Re: Lack of evidence for LDL treatment targets

Susan wrote:
x-no-archive: yes

David Rind wrote:

However, I am quite comfortable that the mortality rates reported in large, well-performed randomized trials of statins are real. It's hard to mess up whether someone is alive or dead. And these mortality rates show important benefits with statins.


Okay, perhaps that's a real benefit and the only benefit demonstrated to date.

It's not the only benefit demonstrated to date -- they also decrease recurrent cardiac events. The reason for focusing on mortality is that it's generally the most important benefit to people.

It still ignores the fact that there may be similar or better benefits derived from much safer, but less profitable interventions. If nothing else, the diet that statin users are told to follow is a recipe for atherogenesis, frex. It's just a sickening misdirection of inquiry and resources, IMO.

Statins haven't been tested head to head against every other possible intervention, but that misses the history of treatments for high cholesterol in patients with and without known heart disease.

Over the past 40 years, lots of treatments were tried (including diets, vitamins, and all sorts of medications developed by the very same drug companies that make statins) and the results on mortality almost always showed either no effect or harm. All this changed when the statins came along. It's not like the same drug companies didn't have a financial stake in showing that those other medications worked -- it's just that they actually didn't work and the trials showed it.

--
David Rind
drind@xxxxxxxxxxxxxxxxxxxxx
.

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