Category Archives: statins

Statins are NOT satan, indeed the contrary!


satan2statins2Ok, so I am not Tim Noakes, neither am I a professor of medicine – though I have listened over the past 20 years to many of them and do on an ongoing basis. They as a whole (generalisation) tend to speak from journals and science. Science these days has to be proven quite well.

There is honestly so much rubbish on the internet from the absolute hogwash about statins to the dribble about vaccines.

LEt’s talks science and let’s talk LIFE quality and quantity.

No I am not a professor but I aim to give my patients the absolute best I can.

What do we know? We know that the diabetes/cardiovascular (another way of saying heart attacks) epidemic is growing on a log curve (if that does not shock you look up what a log curve is). It is not stopping, on the contrary it is snowballing. Why?

Multi-factorial.

What do we know from science and trials like Jupiter – these are big (100 000s) patients across continents. The long and the short is that if your number – LDL is at target (2.8 mmol/l) you will NOT have a heart attack and you will NOT have a stroke.

Now think about this for a minute, would you rather have a heart attack/stroke or would you rather have a bit of muscle ache? Not so bad if the heart attack takes you – although bad for the family. But a trainsmash if you are “maimed” by it, especially when we KNOW it is preventable.

WE have so many statin trials that it is unethical to have one arm on a statin and one arm off a statin – that’s how strong the evidence is as we KNOW the non-statin arm will have “events”.(Secondary prevention).

I am also not a huge fan of big pharma and whilst various conspiracy theories exist in this regard. This is not a conspiracy. This is indeed science.

“Statin therapy is effective at reducing cardiovascular event rates among those with prior myocardial infraction, stroke, diabetes, or overt hyperlipidemia, and current guidelines strongly recommend lipid-lowering therapy among these patient groups as an adjunct to aggressive lifestyle interventions. However, of the nearly 1.7 million heart attacks and strokes that occur annually in the United States, more than half occur among apparently healthy men and women with average or low levels of cholesterol. Thus, novel screening and treatment strategies for cardiovascular prevention are needed that can detect high vascular risk in the absence of hyperlipidemia, that are inexpensive and simple to implement in the primary care setting, and that can provide comparable or superior effectiveness compared to currently accepted approaches”. This is the opening paragraph of Jupiter. What jupiter was trying to ascertain is whether primary prevention is worth doing.

The results ? “Finally, in terms of net clinical benefit, when a composite end point of a first cardiovascular event, venous thromboembolism, or death from any cause is considered, the 5-year NNT in JUPITER was 18.13“”Current guidelines for statin therapy emphasize the need to achieve specific LDLC goals to maximize benefit. However, statins reduce hsCRP in a largely LDLC independent manner, and in the CARE,10 PROVE IT – TIMI 22,9 A to Z,11 and REVERSAL21 trials, best clinical outcomes in terms of event reduction or atherosclerotic regression were observed among those who not only reduced LDLC, but who also reduced hsCRP. Specifically, in these studies, the lowest clinical event rates were consistently seen among those who not only achieved LDLC levels <70 mg/dL, but who also achieved hsCRP levels <2 mg/L. Although these findings are consistent with laboratory evidence indicating antiinflammatory properties of statin therapy as well as current pathophysiologic understanding that atherothrombosis is a disorder of inflammation as well as hyperlipidemia, the concept “dual targets” for statin therapy remains controversial.22

“JUPITER not only confirms that men and women with elevated hsCRP and low LDLC are at substantial vascular risk, it demonstrates that statin therapy can cut that risk by half. Simplified guidelines that advocate combined lifestyle and pharmacological therapy in those groups where trial evidence clearly supports a net benefit have the potential to greatly improve patient care and public health.”

I have specifically quoted Jupiter verbatim as I am so tired of unsubstantiated claims in this regard and I would urge all the statin haters to read the science and chat to the professori of our times. The professori at large.

Statins are not the devil indeed if you are a loved one they may be the saviour. The saviour in terms of preventing a death or a person that now has to be “cared” for. The saviour of our failing medical system that does not need the added burden of cost of multiple patients with stroke and heart attack. Look up how much the average cost to medical aid (or patient if not on one) a heart attack/stroke costs in money terms. Then think about that cost in emotional/psychological terms. Then just have a little think about the vast body of science for a longer while than it takes to read some pathetic unsubstantiated claim on the vast body of internet rubbish. The choice really is yours, the answers are there if you look for them properly.

Circulation: Cardiovascular Quality and Outcomes.2009; 2: 279-285doi: 10.1161/CIRCOUTCOMES.109.868299statinsstatins2

 

 

 

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