval (PI) of 7.1–18.0. For primary, secondary, and mixed prevention trials, respectively, outcome postponements were 10.2 days (PI, 4.0–16.3), 17.4 days (PI, 6.0–28.8), and 8.5 days (PI, 1.9–15.0).

Conclusions

The modeled outcome postponement is amenable to meta-analysis and may be a useful approach for presenting the benefits of preventive interventions. Statin treatment results in a small increase of average survival within the duration of a trial.

The last publication is in German, however it's very interesting as it is published by the Arzneimittelbrief which is a critical paper discussing mainly drug effects, risks and benefits. This paper has been reprinted through the Drug Commission of the German Physicians in 2020.

It is titled “Neue europäische „Leitlinie“ zur Lipidsenkung: As low as possible?“ i.e. „New European “Guideline” for lipid lowering: As low as possible?“

akdae.de/arzneimitteltherap...

Last part of the Summary states:

The target of “as low as possible” seems to apply not only to LDL cholesterol, but also to the level of evidence of the guideline, because it is worthy of criticism on many formal points, so that in our opinion it is at best described as an interest-driven position paper from an industry-related specialist society can be.

So in benefit of your cardiologists /GPs, we shall assume that they treat according to these Guidelines because they do not know better.

Nevertheless, everybody is entitled to a statin of his/her own choice ad libidum.

Long live and prosper.

Ppiman profile image
Ppiman in reply toMiniMeGreen

I've read a few of the linked papers only. It is true that the use of statins is controversial in some quarters, but also the case that none of the papers I read show that statins are not worthwhile in people who have a CV risk and in whom they are well tolerated. Long term side effects from statins are difficult to ascertain and even more so to quantify given the nature of the people taking them.

Death as an outcome when measuring CV illnesses is not as useful as reduction in long term morbidity, I would say. CV illnesses cause massive morbidity and there seems to be little evidence that statins cause much at all.

Both of my parents died before they were 80 of heart attacks, but both had been long term smokers, and yet I am not considered at high risk myself. I don't know whether my taking statins will help me avoid CV disease - I just hope it will. I did stop taking statins for, I think, two years some years ago to see if any of the several symptoms I was having diminished as a result. None did. My doctor said I should resume, and I took his word for it.

I also need to take PPI drugs and wish I didn't. Life is what it is. I trust my GP and the specialists I have seen but always proceed with caution.

Steve

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