You guys might be getting a little sick of my ongoing rants about statins (especially since I'm preaching to the choir) but I do like practicing my ranting skills, and we get a surprising number of women both here and on the NHS group who are "on statins". I did a bit of googling to see what the latest news was on the subject, and came across this:
This is a "statins are wonderful and will save the world" article, which is precisely why it's a great example of how bad things have got.
"Why Has There Been Controversy About Statins in Women?
...when results of these trials were analyzed only among the enrolled women, the benefits of statins have generally failed to reach statistical significance. That is, the benefits of statins in women were unproven.
This is where the controversy has been. There have been two possible explanations. The first, of course, is that perhaps statins just do not work as well in women as in men. Most experts have doubted that this is the case. The second explanation is simply that not enough women have been enrolled in existing clinical trials to statistically prove the effectiveness of statins."
Note the phrasing of that argument. It cannot possibly be that no effect was observed because there is no effect to observe. No, statins work, and we merely need to look hard enough to prove that they do. And lo and behold:
"In early 2015, a large meta-analysis was published in the Lancet reporting that, when the level of cardiovascular risk is taken into account, statins appear to be just as effective in women than in men.
This study, conducted by the Cholesterol Treatment Trialists’ (CTT) Collaboration, analyzed 27 randomized clinical trials with statins, which altogether had enrolled over 46,000 women. The analysis with this large number of women concluded that statins were as effective in women as in men in reducing the subsequent risk of major cardiovascular events."
Let's clarify what this means. To see any positive effect at all, to the extent that you're 95% certain that it isn't pure random chance, you have to give statins to tens of thousands of women. Statins have been around for 30 years, and they've only now managed to locate, with the use of a statistical magnifying glass, a measurable effect in women.
This result tells you nothing about the therapeutic risk-benefit tradeoff involved in prescribing statins. In particular, it doesn't tell you anything about the negative effects that you may have imposed upon the vast majority of those women who saw no benefits at all. Statistical significance is not the same as clinical significance.
In the real world, pills aren't handed out purely on the basis of their desirable effects: the clinician must always weigh up the risks of undesirable ones before prescribing. Ah, but statins are as safe as water, aren't they? Yeah ... well, not when you look at large populations, they're not. The rate of serious side effects is reported at around 10% (that's the lowest estimate - others suggest it's more like 30%, based on the rate at which people unilaterally decide to throw their pills in the trash). "Serious side effects" include muscle pain, neurological disturbances, type 2 diabetes, and liver dysfunction. Let's assume that 50% of the study subjects were on statins, and the others were in a control group. Statistically speaking, 2300 of those women would have experienced one or more of these side effects. 1000+ of them would have experienced debilitating muscle pain (women get this more frequently than men). 0.1% of them (20+ people) would have experienced rhabdomyolysis, a life-threatening condition in which your body literally starts to dissolve its own muscles. All that collateral damage, simply so that a small and indefinite number of them could "reduce their risk of heart disease".
"Most experts now agree that the best evidence available indicates that statins are as useful in women as they are in men."
That bit at least is true. They are as useful in women as they are in men. In other words, they do nothing at all for either men or women, except make them sicker than they were to begin with.
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Agreed. We have been sold the message (pup?) that the road to health is paved with pharmaceuticals.
And the message has been heeded - along with foods that come wrapped in plastic and cardboard.
In the UK we spend three quarters of a billion pounds on probiotics '...guaranteed to reach the gut alive.' Just shows the efficacy of advertising against the skimpiest of evidence.
I was watching a video on Diet Doctor yesterday that showed if your risk was moderate, statins had no impact, but if it were high, it did. As so many people were prescribed them as an early precautionary thing, it reduced the percentage of people who benefited from them.
The other thing that I am not sure if I have read right, or MUST have misunderstood, is that people with high cholesterol have fewer strokes...! but obviously a stroke is not a heart attack, so I suppose you could reduce your risk of stroke but increase your risk of heart attack???
It's complicated. Very complicated. But there's three things to say about those "high-risk" people who supposedly benefit (it's men in their 40s/50s who have already had a heart attack):
1) You have to ask why they're in that sad place to begin with. We know it isn't saturated fat. We know it's not "cholesterol". So what have they done to themselves? With a few strange exceptions (pure bad luck) these people are basket-cases. They've smoked, drank and slobbed their way through life. They could improve their chances dramatically by just not doing ... all that. A statin improves their chances by ... well, what exactly? See 2.
2) Different studies use wildly different metrics for "success". But it goes without saying that no drug will help you live forever; they best they can do is prolong your life, and hopefully enhance the quality of what remains. It turns out that, if you're one of those basket-cases, statins prolong your life by a matter of days or weeks, on the average (although again it's tricky to put an exact figure on that). You still end up dying in the same way, eventually ... because you're a basket-case.
3) Since we know it's not the cholesterol-lowering effect of statins that has the desired effect in these cases, then what is it? Whatever it is, it would be worth finding out, because it would get us a step closer to finding out why these people develop heart disease in the first place.
It's true, people with high cholesterol have fewer strokes. I did a rant about it a few days back. "Fewer" is actually an understatement. They have virtually no strokes. The same paper I referred to indicates that they have a dramatically lower heart disease risk too. Which is what you'd expect, since there's some overlap between the processes underlying coronary heart disease and stroke.
Of course you can't assert direct causation: it would be stupid to tell everyone "you have to increase your cholesterol!". A more subtle reading of the result might be "people who are healthy, and who in consequence do not have strokes, tend to have high cholesterol". The high cholesterol is in some obscure manner a marker of good health. And that does indicate that reducing cholesterol with drugs is a pretty stupid thing to do - particularly since people with low cholesterol have a 40% chance of experiencing a stroke by the age of 70ish.
A chocolate fire guard is as useful to women as it is to men. I was prescribed statins for a while but decided after reading more about them not to take them. One interesting thing I noted was that “The most common reported side effects from all types of statin include nosebleeds, and a runny or blocked nose.” This at the same time that there were reports in the press of a sudden rise in recent years of people in middle age becoming hay fever sufferers possibly due to dryer weather, global warming. Statins perhaps??
And the scary thing is that a vaccine is on its way. Not content with pushing inconvenient(!!!) daily pills (as opposed to a twice yearly visit to the GP practice.???) that can be stopped at any time should unwanted side effects appear, “They” now want people to have a vaccine. Quite apart from any other considerations, This would mean any side effects would have to be endured until the vaccine was out of the body, just like some of the bone meds that are prescribed. Below is the start of the blog from the link below.
Sometime next year you may receive an invitation from your GP to join a large-scale clinical trial of an exciting, new (relatively) cholesterol-lowering drug called Inclisiran that “could” save 30,000 lives in the UK over the next ten years.
Not only is it 50% more effective at reducing your cholesterol levels than the most powerful statins but, says the press release, because treatment involves just two injections a year, it is much more convenient than the fuss of swallowing a daily statin. Inclisiran is being described as a ‘fire and forget’ treatment, a vaccination against heart disease. Mmmmm well, maybe.
Well the fire and forget could cause devastation to anyone suffering side effects.
As for exciting, someone in Big Pharma will be excited about the new cash cow. (Inclisiran also costs about £4k/year as opposed to c£20/year for statins.). Surely NICE can see the value for money here.......
Wild optimism about benefits
The new trial that has just been announced will involve 40,000 patients next year with many more expected to be using the drug soon after that. But all that is known for certain about Inclisiran at the moment is that it can halve cholesterol levels in patients already on high dose statins.
Yet this was enough for a senior NHS spokesperson to make various wildly optimistic claims about the benefits of the drug would bring when announcing the trial at the beginning of January. Giving the drug to 300,000 patients a year would prevent 55,000 heart attacks and strokes and “save” 30,000 lives over the next ten years.
These are very high numbers for a type of drug that is currently only recommended for use on a fairly few high-risk patients. It also shows remarkable optimism about a drug that has never been shown to cut the number of deaths. The purpose of the trial is to get the evidence to support the dramatic claims.
You really have to wonder if backhanders are involved here. It's well-known that drug companies give out minor perks to GPs to push their pills, but perhaps it goes higher up than that.
I live and work in countries where graft is completely normal, and this is exactly the sort of total disconnect between government policy and physical reality that you see over here. The only other possible explanation is that the NICE policymakers sit in boardroom meetings with a supply of LSD instead of the normal coffee and doughnuts.
What about the possible effects of statins on Dementia? I currently take a statin a I have a Chadvasc score of 4! Having lost my grandmother to senile dementia and my mother to vascular dementia I can’t see me stopping the statin yet. Will chat to my EP when I see him on the 18th.
Neurological disturbances are a common and well-documented side effect of statins, because they prevent the brain from maintaining myelin (adequate cholesterol is critical for myelin formation). This is a completely predictable outcome of their mechanism of action.
Whether this might ultimately end in dementia etc is up for debate. I honest don't see how it could not have catastrophic long-term consequences.
Do discuss with your care team, but they'll most likely brush this off as scaremongering. If you're more specific with your questioning, though ("what is the documented rate of serious neurological problems associated with statins?") they are duty-bound to tell you the truth. Most doctors are scrupulously honest, but as has been observed: “It is difficult to get a man to understand something, when his salary depends on his not understanding it.”
And because of your rants/informative posts ☺️ I tell everyone I meet.....if we get into the subject......😂......that statins are ineffective at best and bad for your health at worst. Hopefully the word will spread and people will begin to see through the nonsensical marketing propaganda of big pharma.
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