QUESTION TRIALS

“What about statin use and dementia risk? Dozens of studies involving a total of more than seven million patients found that statin use was linked to lower risks of dementia, like Alzheimer's disease. This could be because of the role cholesterol plays in the development of Alzheimer's, as I've explored before, but it could also be due to things like healthy user bias, where people who diligently take statins may also engage in other health promoting behaviors, and it's those behaviors that reduce the risk rather than the drugs themselves.”

“We actually just lost Doctor. Endo, who discovered the first statin. Microbes are constantly at war with each other. We look to fungus, like penicillin for compounds that kill bacteria, and we look to bacteria to find antifungal drugs. Since some microbes rely on cholesterol like sterols, he was hoping to find some other microbe that produced an anti sterol production compound, and after years looking at approximately 6,000 different microbes, in 1972 he came across this one, a blue green mold that produced something that worked. If he had given up after 5,000 attempts, then millions more people may have died prematurely in the ensuing decades.”

“And when you do that, between a third and a half of patients consistently report muscle pain on statins, but not placebo. So yes, a lot of people who think statins are causing their muscle pains are actually mistaken, but at the same time a lot of people really are suffering because of these drugs. The European Atherosclerosis Society estimates the overall risk of developing statin related muscle symptoms to be anywhere from one in fourteen who go on statins to nearly one in three.”

“Such randomized controlled trials may seriously underestimate adverse effects like muscle pain, since industry sponsored trials include these run-in periods before the study even starts to exclude people who can't tolerate the drugs. So no wonder they see such low rates in the actual trials, where all those folks who suffered never made it into the trials in the first place. Furthermore, the majority of clinical trials don't systematically ask if people are experiencing side effects since the trials are often run by the company that makes them, so there's an incentive to don't ask, don't tell.”

“Most trials also don't systematically ask about other potential adverse effects like fatigue, even though fatigue is among the most commonly reported problems by patients on statins. In a non industry funded trial on the effects of statins versus placebos on energy and fatigue with exertion, effectively four out of ten treated women cited worsening in either energy levels or exertional fatigue.”

“In the Lyon Diet Heart Study, heart attack survivors were randomized to advice to eat a more Mediterranean style diet rich in plant based omega threes or to just continue to eat whatever their doctors told them to eat. And the dietary advice group ate more bread, more fruit, less ham and sausage and other meat, less butter and cream, and though they didn't significantly change their fish consumption, they did eat more of a provided butterless spread enriched with plant based omega-3s, like the kind found in flaxseeds and walnuts. And check out those survival curves. Over the next five years, only about five percent of people in the diet group suffered a fatal or non fatal heart attack, compared to more than twenty percent in the control group.”

“If you are going to start a statin, which one's best? There are seven on the market, lowering LDL levels from about 20 to 60%, based on brand and dose. In terms of comparative effectiveness and safety for primary prevention, atorvastatin and rosuvastatin were most effective in reducing cardiovascular disease events, while atorvastatin appeared to have the best safety profile. No wonder atorvastatin became the best selling drug of all time, raking in more than a $100,000,000,000 as Lipitor before it went off patent in 2011.”