Dangers Associated With Cholesterol Drugs

[taper]

Justin

I am no expert in this area, but a quick Google suggests that rather than dealing in "fact" you are picking facts to support your arguments.

I found an abstract looking at Jupiter (here http://www.medscape.com/viewarticle/712266) which summarised as follows:

"Rosuvastatin lowered CRP (37%), LDL (50%), nonfatal myocardial infarction (55%), nonfatal stroke (48%), hospitalization and revascularization (47%), all-cause mortality (20%), and benefited women and minority subgroups. Rosuvastatin was tolerated relatively well, with a small rise in physician-reported diabetes. Jupiter data suggest that patients with high levels of CRP should receive statins. Approximately 4.3% of the population satisfies Jupiter inclusion criteria. A review of the assessment of cardiovascular risk is under way at the National Institutes of Health to guide practitioners."

So benefits, with some slight impact on diabetes.

[Ladymuck]

???? Wrote:

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> 100

*waves fist at ???? and hmmmmphs"*

[taper]

100 is too many. I have Googled my last tedious abstract on statin use. The" Lipid Hypothesis" is dead to me. Anyone been to Prestatyn?

[JustinSmith]

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

[Peckhamgatecrasher]

Look you, boyo, don't be going there, it's got a giant helmet.

[Huguenot]

"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." Point earlier about booze. You didn't even have to toss with percentages.

Justin. Mate. If you have a valid point go to the authorities. If they're not listening it's probably because they think you're an idiot, not because there's a conspiracy. Masturbating your references on EDF does not a track record make.

If you go peddling snake oil and seraphim, you need to think very very closely. People will die because you're being self-indulgent. We don't need to spend our days listening to engineering kooks inviting people to attend a self-help course.

I'm not part of the establishment. No-one pays me. You do get paid. Your book, your seminars. I really, genuinely think you have very cynical motivations. You undermine doctors to get dollars in your wallet.

Like any quack, you've started to believe your own hype. Your card is marked, not because I'm a weirdo, but because you are. Your activities reflect a long history of come from a history of carpet-bagging.

(Even if you're right, I'll think badly of you, because this is not the forum for your observations). Clever men talk to clever men. They don't hypothecate on forums, they test and refine. Not you.

Lookim, I ashore you his hat is trendy. Gwillum don't mean no harm.

['bout now]

I "heart" Huguenot

[Ladymuck]

Huguenot Wrote:

> ...I really, genuinely think you're a twisted freak.

*drops face into hands*

Oh Huguenot...that is harsh...even by your standards.

[HAL9000]

There are many witty, intelligent and honourable ways to counter an opponent's argument - an unprovoked Ad Hominem attack is not one of them. It diminishes the attacker, the forum and its members. Shame on those who condone this type of behaviour.

[SeanMacGabhann]

Shame on me then. Sometimes people need telling

shame on those who give shelter to those who prey on the weak, the vulnerable and the gullible I say

[Ladymuck]

HAL9000 Wrote:

-------------------------------------------------------

> There are many witty, intelligent and honourable

> ways to counter an opponent's argument - an

> unprovoked Ad Hominem attack is not one of them.

> It diminishes the attacker, the forum and its

> members. Shame on those who condone this type of

> behaviour.

Wise words as ever HAL9000.

Huguenot, even you, being the intelligent person that you (usually) are, must concede that you have overstepped the mark with that comment. I'm sure you just got "carried away", but I cannot help but feel that some sort of apology to JustinSmith is in order.

JustinSmith, you are new to this Forum...what must you think? No...don't say anything...I think I know the answer.

[HAL9000]

SeanMacGabhann Wrote:

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> Shame on me then. Sometimes people need telling

So, it's official: unprovoked Ad Hominem attacks are acceptable behaviour on this forum?

> shame on those who give shelter to those who prey

> on the weak, the vulnerable and the gullible I say

In that case, perhaps the moderators should have been more attentive when this post first appeared in the Lounge.

[Administrator]

HAL9000 Wrote:

-------------------------------------------------------

> So, it's official: unprovoked Ad Hominem attacks

> are acceptable behaviour on this forum?

No it is not official.

[HAL9000]

Administrator Wrote:

-------------------------------------------------------

> HAL9000 Wrote:

> --------------------------------------------------

> > So, it's official: unprovoked Ad Hominem

> attacks are acceptable behaviour on this forum?

>

> No it is not official.

So, it's not official. We just turn a blind eye because ...... ?

[Mick Mac]

Huguenot - You may have valid concerns but I think you have played your part in giving this guy the oxygen of publicity with you many posts on this thread.

I also take exception to your earlier comment that Justin was dealing with schoolchildren on this thread - the obvious implication being that you are so much more intelligent that everyone else who has posted.

Once again a thread has become a bit nasty - Too many people are passive aggresive - surely we can accept that we can have a good debate/argument without there having to be a "winner".

It does not have to be a fight to the death every time. Surely.

[Ladymuck]

Mick Mac Wrote:

-------------------------------------------------------

>surely we can

> accept that we can have a good debate/argument

> without there having to be a "winner".

>

> It does not have to be a fight to the death every

> time. Surely.

One would have thought so Mick Mac...one would have thought so...

*exhausted weary sigh*

[taper]

Justin

Not a game. I'm just keen to see whether there's anything in what you say, for personal reasons, but also because we get a lot of support for quackery on here (eg in relation to homepathy, chiropracters, ear candlers, water diviners) which I think gives people wrong and sometimes dangerous advice.

For what they're worth (not much: I am not qualified in this area) my conclusions are: a) the link between cholestrol and heart disease is pretty well established and the "cholestrol myth" has been rebutted; b) statins are effective in reducing the risks of cholestrol and the risk of heart attack, particualrly for high risk cases; c) they aren't though the panacea some have an interest in saying they are and I would guess there is a lot of over prescription; d) there is some evidence of a marginal impact on diabetes, so see this review called for more reserach - http://www.nlm.nih.gov/medlineplus/news/fullstory_91024.html -

which concludes, as I do, that "the benefits of statins on heart disease "by far outweigh any detrimental effects on ... diabetes risk."

[JustinSmith]

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

[DaveR]

JustinSmith, why are you here? Or rather, why are you still here? I don't believe in censorship, you can say what you want, but I reckon any reader of this forum who is going to be persuade by your hypothesis has been by now, and it seems a strange place to pursue your single-issue fanaticism.

Alternatively, can I recommend this lively thread for your perusal/participation:

criminalisation of islam4UK

[JustinSmith]

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

[ruffers]

JustinSmith Wrote:

-------------------------------------------------------

> 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

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?

[taper]

"ill-found idea that cholesterol causes heart disease because this false idea is actually harming people significantly."

In the unlikely case that anyone is interested in reading a good and balanced rebuttal of "cholestrol sceptics" (who'd have thunk there was such an active crowd), I'd recommend an article I found by Harriet Hall (see here - http://www.sciencebasedmedicine.org/?p=219.) on the issue (also here, which takes on the Queen Bee of cholestrol scepticism, Uffe Ravnskov, and provides a good survey of the evidence - http://www.sciencebasedmedicine.org/?p=22).

Harriet has her own blog (http://www.skepdoc.info/) and writes for Quackwatch, which I've referenced before.

Digest of her views:

"agreed that cholesterol does not ?cause? heart disease, that low-fat and low-cholesterol diets have been promoted way beyond the evidence and that statins are being over-prescribed. The public has a lot of misconceptions, but thoughtful science-based doctors agree that the evidence shows:

? High blood levels of LDL cholesterol are a significant risk factor for cardiovascular disease.

? For primary prevention, lowering high LDL levels in high risk patients is associated with lower morbidity.

? For secondary prevention, lowering high LDL levels is associated with lower mortality.

? Low fat diet is only likely to lower LDL levels slightly (3-6% by one estimate).

? 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."

That sounds sensible to me.

[JustinSmith]

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

[Huguenot]

Okay, I've toned it down somewhat.

The ad hominen charge is somewhat disingenuous I feel - it's Justin here who is perpetrating an act of some cynicism in order to attract adherents to his self-help groups, purchases of his books and cash to his wallet.

I'm not attacking his arguments about cholesterol, I never was. I made perfectly clear that I knew next to nothing about the debate.

The issue is a quack peddling snake oil masquerading under a veneer of gobbledegook to prey on the weak and the gullible.

The entire argument is ad hominem.

If Justin had not peddled his book and invited people to join a special group as part of his opening post this never would have happened. However, he did. And not by accident, but because he wanted to make money out of ED citizens by creating a state of paranoia and disaffection with conventional medecine.

Regarding the kids in the playground Mick Mac, I consider myself one of the children in this metaphor. It has nothing to do with intelligence, but everything about someone pumping themselves up for a fight (in this case about statins), taking it out on people ill-prepared to defend themselves, and then declaring themselves some sort of winner.

Rubbish. If Justin wants to win, I suggest he takes up his fight with someone in the industry, equally armed with quotes and references.

He won't though, because he doesn't want the fight, he wants the money from the pockets of the susceptible.

[Huguenot]

PS Justin, it doesn't surprise me one iota that you're pleased "to get back on the facts", because you know full well that you've boned up for years to win this false argument and sell your services.

You have a collection of ill-founded facts that you peddle knowing full well that no-one on the forum is equipped to respond.

If you want to get back on the facts, I suggest you speak directly with Harriet Hall.