Tuesday, July 21, 2009

14. Statin Drugs: the Future

Clearly, high-dosage programs for statins have the same goal as Vytorin, to aggressively reduce LDL to levels below 70 mg/dl. My prediction is that they will also yield the same unwanted result -- alarming increases in the incidence of cancer, sepsis, heart failure, and birth defects. Under the influence of Big Pharma, medical doctors appear to be embracing these aggressive treatment plans with abandon. It will be in the end a very positive outcome if high-dose statins become the smoking gun that finally causes us to realize the absurdity of trying to play God to this degree. We need to step back and realize that we should stop demonizing cholesterol -- that it is an amazing biological substance with widespread roles in diverse mechanisms throughout the body, that we have only barely begun to understand.

In 1990, a group of researchers from 19 studies around the world met at a workshop in Bethesda, Md., and pooled their collective results into tables of the relationship between total cholesterol levels and all-cause mortality [9]. The tables were computed separately for men and women, and subjects were binned into four categories with dividing points at 160, 200, and 240 mg/dl.

Men in the two middle categories had equivalent optimal values, with mortality increasing sharply for the >240 range. However, mortality was even higher for the group whose cholesterol was abnormally low (below 160). For women, the results were even more dramatic in that the upper two bins (cholesterol > 200) had equally good and optimal mortality rates. All-cause mortality was higher for those whose cholesterol was between 160 and 200, and even higher for those whose cholesterol was below 160. So, for both men and women, below 160 mg/dL was the highest mortality group.

With those numbers in mind, it is interesting to take a look at the current situation with respect to heart patients. A comprehensive study involving 136,905 heart attack patients from 541 hospitals around the country was done recently to assess lipid levels in these patients (Heart Attacks and Cholesterol Levels) . It can be inferred from the numbers they quote that a substantial percentage of these patients are in the <160 bin with respect to total cholesterol. Half of the patients with a prior history of heart disease had LDL levels below 100 mg/dL, and 54% of all the patients had an HDL level below 40 mg/dL. 100 plus 40 is just 140, which, if augmented by 20 mg/dL in the "other" category would just hit the 160 mg/DL boundary needed to get out of the lowest and highest mortality bin. The article claimed that nearly 75% of the patients had met the current guidelines -- i.e., had cholesterol levels low enough to be considered good with respect to heart disease. The authors, funded by GlaxoSmithKline and Pfizer, two statin drug producers, argued that we need to further reduce the guidelines in order to encourage more people to take statin drugs.

Is there no end to this madness? Can it possibly be considered that cholesterol is not the cause of heart disease for these patients who still have heart disease despite having artificially achieved cholesterol levels not normally seen in nature? Big Pharma may succeed in reducing the incidence of heart disease in the population just by virtue of the fact that they kill off these people with sepsis and cancer and heart failure before they would have died of a heart attack if left untreated.

The following quote portends what is to come as high-dosage statins become a routine program for more and more people:

"In articles posted at MedicationSense.com in recent months, I discussed the findings of two major studies of maximum-dose 80-mg Lipitor (atorvastatin). Despite the authors' claims that these studies proved the benefit of maximum-dose Lipitor for preventing heart attacks and strokes, the MedicationSense.com articles revealed that maximum-dose Lipitor caused far more liver injuries than placebo or low-dose Lipitor. Even worse, despite a reduction in heart attacks and a slight reduction in strokes, there was no improvement in overall mortality because more subjects on maximum-dose Lipitor died of other causes including cancer." (High Dose Statins and Liver Damage/Cancer) .

When you become obsessed with getting your LDL numbers low, you're just trading off death by heart attack with death by cancer or infection or heart failure. At the same time, you're incurring additional expense, along with often annoying and in some cases devastating side effects associated with statin drugs. Doesn't this seem counterproductive?

While Americans seem to want to rely on a magic bullet to solve their medical problems, they would be much better off to focus on the things that take effort: stop smoking, start exercising, lose weight, eat healthy foods, get plenty of sleep, spend some time outside in the sun without sunscreen, and reduce the effect of stress through relaxation exercises. Achieving these goals is much more rewarding and beneficial than popping a pill. These are the true secrets to a long and healthy life.

No comments: