If you’re over 45 there’s a good chance that you are taking or have at least been offered a statin drug to lower your cholesterol and so cut your risk of heart disease but is it good idea? Your doctor obviously thinks it is, but there is another side to the statin story. The link between cholesterol and heart disease is not as strong or as simple as the familiar statin story suggests.
For instance, the UK is quite high in the international heart attack league table but on a table ranking countries average cholesterol level, it’s quite far down. If high cholesterol equalled high heart attack risk, the two should match. What’s more the number of people in the UK with high cholesterol has been falling for several decades but during that time the rate of heart attacks has been flatlining. Likewise you’d expect the two to come down together.
And there are more examples where the population-wide figures don’t match the theory. One big study found that the average cholesterol level of over 100,000 people admitted to hospital in the States with a heart attack was actually lower than the level in the general population.
High risk but low cholesterol
Or this one: your social class is one of the best predictors of your risk of a heart attack – if you’re a fairly well off ABC1 it’s much lower than if you’re a poorer C2, D or E. There are all sorts of reasons for this – diet, access to information etc – but if cholesterol was a key factor you’d expect the As to have low levels and C2s to be high. Actually it is the other way around.
These are just a few of the points made in a very watchable new video called $tatin Nation which combines interviews with a number of cholesterol sceptical doctors and researchers with clips and strong graphics. By the end, at the very least, you are going to have a lot more questions to ask your doctor.
The video come at a time when the debate over statins is hotting up. In the last couple of years several large trials have concluded that if you are healthy, but just have some risk factors – being over 55 is one – then statin benefits are vanishingly small.
Give them to everyone
But in the last few weeks, two more big studies have come out claiming that statins are safe and well-worth taking whatever your cholesterol level. Their message is that giving them to everyone over 55 would greatly cut premature heart disease deaths saving the NHS billions.
So what to do? The case for statins is available on every official website about heart disease while sceptical case is spread across dozens of sites. $tatin Nation saves you an impossible hunt by summarising the sceptical case in one place. It’s worth finding out what it is.
Here are a few more pointers from the video. You might ask: how come lots of reports say statins cut the risk of heart disease by 30%, 40% even 50%. How can that be bad? The short answer is clever marketing and a nifty way with statistics. Here’s how it works.
A couple of years ago a statin trial called Jupiter came out with a remarkable result: statins cut the chance of a heart attack by 54%. To understand why that is not exactly a lie but is astoundingly misleading, you have to look deeper into the results than the drug company’s own summary – the one used by nearly all the newspaper and media reports – which is where the 54% figure came from.
What you are interested in is the difference between those getting the drug and those getting a placebo. This shows that 0.35% of those taking statins had a heart attack compared with 0.7 of those on a placebo. In other words, out of 1000 people who had no treatment. 7 had a heart attack.
There were certainly fewer heart attacks in the statin group – only 3.5 people out of 1000 had one. Now that is a 54% improvement, so no lies are being told, but it means that a thousand people have to take statins for just three to avoid a heart attack. Taking statins does seem less appealing doesn’t it?
And then there are the side-effects such as diabetes which showed up as a risk in the Jupiter trial. The figures aren’t precise but there could be one extra case of diabetes for every 200 people on the drug. That’s not far off the number who can expect to benefit
But diabetes isn’t the only possibly side effect. There is a frightening section in the film where patients describe the range of nasty effects linked with statins – muscle pain is by far the most common, other include fatigue, memory loss and brain fog. A common theme is how uninterested and unhelpful doctors are when told about them.
Several of the experts estimate that between 10% and 20% of patients suffer some sort of side-effect. That’s 100 to 200 people having unpleasant or possibly disabling symptoms for every three people who avoid a heart attack.
There’s lots more in $tatin Nation, such as clear links between stress, loneliness and heart disease that has been largely side-lined by the heavy concentration on cholesterol lowering. And then there is CoQ10, an enzyme and anti-oxidant called CoQ10 that’s vital for energy production in both the muscles and in the heart. As well as cutting cholesterol production, statins also cut CoQ10 production.