Did anybody else see this interesting interview with Dr Laurence Buckman and Dr John Briffa? I only came across it on Dr Briffa's website which is not mainstream.
I was wondering why I wasn't getting any comments as I think this interview is a bit of a revelation. Jon Snow called it " a benchmark".
Basically it's the outcome of the Cochrane Committee that looked at all the statin trials and came to the conclusion that for pure primary prevention, that is people who don't have cardio vascular disease, the disadvantages of statins may outweigh the benefits. This is because of the large number of people you need to treat to prevent one "event" and the side effects (some of them very serious).
Some of the trials were not purely primary prevention as the participants often had other problems like diabetes or raised CRP.Dr Buckman seemed like a very nice man but definitely medical "establishment" but even he was using phrases like "the jury is out on this" and "there are some people who if they even get a whiff of a side effect should stop taking them"
Do watch it ,if you can. Dr Briffa's blog is not for the faint hearted though, if you have conventional views on statins and the cholesterol theory.
Overall these results are surprising when compared with the opinion prevailing say 10 years ago. The data requires very careful study but access to the full papers are only available through subscription (US$30+tax/paper). Could HEART make such access available as an institution?
Yes, I agree with what you say about attitudes 10 years ago, I think that was when the quip about putting them in the water supply was made. Personally, I think statins are the most over hyped drug in the history of the universe (personal opinion only).
Why can't people just say that they are good at what they do, that is lowering LDL !
I think penicillin-intolerant patients may disagree about the most over hyped drug in the history of the universe...
Anyway, by "the cholesterol theory" do you mean the lipid hypothesis?
I think this is referring to drbriffa.com/2011/09/29/med... but I don't know who "the editors of the Archives of Internal Medicine" are, nor why I should trust them more than the medics who are responsible for me.
Reading other things on drbriffa.com, it seems like he started with a zoology degree (does that happen often?) and assumes that the hypothesis is false (he makes hard statements like "cannot be due to their cholesterol-reducing properties" when I don't see any evidence of causality either way). He's an interesting dissenting voice, but I feel he's annoying as the statins-are-always-good voices: he seems to have made up his mind first.
Anyway, didn't we already know that statins don't change all-cause mortality? I thought it had been widely acknowledged that statins do a specific job and that specific effect becomes insignificant when you broaden the scope to look at everything. Their effect gets lost in the noise of life and other health problems but that's not medicine - that seems like simple mathematics to me.
I think ulimately a lot depends on each individual's medical history and the cause of their hyperlipidaemia and how well they can tolerate statins. Some people may decide that the risks outweigh the benefits. and that should be their choice.
Somebody famous once said - if you haven't got anything interesting to say - don't speak. Based on that - I've decided that until the medical profession sort themselves out and work out exactly what causes heart disease - there is no point debating the issue. It's obvious now that they have no clue - wild theories based on dodgy research. What can be said for certain is that statins do reduce cholesterol. Statins have also been shown to reduce CVD in secondary patients. What that means in practice is still anyone's guess. Is it the cholesterol reducing properties? Is it statins do something else? Why not focus on the 'something else'? There is obviously a lot of work to be done and a lot of money to be made by the drug companies.
Well, medicine is an experimental science, so they may never "work out exactly what causes heart disease". Human bodies aren't as neat as structural engineering. Most of the time, all we can do is take a best guess, weighing the evidence we have at the time.
One of the failings of mass media coverage of medicine is that it tends to give disproportionately large coverage of minority views. I'm not sure whether Dr John Briffa is benefitting from that.
I would disagree with you. My opinion is that people like Dr Briffa (who is medically qualified) and Dr Malcolm Kendrick open up the debate . For me this has caused me endless anxiety as to the "best" thing to do, but I would rather have this than the old days of medicine when we all did exactly what our doctors told us without questioning.
How many women had unecessary hysterectomies for example or children had their tonsils removed because that is what we were told at the time. I know medicine moves on all the time but at least we now have the internet and a free press to make more of our own choices.
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