Statins

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Statins are cholesterol-reducing drugs. The widespread opinion is that statins are among the most successful drugs ever developed, and that they have prevented millions of strokes and heart attacks. This opinion is debatable.

THE STATIN CONTROVERSY

Very few reliable, non-controversial statements about statins can be made, so the least biased way of presenting here the current state of knowledge about statins, is presenting opposing information in an adversarial way; here are some representative examples of the published information on statins:

Two encouraging quotations from a reputable source Bandolier[1] related to the Oxford University (UK):

"Statins are undeniably good at altering lipid profiles and reducing morbidity and mortality associated with unfavorable lipid levels“. „Statins bring many other beneficial effects: anti-inflammatory effects, antioxidant effects, anti-thrombotic effects" (that is they prevent dangerous bursting of plaques in veins).

- a summary of another article[2]

Statins do much more than helping protecting against cholesterol-plaque build-up in arteries and from heart attacks: they reduce inflamation in veins, reduce fracture risk in osteoporosis, slow down progression of Alzheimer's disease and congestive heart failure, and may help acceptance of transplanted organs, and produce anti-inflammatory effects, antioxidant effects and antithrombotic effects.

- and from yet another reliable article[3]:

Statins slightly improve functioning of kidneys and slows down deterioration of kidneys caused by aging.


Now the opposing opinions:

Researchers have found [4] that statins did lower the risk of heart disease, saving 271 people for every 10,000 treated. In other words, for each person whom statins saved from a heart disease, 33 men or 37 women are treated without any beneficial effect, but with large expenses and a comparably-small risk of severe damages in other areas of the body: 74 develop liver dysfunction, 23 develop kidney renal failure (catastrophic), 307 develop cataracts, 39 a muscle disease, some rhabdomyolysis, a catastrophic decomposition of muscles, followed by kidney failure.

In another study (the WOSCOPS trial) 1.6% of previously healthy people had a heart attack within five years if they were not using statins, and 1.2% if they were using statins - less than one half of one percentage point of credit for statins. In another study (the CARE trial) 5.7% of people who had had a previous heart attack, had another attack within five years if they were not using statins, and 4.6% if they were using statins - about one percentage point of credit for statins.


- and a short quotation from another article [5]:

"Claims of unintended benefits of statins appear to be largely unsubstantiated and known risks -- including liver and renal problems and myopathy -- confirmed, British researchers concluded based on findings from a large prospective open cohort study"

The paragraphs presented above are just typical examples of opinions expressed in thousands of articles published on the subject of statins.

THE CAUSES OF THE CONTROVERSY

The use of statins is highly controversial, which has roots in the controversy about atherosclerosis and about cholesterol whom statins supposedly supress. It is true that atherosclerosis is a real medical problem, and it is also true that the imperative to use statins was unjustifiably imposed on US government, on American doctors and on American public, without prior scientific proof (see article Cholesterol).

The second cause of the great controversy about statins is the enormous amount of money involved in statins. The price of some statins, one-month supply, is more than 500 dollars; multiplied by millions of user, the profits are likely to be monumental. Pharmaceutical companies are commonly accused of greed, but they rebuke that accusation, blaming the excessive government regulations that impose on them such procedures, that it takes average twenty years from developing a new drug to the final approval by the US Government. That is true, but in Canada the regulations are about the same, yet the before-the-insurance prices of drugs are only a half of the American ones. Therefore consumer organizations blame the powerful pharmaceutical lobbying in USA, so powerful that both American insurance companies and the Government, accept prices twice higher than those in Canada. So who deserves the blame? The greedy manufacturers, the regulations, the lobbying, the lenient health-insurance organizations, or the US Government organizations and the lawmakers? Deservedly, “All the above.

The third source of the confusion is the corrupting link between pharmaceutical manufacturers and universities and other research organizations. At most of American universities, research is funded predominantly by grants. This often presents university professors a difficult choice: to produce honest research data, and risk severing connection with the grantor, or “stretch” the data and continue with the research grants. That is especially evident in the case of statin research, e.g. five large studies have been conducted on comparison of health benefits of statins vs. their cost. Each of those studies “scientifically proved” that their sponsor’s product was the most health/cost effective. That is clearly a moral prostitution with grave effects on health and well-being of people who trust university professors.

Scientists can disagree about theories and their interpretations, but not about facts. If they do, something is wrong. Overall, this situation is disgraceful, deplorable and unacceptable. In view of the link of the academy to the huge money of the industry, this situation reflects the degree of corruption of a large part of medical research. It must not be overlooked that in this money-and-career game, the health and the even lives of millions of people are disregarded and/or harmed.

A POSSIBLE RESOLUTION OF THE STATIN CONTROVERSY

The controversy is so strong, it has been lasting for so long time, and the question is so important, that Consumer Reports, a non-profit organization whose objectivity has never been questioned, has stepped in and issued their report[6], which provides a balanced and cautious, yet encouraging guidance: who should use statins, what kind of statins, and how much that will cost. That paper consists of several forms of the report, ranging from a full report, down to a simplistic summary.

Neutral advice: People who decide to use statins, should ask their Doctors to periodically check the kidney functions all the time the statins are used, plus up to three years after statin use discontinued, since that is how long statins’ side effects on kidneys last.

References

  1. Non-lipid effects of statins
  2. Non-lipid effects of statins, Aylin Yildirir; Haldun Muderrisoglu, Volume 2, Number 4, October 2004 , pp. 309-318(10)
  3. Chronic kidney disease (CKD) Management and General Practice, The Royal Australian College of General Practitioners), April 13, 2012
  4. Statin drugs cause liver damage, kidney failure and cataracts, says British Medical Journal, (BMJ), November 07, 2010 by: David Gutierrez, Naturalnews.com
  5. Medpagetoday.com Noncardiac benefits of statins found lacking, By Kristina Fiore, Staff Writer, MedPage Today, Published: May 21, 2010 Reviewed by Dori F. Zaleznik, MD; Associate Clinical Professor of Medicine, Harvard Medical School, Boston and Dorothy Caputo, MA, RN, BC-ADM, CDE, Nurse Planner
  6. Evaluating statin drugs to treat: high cholesterol and heart disease, comparing effectiveness, safety and price. Consumer Reports on statins
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