This week, the new guidelines on preventing heart disease were released by the American Heart Association and the American College of Cardiology. The media reported widely about this. Now, for most people, monitoring LDL-cholesterol and total cholesterol levels is not indicated. If your risk of developing cardiac disease is over 7.5% over a ten year period, then statins are recommended. The risk can be calculated by going to the American Heart Association website (www.heart.org) and plugging in your cholesterol and HDL-cholesterol numbers as well as your age and whether you smoke or not. Then a number is revealed.
It is hard for me to believe that this is where modern medicine is at. I guess nobody needs to see a health care professional anymore—just put your numbers in and if you have a 10-year heart attack risk of >7.5%,then you must take a statin for the rest of your life. I have one word for this nonsense: fugetaboutit.
The new guidelines are contained in an 85 page, mind-numbing document. It is a very difficult manuscript to read. I will take pieces of it and share my concerns with you. Let’s start with the recommendations that would put most adult Americans on statin drugs. On page 18, the report states, “Data has shown that statins used for primary prevention have substantial ASCVD (atherosclerotic cardiovascular disease) risk reduction benefits across the range of LDL–C levels of 70-189 mg/dL.” Of course, that is after the “experts” state that it is unclear of lowering LDL-cholesterol levels have any benefit. Nonetheless, the authors cite a meta-analysis by the Cholesterol Treatment Trialists’ (CTT) to support their conclusion. (1)
The CTT article was a meta-analysis of 27 randomized trials to ascertain whether reducing LDL-cholesterol levels with statin use reduces vascular events in people who are at a low risk for cardiac events. The authors of the article reported that reduction in LDL-cholesterol levels with a statin reduced the risk of major vascular events by 21%. However, this is a relative risk reduction. When deciding whether to prescribe a statin for a patient, the 21% relative risk reduction should not be used. Unfortunately, most (or nearly all) doctors have absolutely no understanding about statistics and what relative risk means.
What has more clinical meaning is the absolute risk reduction. “Absolute differences in risk are more clinically important than relative risk reductions in risk and deciding whether to recommend drug therapy.” (2) I and my trusty calculator went to work to figure out the relevant numbers. The absolute risk reduction in the CTT study was 0.77%. The authors should have reported, “The reduction in LDL-cholesterol levels with a statin reduced the risk of major vascular events by 0.77%.” According to the CTT numbers, 129 people would need to be treated with a statin for at least five years to prevent one vascular event. That means that 128 subjects took the statin without any benefit and they could have developed adverse effects. In other words, this study showed that statins failed 99.3% of those (128/129) who took them.
So, tell me, does this study make you want to take a statin to prevent a vascular event? If anything, it should make you think the opposite.
People do not get vascular events from a lack of a statin medication. Vascular events occur from a myriad of reasons including eating a poor diet, dehydration, as well as nutrient and hormonal imbalances. More information about statins can be found in my book, Drugs That Don’t Work and Natural Therapies That Do.
Don’t be scared about the media headlines. As you become more educated you will be more comfortable making your health care decisions.
(1) Lancet. 2012;380;581-90
(2) New Eng. J. of Med. Vol. 359. 2280-82. 2008
What do we do when cholesterol is too low?
Jen,
Sometimes, that is a difficult thing to treat. I usually recommend a higher fat/protein diet along with a liver cleanse, like Total Liver Care (TLC). TLC is a product that I designed. It can be found at my office http://www.centerforholisticmedicine.com.
DrB
Question: what about patients who are having T.I.A.s? should they be on statins?
My friend Al is 70, has had two TIAs and has been prescribed statins.
Robert
Thanks for reporting results of statins in absolute risk reduction numbers. This is what the public needs to here. I also did an in depth article regarding the disappointing guidelines promoting more statin use. There is a lot of conflicts of interests behind the scenes between the authors/peer reviewers of the new guidelines and the pharmaceutical companies – http://www.plantbasedpharmacist.com/2013/11/2013-ahaacc-cardiovascular-risk.html
Regards,
Dustin Rudolph, Pharm.D.
Hello, Dr. B. Every time I read one of your articles, I become More and More Glad that I do. Yeah, Yeah, Cholesterol.
In my personal history, I have never had a problem with “High Cholesterol”. About 15 or 20 years ago (I’m 75 now) My Cholesterol numbers were in the mid-range. I decided on my own to help that out. I began to consume whole-wheat cereal products – about 6 – 8 oz. per day ( I am not Gluten intolerant). That began a steady decrease in my HDL / LDL nos. Mine is now at the “Low End” of the range. Works for me !
Keep up the Great Work !
Bill in Idaho
The AHA risk calculator says I have a 10% risk over ten years. So I should be on a statin according to the new guidelines.
I subtracted 100 points from my HDL (“good”) cholesterol and reduced my total cholesterol accordingly. I left my LDL the same. Now my risk is 5% and I should not be on a statin.
So according to the AHA I have too much “good” cholesterol.
Madness!
The article I read stated that since the statin drugs have lost their patent protection (except for Zetia) that there’s no monetary motivation to push statin drugs. But it seems to me that with a lower profit margin there would be an increased motivation to prescribe statins. That’s what this study’s recommendations will do: double the number of people on these drugs. That’s a lot of money on the line.
Hi Dr B-
The internist I had been seeing up here just declined to care for me because I refused to take his recommendation to take a statin……..and I refused a flu shot. I am now seeking out a new physician who is better informed and more open minded to treating a patient who is able to think and choose for herself!! thank you for keeping us all informed on the truth about all of these toxic treatments.
ABC Australia broadcast a programme called Catalyst a couple of weeks ago on the cholesterol beat up. Amid howls of complaints from braindead doctors.
What fascinates me is that muscle weakness is a huge and very common side effect to taking their poison, and it is supposed to protect the heart, which is a huge muscle?
I agree
FUGETABOUTIT.
People’s Pharmacy have many reports in their Newsletters from subscribers on the multiple serious side effects of statin drugs. Those drugs block a critical pathway in the body. No wonder there are multiple side effects.
I have seen a couple of articles questioning if statins are at least partly responsible for the terrible increase of diabetes since this is appearing more and more frequently in statin drug users. Some say their blood sugar levels had been normal prior to taking these drugs.
There was also an article of protest in the Newsletter from a family doctor who is reluctant to prescribe statins for his patients. He might be subject to censure or possibly even suspension of his medical license if he doesn’t follow those quidelines.
I also read that some physicians quit the panel that came out with the new recommendations as a protest to what was being recommended. That has not been widely publicized. There was another article mentioning how many physicians who made this decision have strong ties to drug manufacturers.
Hi Doc,
I LOVE your book on Iodine/ Why you need it ~ Awesome!
About cholesterol… I was hoping you would bring up the
inflammation factor here on this blog as it is critical in the
production of cholesterol and why. If you have addressed
that in another area, I have missed it.
Thank you,
Paulette
Paulette,
Cholesterol has anti-inflammatory capabilities. Inflammation is not the underlying cause of any disease. Inflammation is associated with heart disease, but something is causing inflammation–poor food choices, dehydration, nutritional imbalances, etc.
You are right: inflammation promotes increases in the body’s production of cholesterol. The worst thing you can do when inflammation is present is to take a statin drug.
DrB