Re: Blog on Statins FYI

On Sep 24, 11:41 am, MarilynMann <ma...@xxxxxxxxxxx> wrote:


This is exactly the kind of discussion that irritates me. It's all
anecdotal and opinion-based.

For example, I know of no evidence that lowering LDL with plant
stanols (e.g., Benecol) will lower your risk of having a CVD event.
It is possible that it will, but that has not been proven. Not to
mention that, for people who already have high CAC scores, lowering
their LDL through diet and exercise is unlikely to undo the damage
that has already accumulated, although it may lower the rate of plaque
accumulation and have other benefits. One of the reasons for
prescribing a statin to such a person is that it may help stabilize
the plaque and prevent them from having a heart attack.

I'm not an expert on niacin, but I'm not sure why you would prefer
using niacin over a statin. Niacin has a number of side-effects
(e.g., raises BG). If he has reasons for preferring niacin, he should
say what they are and cite the evidence for them.



Maybe because many people realise that statins have serious sometimes
very serious side effects and that doctors heavily influenced by
marketing offen miss even the common side effects of statin drugs.
Heres a nice article about that very subject.
Is Your Doctor in Denial?
Survey Finds Physicians Often Dismiss Complaints About Drugs' Side
Effects

By Ishani Ganguli
Special to The Washington Post
Tuesday, August 28, 2007; Page HE04

'On many online message boards and Internet chat rooms, anxious
patients share details about the muscle pain and memory loss they
have noticed since they started taking statins to lower their
cholesterol. A new study suggests these people may be seeking
validation for good reason: Some of their complaints might otherwise
be going unheard.

According to a survey of 650 patients published last week in Drug
Safety, a peer-reviewed journal, doctors frequently ignored or
dismissed patients' concerns about such side effects. The study
suggests this pattern of reaction goes beyond statins to other
drugs.'



The piece also notes that.....When doctors fail to recognize a
patient's symptoms as drug side effects, more than that patient's
care is put at risk. Because the doctor makes no "adverse event
report" to the Food and Drug Administration, the regulatory agency
may underestimate the problem, and other doctors and patients may
assume the drug is safer than it is. " ... The researchers
noted ...... "Person after person spontaneously [told] us that
their doctors told them that symptoms like muscle pain couldn't have
come from the drug. We were surprised at how prevalent that
experience was," said Beatrice Golomb, associate professor of
medicine and the study's lead researcher."...... and
noted... '.According to experts, muscle pain and other side
effects occur in up to 30 percent of statin patients, by some
estimates, and often lead doctors to stop or change a prescription.
But patients surveyed said their doctors rarely linked their
symptoms to statins -- even when the symptoms were well-documented
as side effects." ....

and the piece noted ....
"Golomb speculated that doctors' actions might reflect the relative
dearth of information on the downsides of statins. "Ad campaigns
that preserve statins' miracle drug image are more powerful than
education about side effects," she said.

The findings raise important concerns about American drug safety
monitoring, said Harvard Medical School professor Jerry Avorn,
author of "Powerful Medicines: The Benefits, Risks and Costs of
Prescription Drugs."

"We already know that there is horrendous underreporting of side
effects. Ninety to 99 percent of serious side effects are not
reported by doctors," he said ."
http://www.washingtonpost.com/wp-
dyn/content/article/2007/08/24/AR2007082401714.html?nav=rss_health

That and the fact that many even in the medical community have doubts
about statins
Inside Medicine: Chances are, cholesterol pill is of little help
Sacbee.com
By Dr. Michael Wilkes -
Published 12:00 am PDT Saturday, March 31, 2007

Heart disease is a major killer in the United States. Let's say I
could give you a pill to prevent a heart attack. You would need to
take the pill every day for five years at a cost of $3,000. Would you
take it? Most would.


But now, let's say that the pill actually prevented a heart attack in
one of every 67 people who took the pill for five years. That is, 66
people would take the pill and get no benefit -- only one would
benefit, and we can't predict which person that would be. Would you
take the pill? This time, you need to think carefully and weigh the
pros and cons.


Well, this is exactly the type of information you need to know when
choosing any treatment, but particularly when thinking about taking a
medicine to reduce cholesterol.


Jenny is a healthy 50-year-old with no history of heart disease in
her
family. But when she went to her doctor for a checkup, he did the
exam
and took some blood for cholesterol, which came back elevated. In a
follow-up phone conversation, the doctor recommended to Jenny that
she
start taking a drug to lower her cholesterol. There was no discussion
of the expected benefit from the drug (which is probably much less
than 1 in 67 over five years).


In the United States, 36 million Americans take a pill each day to
lower their cholesterol. For those with a history of heart attack or
symptoms of heart disease, the benefits of lowering cholesterol are
substantial and well documented.


However, it is not good science to assume that if something helps
people after heart attacks, it might also help people who have not
had
a heart attack. Antibiotics are life-saving for those with pneumonia,
but we don't give antibiotics to healthy people as a precaution.


Most of the 36 million people who take cholesterol pills do not have
heart disease. Their doctors prescribe pills as a form of preventive
medicine -- hoping that lower cholesterol might prevent heart disease
in the future.


In some cases, there is no data to support these assumptions at all.
In other cases, the data suggest only a very small benefit. Given the
small benefit, some reasonable people might decide to not take the
pills when they consider the expense and the daily reminder that
their
bodies are abnormal.


For example, despite official recommendations that women and people
over age 65 who have high cholesterol take medication to lower
cholesterol, there are no good studies to show a benefit. Admittedly,
there might be a benefit -- it's just that we don't know for sure and
the data we do have aren't convincing. Yet are patients ever told
about this uncertainty?


Jenny was not, and she would have chosen not to take the drug if she
understood a bit more about the benefits.


As a recent article in the journal the Lancet points out, if people
understood the small magnitude of benefit from taking cholesterol
medicine, some might choose a more healthy alternative -- using diet
and exercise instead of taking a daily pill. This personal choice
might lead to far fewer people taking medications to lower
cholesterol.


My point is twofold. First, given the lack of scientific data proving
a sizable benefit in otherwise healthy, low-risk people, we might be
pushing cholesterol reduction a bit too hard. And second, people
should be told, in simple language, the expected benefits of taking a
drug so they can decide for themselves whether to take a pill for the
rest of their lives.


About the writer:
Michael Wilkes, M.D., is a professor of medicine at the University of
California, Davis. Identifying characteristics of patients mentioned
in his column are changed to protect their confidentiality. Reach him
at drwil...@xxxxxxxxxxx


Then the fact that fish oil an other modes have been shown to produce
similiar results in a much less toxic manner [ no muscle pain and
sometimes loss] and the many other side effects that come with statin
use the better question is why rush to a statin based on science not
sales. I think Wilkes piece is pretty balanced.

Thanks Vince

.

Relevant Pages

  • Trial: Popular cholesterol drug fails to improve heart disease
    ... CHICAGO, Illinois -- Leading doctors urged a return to older, tried-and-true treatments for high cholesterol after hearing full results Sunday of a failed trial of Vytorin. ... Millions of Americans already take the drug or one of its components, ... But doctors were stunned to learn that Vytorin failed to improve heart disease even though it worked as intended to reduce three key risk factors. ...
    (soc.senior.issues)
  • Re: Do I really need to be taking a statin?
    ... Reading the materials at the National Cholesterol Education Program, ... cholesterol pill is of little help" ... a heart attack in one of every 67 people who took the pill for five ... benefit from the drug (which is probably much less than 1 in 67 over ...
    (sci.med.cardiology)
  • Re: Many Patients On Cholesterol Meds Stop Treatment
    ... rather risk a heart attack than my memory or even some of the other side ... if it's CRP not cholesterol, there ought to be a drug that targets CRP, not ... doctors are too heavilyinfluenced by the drug companies. ...
    (soc.senior.issues)
  • Think Twice Before Your Pop That Pill
    ... Take the blue pill: It will be like none of this ever happened. ... the two drug companies ran extensive advertising ... both block the absorption of cholesterol from food, ... be prescribing that healthy people without an inkling of heart disease ...
    (misc.health.alternative)
  • The Pill Pushers
    ... When Shahram Ahari went to work at pharmaceutical giant Eli Lilly ... His job was to schmooze with doctors in order to get them to prescribe ... drug has not been approved by health regulators. ... The number of detailers here jumped from 3,990 to 5,190 ...
    (misc.health.alternative)
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