Re: Lack of evidence for LDL treatment targets


David Rind wrote:

Susan wrote:
We also don't seem to have any evidence that LDL lowering by any means
is useful. In the case of statins, it comes with a lot of risk of
adverse reactions.

Statins save lives when used for secondary prevention of CHD, as well as
in various other situations. They save enough lives that for most people
with CHD the benefits are well worth the risk of side effects, since for
most people who develop side effects, the side effects go away when the
statin is stopped.

The evidence clearly shows that statins are beneficial, it just doesn't
clearly show that that benefit is related to the degree to which they
reduce LDL.

--
David Rind

Dr Rind,

I want to personally thank you for your above post. It is an
understandable post that gives great insight into when statins are
appropriate based on all kinds of available data. Folks can argue all
they want about the funding source but the data is still data and those
of us who have been involved in developing regulatory data know such
data can not simply be ash canned because you do not like the results.
And it makes no difference if the results are favorable to the funder
or unfavorable. Once he has done the study he is stuck with the data
just like the rest of us are stuck with the data.

I have said over and over that there exist classes of people who
benefit from statins. Not one of the pro statin people ever
acknowledges that I have ever said such things. I have also, like
Susan, said over and over there exist classes of people who have shown
no benefit from statin treatment that justifys the risk and expense.
That brings a storm of denial from the pro statin people and snarky
comments from some of the most ignorant. I have said repeatedly that
it is not a bit clear, based on the evidence, that those who benefit
get that benefit as a result of lower cholestorol. That is like
pouring gasoline on a fire. It is interesting that this is such a
black and white issue with such a large group of people on both sides.
I can only conclude talking about who benefits from statins and who
does not benefit is like talking religion or politics.

It is truly great to see someone who has real medical credentials give
balanced answers. Keep up the good work.

.

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