Putting Statins in the Water
The thought leaders of this world now are recommending that basically everyone 40 and older should be considered for the drug therapy. Wow. I guess they want it in the water? Intuitively, though, does it makes sense that nature would have had men and women on a statin at age 40? It is not like the earth has mushrooms with statins in them everywhere. Could it possibly be that statins are just all we have to help people because most people won’t eat right and exercise? That is my guess. And it’s not like statins are amazing drugs. If you look at www.theNNT.com you will see the following:
Taking a statin for primary prevention (with prior heart disease) over five years
Benefits in NNT
- None were helped (life saved)
- 1 in 104 were helped (preventing heart attack)
- 1 in 154 were helped (preventing stroke)
Harms in NNH
- 1 in 100 were harmed (develop diabetes)
- 1 in 10 were harmed (muscle damage)
Does this sound that great to anyone? You also have to add to this that most patients’ diets get worse after taking statin (can’t find that study right now) as they figure they have some sort of protector on board. Or how about that a Mediterranean Diet may work better than a statin?
I am not some conspiracy dude or weird granola doctor but they still don’t have me convinced. What am I missing here?
I have been preaching against statins for years using these exact statistics. You do have a little typo in there. Primary prevention means WITHOUT prior heart disease. Basically, there is very little reason to lower someone’s circulating cholesterol levels when the only risk factor they present is high circulating cholesterol levels.
Er, ummmmmm. I hate to disagree with you guys but this shit works. Yeah, I agree it allows people to continue to eat crap and keep the lipids down and prevent disease but yes there can be side effects. I will argue the point about developing diabetes while on a statin. With the 1 in 100 number concerning diabetes, I’d bet it was an obese at risk person who was going to get it anyways. I disagree with throwing it around like those above maintain but in the light of one with established vascular disease, it’s a must. Now I do have a few diabetics with great glyco-hb, no bad habits, no evidence of any vascular disease and have a PERFECTLY normal lipid profile. I mean danged normal (and they don’t smoke) I absolutely refuse to force a statin on one of those folks in spite of what the ivory tower bastards contend.
This is one in a long (and growing) list of reasons why I no longer do primary care. I was required by training, core measures, guidelines, nervous patients, and the omnipresence of legal liability to prescribe something I would not myself take.
Hey, didn’t Merck get the real red yeast rice kicked out of the US market back in the Mevacor days?
Common guys, without statins that is 2 less visits a year, lots of labs, and the chance to plug and play numbers into ACC/AHA risk calculator (where the answer is always above 7.5%).
Next you’ll tell me there is no benefit of getting that blood pressure under 70/30, let alone under 120/80. Oh wait, yeah, we’re back the 1970’s goal of 140/90 again.
But wait, get all the A1C’s under 6….
PHQ-2 everybody so everybody gets an SSRI.
What we should be doing is a NMR scan of lipids. Particle counts and particle sizes for everybody, so we can all get a statin.
Doug and Perry, you are both sooooo right.
Now, where is my bottle of Pravastatin……
Personally, I think we’d all be better off with cannabis in the water.
You have to wonder if someone is being paid off by the drug companies. Why on earth, with those NNTs and NNHs would someone recommend this?