Statins from the Editor of JAMA Internal Medicine
I am going to let you all comment on this. Didn’t they once recommend statins basically be put in the water supply? Even better, the quality metrics sham demanded that you put your patients with high cholesterol on statins so you can look better, get better grades, and be paid a bonus.
Who is Rita Redberg?
She is NOT a nobody, that’s for sure. Her tweets may be her own but this “statin” tweet goes against the grain. I would predict that she is in trouble for saying this and that she will have to retract it. After COVID, doctors are now on a short leash. That’s the world we live in now.
What are your thoughts?
I flirted with research medicine but found that after 1980 and Reagan, the drug companies co-opted research. Monoclonals are all the rage. Big Pharma buys publications showing their benefits. Medicine is now blind.
12 years ago I started doing calcium scores, essentially the first person in the area to order them regularly. I had two people who had high scores and I sent them to cardiologists for the next steps. Both of them these two cardiologists called me an idiot for ordering the calcium score. They were feeling the pressure on their stress tests which were a very large portion of their income. Very clearly I was right and it has shown to be an extremely good crystal ball for telling the future. Don’t treat numbers, treat patients. If there is anatomic confirmed atherosclerosis then the statins are indicated. Stress tests do a very poor job of telling the future. One of the two men who called me an idiot four weeks ago died of sudden cardiac death. I find that tragic. That is the thing that drives me: every marathon has a death from a heart attack. We need to predict who those people are. They eat well, obviously exercise like crazy, and are running away from their family history and they just can’t. I do use statins liberally in diabetics and those with confirmed atherosclerosis. I have patients with very high cholesterol who do not warrant therapy because they have no plaque. And I have patients with low cholesterol who need statins because they have a lot of plaque. My mother is one of those people. She couldn’t tolerate the Statin, she tolerated her bypass surgery. Now she’s on repatha.