Prescribing statins (lipid lowering drugs) prophylactically to try to reduce heart attacks has become big, big business. Just one drug, Lipitor, made by Pfizer, made $12.7 BILLION of sales last year alone. Health Insurance companies in the US, and the national GP contract in the UK reward doctors for putting patients with “high” cholesterol onto statins to produce lower blood levels in those patients. But does this do any good?
Many studies have shown that if you prescribe statins to people who have had a heart attack, then you are likely to reduce the rate of death from strokes and further heart attacks. For every 28 patients over 65 with heart disease who take statins, one life will be saved. The population based West of Scotland study showed you needed to treat 715 men to save one life.
However, studies of those without heart disease, and those aged over 70, have failed to show any significant lowering of mortality from the consumption of statins.
There are two other problems with statins – firstly, if they do what they say they do, they will reduce deaths from heart disease. What they don’t do is improve the quality of life of those who take them. Secondly, many experts believe the incidence and severity of side-effects from taking statins for many years is unknown, and probably underestimated.
We are right to be sceptical of drug company sponsored “evidence” when considering mass treatment of healthy individuals whose cholesterol level happens to fall outside the promoted “norms”. This is a problem which is widespread in medicine. A finding from one group of patients is turned into “evidence” and is then applied widely to groups of the population who are significantly different from the experimental group.
Am I a hero or a coward? Should I stop taking Lipitor because I haven’t had a heart attack – yet?
Being Scottish, immediately a high risk category, and having a family with a history of heart ailments I am inclined to take the risk of side effects, and hope that those around me aren’t too annoyed by them.
The extra day or two of life I (maybe) get may be a Saturday when I win the lottery and become a muli-millionaire, or Scotland actually win at rugby. I’ll leave you to ponder which is more likely!
Hey, you’re a hero – and being a hero means you take your own decisions about things on the basis of a conscious choice! That’s the bottom line. The point is that there is never a one size fits all answer because not only is everyone different but no two people share the same circumstances and values. Statistics tell us something but they sure don’t tell us everything.
The best decisions you make are the most consciously chosen ones, and, Douglas, they are the ones you continue to make every day.
What’s more likely? You winning the lottery or Scotland winning at rugby? Fancy sharing the cost of a lottery ticket?
I have my 50p all saved up, hope you have yours. I assume equal share of cost means equal share of winnings.
My real concern now is that if we win the lottery on Saturday I’ve committed to Sunday being the last day of my life!
Hi again Bob,
At risk of probably repeating myself, I think statins are scary. If these drugs work as wonderfully as proposed then the developed world would have had a major reduction in coronary incidences due to the popularity of these drugs, but this is not so. Even a new drug that raised good cholesterol had a shambolic trial run. And WHO MONICA figures clearly show no link between high cholesterol and heart problems.