In the movie The Big Short a small number of fund managers “bet” against the mortgage market prior to the GFC. Rather than rely on brokers recommendations, rating agencies or government endorsement, they first hand viewed the properties and spoke to borrowers. This revealed a different reality to that believed by everyone else. History proved them right!
In medicine we have tended to believe industry-funded studies (broker recommendations) rating agencies (assorted health authorities and foundations) and government endorsement. Much like the “official” version of mortgage securities did not stand up to genuine scrutiny, what about claims of the benefits of medications.
The claims of benefits are, in the real world, often not what is promised.
What if someone went back to basics and examined what a medication does at the cellular level?
A new paper published in Expert review of Clinical Pharmacology has claimed that people taking statin medications to lower cholesterol are actually at an increased rather than decreased risk of coronary artery disease and heart attack. This is by the physiological effect in cells inhibiting the synthesis of vitamin K2, which has a role in preventing calcification. You can click here to read the original paper.
The lead author Professor Harumi Okuyama of Nagoya City University Japan said “We have collected a wealth of information on cholesterol and statins from many published papers and find overwhelming evidence that these drugs accelerate hardening of the arteries and can cause, or worsen, heart failure. I cannot find any evidence to support people taking statins and patients who are on them should stop.”
He added that manufacturers paid for many studies sowing benefits from statins and they are unreliable.
Lets be clear on the two things everyone agrees on. Taking statin medications will lower cholesterol levels and they can have side effects. But what happens next depends on your view on the role of cholesterol in heart disease and your view on the importance of side effects.
Nobody dies of raised cholesterol. It has been classed as a risk factor for heart disease and stroke. Yet people with high cholesterol may have no problems and many people with heart attacks have “normal” cholesterol. The original work by Ancel Keyes, which started the cholesterol story, has been rightly criticized for omitting data, which did not support his thesis that raised cholesterol was a risk factor for heart attack.
Yet history shows that the cholesterol story took hold and treatment with statins to lower cholesterol in the belief that it will lower rates of heart disease became accepted orthodoxy. The big problem with accepted orthodoxy is that those who question it are viewed as heretics. Their arguments are generally not countered. They are criticised for daring to raise questions. The most egregious example of this was the Catalyst program in 2013 questioning the use of statins.
Low cholesterol is not an end in itself. Increasingly evidence is showing that these medications are used in too many people who do not get any health benefit. Yes their blood tests show a different result but they do not feel any better, do not have a lesser likelihood of heart attack and most critically do not live more than three days longer!
So this latest paper as a stand-alone is interesting whilst not necessarily being the last word. However when you add it to previous work and data from the real world, it provides a cellular mechanism to explain the disconnect between what is promised (less heart disease) and the reality (no change).
Not surprisingly this paper has received little media coverage. It is heresy. Some have dared speak out. Quoted in the Sunday Express Dr Malcolm Kendrick, who has studied heart health and statins, said: “This study demolishes the argument that these drugs should be prescribed to anyone, as the harms clearly outweigh any previously suggested benefits.”
Dr Peter Langsjoen a cardiologist from Texas (a study co-author) said “Statins are being used so aggressively and in such large numbers of people that the adverse effects are now becoming obvious. These drugs should never have been approved for use. The long-term effects are devastating.”
Equally not surprisingly the British drug regulator said “the benefits of statins are well established and are considered to outweigh the risks and side effects in the majority of patients”. Straight from the party line.
So what are we to do? The answer is to ask a different question. Rather than ask if my cholesterol needs treating ask whether taking a statin will improve either my quality of life or life expectancy? Whilst there is no absolute answer to this question it will enable you to make a more informed decision as to whether these tablets are worth your taking.
This article was first published on www.drjoetoday.com