Stay away from statins

Cholesterol-lowering drugs are the top-selling drugs in the U.S., with $27.4 billion in sales projected for this year. In 2005, 29.7 million people were taking statins, the best-selling form of the drugs.

Because the National Cholesterol Education Committee has set the “desirable” level of total cholesterol to less than 200, high cholesterol can be diagnosed as a “disease” in half the population. (Most members of the Committee, by the way, have financial ties to the cholesterol-lowering drug manufacturers.) This is a dream come true for Henry Gadsen, a former chief executive of Merck. He told Fortune magazine that it had long been his dream to make drugs for healthy people so that Merck would be able to “sell to everyone.” Now they've done it: healthy people have been turned into patients.

Advertising hype to the contrary, the benefits of these drugs are minimal at best. For example, a 3-1/3-year study of Lipitor sponsored by its manufacturer revealed that only one person out of 100 appeared to have benefited from the drug, which means that in order for one person to benefit, 100 people had to take the drug. But in their advertisements, Pfizer casts this meager result in a more attention-getting light: “Lipitor reduces the risk of heart attack by 36%...in patients with multiple risk factors for heart disease.” In smaller type, the ad says, “That means in a large clinical study, 3% of patients taking a sugar pill or placebo had a heart attack compared to 2% of patients taking Lipitor.”  This, of course, translates to a number needed to treat of 100 in order for one to benefit. Actually, the number needed to treat is probably higher, since those chosen for the trial were carefully selected people, such as those who smoke. (Compare this to the standard antibiotic therapy to eradicate ulcer-causing H. pylori stomach bacteria: of 11 people given the antiobiotic, 10 will be cured.)

Studies have shown a small reduction in heart attacks for middle-aged men, but even for them, there was no overall reduction in total deaths. For those few who seem to benefit from statins, the reduction of heart attacks is unrelated to cholesterol levels (people with low cholesterol have just as many heart attacks as people with high cholesterol). Rather, the benefit is most likely tied to the reduction of arterial inflammation. 

Just keep me out of it. Though I’m an old lady with a cholesterol level of 258 (when last checked many years ago), I don’t take cholesterol-lowering medication (or any other, for that matter). I’m saving Medicare a few bucks and myself from being a sick person with muscle cramps.

Next week: questioning conventional "wisdom" about high blood pressure.

For an introduction to this blog, see I Just Say No; for a list of blog topics, click the Topics tab.