JustinSmith

Mick Mac Wrote: ------------------------------------------------------- > Is this really worth your while Justin? All this > writing in defence of your theory and for such a > small audience? You are absolutely right Mick Mac, thank you!

taper Wrote: ------------------------------------------------------- > > or here > > http://www.ctsu.ox.ac.uk/projects/ctt Taper, I think you should slow down, I said in my previous post ... "Remember that statin clinical trials cannot be used to claim a link between LDLs and cardiovascular disease because statins do all sorts of other things as well as lower cholesterol" The link you have provided is for a statin clinical trail. Drugs have all kinds of effects - thats obvious.

JustinSmith Wrote: ------------------------------------------------------- > 'bout now Wrote: > -------------------------------------------------- > ----- > > No comment on the three articles Taper supplied > > then Justin ? > > I'm getting there if you will give me 5 minutes! > Strewth its like being surrounded by a ring of > bullies in here!! And all of this just because I delicately said that people who disagree with your views on climate change should not be branded denialists - wow you really were offended by that were you not?

'bout now Wrote: ------------------------------------------------------- > No comment on the three articles Taper supplied > then Justin ? I'm getting there if you will give me 5 minutes! Strewth its like being surrounded by a ring of bullies in here!!

taper Wrote: ------------------------------------------------------- > > ?High blood levels of LDL cholesterol are a > significant risk factor for cardiovascular > disease? - There is simply no evidence for this" > > Here perhaps > > http://www.thelancet.com/journals/lancet/article/P > IIS0140-6736(07)61778-4/abstract > > "Total cholesterol was positively associated with > IHD mortality in both middle and old age" I asked you for evidence that higher LDLs correlate with heart disease - thats what we were discussing. The researchers for this study did not find a correlation between LDLs and heart disease. Look at your own text, you are confusing total cholesterol with LDLs. Now look back at the summary results and you will see no reference to LDLs - thats because they didnt find a correlation! It does not state in the summary if the participants in the study were taking statins - without this information its difficult to comment on total cholesterol.

taper Wrote: ------------------------------------------------------- > "The AHJ study disproves this idea" > > It does not! It doesn't set out to test the > hypothesis you're saying has been debunked. So it > can't be used to disprove it! The data is all > wonky. You simply cannot interpret the study in > this way. I'm a layman and I can see that. All the people in this study had heart disease, and they had a LOWER LDL level than the general population - its amazing how you refuse to see the most basic of facts!

Taper, Looking at the graph from the AHJ study....http://4.bp.blogspot.com/_B6Khn2glPMI/SyAfWKQV15I/AAAAAAAAADM/kfg8j2M-lyk/s1600-h/LDL_graph_1.jpg An LDL level of 40 (or 1 mmol/l) has the same risk as an LDL level of 170 (or 4.3 mmol/l). My point is that there is no linear trend in this data at all.

Taper, I didnt reply to your earlier post because there was nothing new in it. It only contains points that I have already discussed. You keep repeating that quote from the summary of the AHJ report but please do read the whole report instead of just the biased summary. You will see straight away that higher LDL levels follow a normal distribution and in fact the mean for this distribution is below the mean for the general population. The only possible conclusion is that higher LDLs do not correlate with heart disease. Please read the full study! Here is the graph..http://4.bp.blogspot.com/_B6Khn2glPMI/SyAfWKQV15I/AAAAAAAAADM/kfg8j2M-lyk/s1600-h/LDL_graph_1.jpg You can see from the graph of the data that the risk for heart disease generally decreases as the level of LDLs increases! As for the points you quoted from Harriet Hall. First of all her discussion is one-sided and biased heavily toward the use of statins. It is not me who is cheery-picking as you say. ?High blood levels of LDL cholesterol are a significant risk factor for cardiovascular disease? There is simply no evidence for this. The AHJ study disproves this idea. Please, if you can find any studies that show this correlation please do post them! Remember that statin clinical trials cannot be used to claim a link between LDLs and cardiovascular disease because statins do all sorts of other things as well as lower cholesterol ? we have to look at population based studies. Also, LDLs are not even cholesterol!!!! LDLs are a bundle of fats, protein, cholesterol, and vitamins. LDLs transport nutrients to the cells where the nutrients are needed. Any lowering of LDLs automatically lowers the availability of vitamins! We dont even know how much cholesterol a LDL molecule will contain. The very idea that LDLs are bad is fundamentally flawed! ?For primary prevention, lowering high LDL levels in high risk patients is associated with lower morbidity? Well, yes, the use of statins is associated with slightly lower levels of CVD but as I said before, it is all-cause mortality that we have to look at in statin trials. Whats the point in reducing the risk for heart disease if at the same time the statin increases the risk for something else? Most primary prevention trials have shown that statins do not actually reduce deaths from all causes. The first primary prevention trial to show a reduction in all-cause mortality was the WOSCOPS trial and it is questionable if this trial accurately represents the general public because 80% of the people in the trial were smokers or ex-smokers ? and smoking of course greatly increases the risk for CVD. ?For secondary prevention, lowering high LDL levels is associated with lower mortality? I've already said that I agree that statins can produce some benefit in secondary prevention but I have also said that this benefit is much more likely to be due to the reduction in inflammation that is associated with statins. ?Low fat diet is only likely to lower LDL levels slightly (3-6% by one estimate)? Yes thats about right but actually, the longer-term, more recent dietary trials show that LDL levels are not affected by fat in the diet at all. ??Statins are effective in lowering risk when prescribed selectively for patients at high risk, although the NNT (number needed to treat for one person to benefit) is relatively high." Yes, but this is a vague and misleading statement. Stains are most certainly not being ?prescribed selectively? if the number of people taking them in the UK is already greater than 6 million and increasing. As I've said before, some high risk people can experience benefit (at least in the short-to-medium term but we dont know about the long-term) and by far, most of the people being prescribed statins are not at high risk. At least she points out that the NNT is high ? for example in WOSCOPS it was 111 people for 5 years.

Huguenot, You may have toned it down but you are still making irrelevent references to snake oil and such like. In order to be taken seriously I suggest that you adopt a more mature discussion. What you are indicating is that you would like me to go away and not provide people with the facts - you would rather let people continue to be misled by an over-enthusiastic pharmaceutical industry. No-one can deny the influence that big pharma has over the medical profession. Anyone who looks at the whole body of evidence will instantly realise that we are having the wool pulled over our eyes and that cholesterol does not cause heart disease. Pharmaceutical companies control what goes into medical journals to a large extent - they then issue a press release that exaggerates statin 'benefits' and plays down the adverse effects - then the media take this exaggerated press release and use it for a news story. This basic process can be seen time and again. As I said before, the problems within medicine have been discussed by several editors of medical journals. Shortly after trying to inform more people about these facts, most of these editors have lost their jobs or have 'moved-on'. The medical profession does not look favourably on any of its members that try to stand up and be counted. Do you think that I (just one small voice) can realistically change an industry that is worth hundreds of billions of dollars. Believe me, I will debate this issue with anyone!!! However, the only way that this terrible state of affairs can be changed is by more people becoming aware of the facts. Our government, the regulatory bodies and much of the medical profession as a whole are failing us on this particular issue. For some reason you do not want people to know about this. You have already stated in a previous post that the only reason you are hounding me down in this thread is because you did not like something I posted on a climate change thread. There is no "special self-help" group as you call it. You persist in perpetuating imaginary nonsense and this does not help those who would like to know the facts. You seem to forget also that the profit from any book sales is going to an Indian orphanage. I think that you should take a deep look at your personal goals and values and reflect on your automatic ill-found and unsubstantiated disregard for other people.

ruffers Wrote: ------------------------------------------------------- > Relating to the bit I've boldened Justin I have a > question. There seems to be a balance of sorts > between the increased risk of diabetes and > reduction in deaths, am I reading that right? > > I'd rather have diabetes than be dead so that > seems a positive, no? Well, to an extent I agree, if you only look at this aspect. However, this statement does not include the other significant issues that I have highlighted in other posts. For example, the unknown risks associated with cancer, the fact that life expectancy reduces in the elderly when cholesterol is low (a very clear correlation), the lack of long-term data on statin use, the fact that statins paradoxically make heart failure worse, the large numbers of people who become inactive because of statin-related muscle damage, etc... If statins really were as good as we are lead to believe we could accept some of the known and unknown risks, but as you admit, the benefits are so slight to begin with it raises questions about if there is in fact any net benefit. Even if it was just a simple balance of diabetes or death then the issue still remains that we surely could still do better than this given the billions of pounds investment in statins. Again, if we re-direct efforts surely we can reduce deaths more. My point is that the risks or benefits are not presented accurately to the general public - people should be told about the meagre risk reduction and the other risks so each person can decide if the medication is wort it. I do have to say that its refeshing to get back on the subject and your questions are good ones because they help to flush out the facts. Justin Smith

Taper, By the way, I am not suggesting that statins are useless for everyone. There is strong evidence for the use of statins in middle-aged men who already have cardiovascular disease. Statins may have a significant net benefit for this group of people because statins reduce inflammation and inflammation is the major component of heart disease. However, I have to state that I am certainly not trying to advice any individual person to take or not to take statins. I just want to present the facts (these facts are being distorted by an over-enthusiastic pharmaceutical industry) so people can decide for themselves. My point is that the majority of people who take statins do not have cardiovascular disease. Does it make sense to take a toxic medication to try and "prevent" a disease that you don't even know if you will get? My main point is that we need to get away from this ill-found idea that cholesterol causes heart disease because this false idea is actually harming people significantly. Justin Smith

Taper, I am sure that you will not have the same view if you look at the mountain of evidence against the cholesterol hypothesis. It is simply not possible for cholesterol to cause heart disease. I can not understand how you can come to the conclusion that the "benefit" of statins outweighs the risks. As I said before, studies have shown the increased risk for diabetes associated with statins to be the same magnitude as any reduction in deaths from all causes. The link you provided was related to a study that I have already discussed in a previous post. Again, when you look at the actual data, it is clear that statins do increase the risk for diabetes. And this is before we consider the large amount of evidence showing significant other serious adverse effects associated with statins. Now, even if we imagine for a second that statins do not have these serious adverse effects (and they most certainly do). The latest meta-analysis showed that the reduction in deaths from all causes is around 0.6% for most people. Surely we must be able to do better than this! Surely the hundreds of millions of pounds (total cost may be ?2 billion per year) that we spend on statins could be spent on something else that would reduce this risk by more than 0.6%. And remember that we have no idea if this 0.6% benefit is maintained over more than 6 years. We are being asked to take statins for several decades but pharmaceutical companies have not published any data to show the effect over the longer-term. The flawed focus on cholesterol-lowering is merely sustaining an industry and is preventing us from finding new ways to have a much bigger impact on cardiovascular death rates. I posted earlier the latest heart disease figures showing that cholesterol-lowering simply does not reduce the risk for heart disease. Justin Smith

taper, Again, you should look back at the previous posts! In an earlier post I discussed the issue of reporting relative percentages instead of absolute percentages. Those percentages you have copied are relative percentages and they grossly exaggerate the 'benefits' of the statin. For example, when the results of the JUPITER trial were published it was widely reported in the media that the statin used in this trial reduced the risk of serious cardiovascular events by 44%. However, this was a relative percentage reduction. In fact, 1.8% of the people in the placebo group suffered serious cardiovascular events compared with 0.9% in the statin group (see New England Journal of Medicine Editorial by Hlatky, 2008). So in fact the risk reduction was 0.9%, not 44%! The same is true for the other percentages that you have cut and paste into your post. All-cause mortality is quoted there as a relative percentage of 20%, but in fact the actual percentage reduction is 0.55%. Now, the increase in type 2 diabetes associated with the statin was 0.6%. So you can see that the facts I presented are accurate. A quick google search (as you admit to doing) does not substitute for a proper reading of the full study. The JUPITER study is free from the NEJM so I suggest you take the time to look at the actual data. This subject may seem like a game to you but I assure you it does not feel like that to the large numbers of people who have had their life ruined by taking statins that they did not need. Justin Smith

Taper, With respect, you should go back and read my previous post on statins and type 2 diabetes. This was a lengthy post on the subject. The study I mentioned there (the JUPITER trial) came after the study you quoted and found a significant increase in type 2 diabetes in the people who took the statin. In the JUPITER trial the increased risk for developing diabetes (associated with the statin) was around the same as the benefit in terms of all cause mortality. Another meta-analysis was done (again after the one you quoted) containing more recent data. This meta-analysis confirmed that statins increase the risk for type 2 diabetes. This increased risk is reduced if the WOSCOPS study is included in the analysis, but WOSCOPS was so different in characterists that it should not be included in the analysis. This was explained in an editorial in the New England Journal of Medicine. This is the most recent and up to date information on this issue. There are also other studies to show the link between statins and worsening control of blood glucose. As someone else said, its the balance of the argument that matters and thats what I am presenting to people.

I was discussing these issues with a physician colleague recently and his response was that doctors are prescribing on the back of inadequate information and its happened before with Thalidomide, Co-Proxamol, HRT, Vioxx and scores of other drugs withdrawn from the market each year despite having passed ?safety? tests as set by medical governing bodies. Huguenot, I believe that I have posted sufficient information and references on this thread for people to decide for themselves if we can just sit back and accept that everything is being taken care of for us. You openly admitted in a previous post that you have no interest in the subject of cholesterol or statins and that you are only posting on this thread because you didnt like something I posted on another thread. You dont like what I have to say, fine, but at least let people get to the facts for themselves.

No its not. The Medicines and Healthcare products Regulatory Agency (MHRA) is responsible for doing that. The MHRA recently conducted a safety review of statins but it only investigated relatively minor adverse effects of statins and failed to look into the serious issues associated with statins and type 2 diabetes, heart failure or cancer. We are now in the strange situation where a drug can be approved by the MHRA in the UK or the FDA in USA on the basis that the drug reduces a suggested risk factor for a disease ? even if this reduction in the 'risk factor' does not produce any real benefits to people. The National Institute for Health and Clinical Excellence (NICE) provides guidelines to GPs in the UK based on an assessment of the benefits, risks, and financial costs associated with a drug. So NICE is more concerned with money. When NICE did this assessment for statins, the costs associated with drug adverse effects were not included in the calculation. More worryingly, the calculation has been done on the basis of cardiovascular benefits alone, without addressing the issue of deaths from all causes ? these issues impact the cost-effectiveness of statins greatly but they decided not to include them.

I am aware that various authors have attempted to use the study as justification for lowering cholesterol even more. The study itself was financially supported by pharmaceutical companies that make statins. Having spent many years researching this subject I was not at all surprised by the attempts of some authors to put a spin on the data that would support further cholesterol lowering. The idea that so called 'bad' cholesterol needs to be lowered is built on an idea that people who have heart disease have higher levels of 'bad' cholesterol. The simple fact from the study is that people with heart disease do not have higher levels of 'bad' cholesterol. As I said, this study was financed by companies that make cholesterol-lowering statins. It is highly unlikely that they will write something in the conclusion that will bring into question the whole basis of identifying someone who needs a statin. Not to mention the fact that lower cholesterol correlates with a shorter life expectancy and the 12 studies I referenced in a previous post showing that lower cholesterol correlates with increased cancer mortality. It is extremely important to state here that there is no conspiracy in all of this, only fact. Many people will find it difficult to believe that things are scewed in favour of drugs within the medical literature. But it is not just me who is saying that these problems exist, it is the editors of the medical journals themselves. For example, you mention the BMJ..... Richard Smith worked for the British Medical Journal (BMJ) for 25 years and was Editor and Chief Executive of the BMJ Publishing Group from 1991 to 2004. During this time he became one of the most influential people within medicine. In his book (The Trouble with Medical Journals), which is published by The Royal Society of Medicine, he analyses the problems and current trends in medical publishing. The book provides a fascinating and highly readable account of the issues within medical research and the reporting of research within journals. The book is is highly recommended to anyone who wishes to gain an insight into the world of medical research and how it influences our daily lives. I was, frankly, shocked when I first read Richard Smith's book. Here is someone right at the core of medical research desperately trying to communicate the significant issues. After reading his book and other books written by editors of other medical journals, I was not at all surprised to find that the above mentioned study was being presented as evidence for cholesterol-lowering when it clearly does not support cholesterol lowering at all. As for my position on statins. My aim is to present the facts about the risks and benefits so that people can make an informed choice. At the moment these facts have been heavy distorted. As for my position on Cholesterol. There is no correlation between cholesterol levels and heart disease. Most people who have a heart attack have an average cholesterol level or a low cholesterol level. Furthermore cholesterol-lowering as a specific goal does nothing to reduce the risk for heart disease. For example, according to data published by the British Heart Foundation, between 1994 and 2006 the percentage of men aged 65 to 74 with ?high? cholesterol decreased from 87% to 54%. Despite this, the rate of coronary heart disease for this age group stayed about the same. Other age groups have experienced an increase in the rate of heart disease as the number of people with ?high? cholesterol has decreased. There are just so many examples like this that contradict the idea that higher cholesterol causes heart disease. Despite all this evidence, we the tax payer spend hundreds of millions of pounds every year on the specific goal of lowering peoples' cholesterol.

It is very encouraging to hear examples where an investigation is undertaken at an individual level. However, you might like to read about a study published in the American Heart Journal showing that LOW LDL levels are more likely to be associated with heart disease and not high LDL levels. The study included 136,905 people ? all of these people had their LDL level measured within 24 hours of arrival in hospital. We can immediately see that the majority of these people with existing heart disease had an LDL level below the suggested ideal level. The average LDL level for this group of people was 2.7 mmol/l. However, the average LDL level for the general population around the same time was 3.2 mmol/l ? LOWER levels of so called 'bad' cholesterol were much more likely to be associated with heart disease than higher levels. The idea that LDLs are 'bad' is propagated by the pharmaceutical companies. However if people with heart disease have lower LDL levels, this of course challenges the idea significantly. Unfortunately this study did not get into the media. If it did, more people would ask questions. http://www.29billion.com/2009/12/bad-cholesterol-is-now-good.html Not to mention the fact that LDLs are not even cholesterol!! They are lipoproteins that carry, yes some cholesterol, but also proteins. fats and vitamins. LDLs are an essential part of the transport mechanism used by the body to transport vitamins and nutrients to the cells of the body where they are needed. These simple facts are not talked about because there is so much money involved in statins.

JustinSmith Wrote: ------------------------------------------------------- > ???? Wrote: > -------------------------------------------------- > ----- > > What's your favourite place in SE22 by the way? Can you explain why you ask this question please?

???? Wrote: ------------------------------------------------------- > What's your favourite place in SE22 by the way? Why are you asking this?

???? Wrote: ------------------------------------------------------- > Justin this is all my own work, I'm capable of > free thought and putting some words > together...once again what are you on? It's hardly > a mega bit of english, I'm just saying what I > think and I suspect regular posters will recognise > it's pretty much in my own style??? > > Seriously, you really think I've been off to other > websites to cut and paste my responses to you?? > Really? I find that laughably odd...you are a > weird mixture of delusional and paranoid. If you actually read my post, I asked you to stop cut and pasting your favourite standard comments that do not apply" I did not say anything about you taking them from anywhere else. In the same way as your approach to other threads you are letting your imagination run wild. There is so much entertainment from you - its fantastic! :-)

Exactly HAL9000, thank you!

ruffers Wrote: ------------------------------------------------------- > The cut and paste nature of Justin's post above > and lack of reference to the points raised in the > intervening posts seems to bear this out > somewhat.. The post you are referring to is taken from my book. And you can see the references that it is based upon listed below the post. Regarding any intervening points, I have entered almost 30 replies to points raised and many of these posts that I have made have been of considerable length with many references and supporting documents.

???? Wrote: ------------------------------------------------------- > nor do I work for a Pharma or > the CIA etc etc - That you are are a conspiracy > loon is now confirmed in my mind. Anyone who > disagress or even questions is working for 'the > man'...conspiracy nuts the world over. Please stop cut and pasting your favourite standard comments that do not apply to anything I have said - it shows a distinct lack of imagination -lets be grown up and sensible here or are you afraid of a mature scientific conversation?

????, My book and seminar that you refer to relate as you know to a totally different subject and a different thread - I have already stated that any profit from that is going to be donated to charity. The fact that you mention that here can only mean that you are short on scientific debate.