It’s time to stop mainlining anti-cholesterol drugs

By March 2, 2012Big Fat Lies

In Australia, statins (the class of drugs used to lower blood cholesterol) now chew up 13 per cent of the money paid out by the Pharmaceutical Benefits Scheme (PBS), and the amount shelled out for them by the Australian taxpayer (via the PBS) grew by a third in just the last year alone.

That’s a worry for taxpayers, but with one in three Australians over the age of 50 now taking them, a greater concern is that new research suggests statins significantly increase the risks of Type II Diabetes and dementia.

The United States Food and Drug Administration is worried enough about those little ‘side-effects’ to require that statins immediately carry warnings about diabetes and cognitive impairment.  But here in the land of nod, we’ve happily become the world’s biggest statin pill-poppers.

Don’t get me wrong.  Statins do work. The studies have shown that they do lower LDL cholesterol and they do reduce heart-disease in younger men who’ve already had a heart attack. But there’s a good deal of evidence to suggest that the benefits for these folks had nothing to do with the cholesterol-lowering and quite a lot to do with their blood-thinning properties.

Unfortunately (for drug marketers) ‘younger men who’ve already suffered a heart attack’ (and lived to tell the tale) is a very, very small market. The only way to turn a buck from statins was to convince doctors to prescribe it (and the PBS to fund it) for ‘prevention’ (among people whose only sign of illness is being diagnosed with a higher than ‘normal’ blood-cholesterol reading).

A comprehensive review published in 2007 of all of the major high-quality trials on statins concluded that for these not-sick people (who make up the overwhelming majority) taking statins did not alter the overall risk of dying at all.

The studies showed that we would need to treat 67 otherwise healthy people with statins for five years in order to prevent just one of them suffering a heart-disease event. This puts the drugs in the category of being almost completely ineffective. By way of comparison, we need to treat 11 people with antibiotics in order to completely cure 10 of them.

When the data were broken down by gender and age, the results became even less impressive. Statins delivered absolutely no benefit for women at all. And men aged over 69 (those most at risk of fatal heart attacks) enjoyed no benefits either. The only people the drug appeared to help were men aged 30–69, and then only by a very small absolute margin.

The reason for the disappointing results may be that statin drugs work by shutting down the enzyme we use to manufacture cholesterol.  Unfortunately we also use that same enzyme to manufacture one of our primary anti-oxidants, co-enzyme Q10. Shutting down cholesterol production also means shutting down Q10 production (and thereby impairing our ability to fight heart disease and other types of inflammation).

This might be why (although these drugs have a big effect on cholesterol levels) they have very limited effect on heart-disease outcomes. It might also be that although statins lower cholesterol, this has nothing to do with why they lower risks for people who’ve already had a heart attack. Just like aspirin, statins reduce clotting. And just like aspirin, the people who benefit the most from statins are those who’ve already suffered a heart attack. But no one will make a fortune selling aspirin at 97 cents a box.

However they are not merely harmless profiteering.  A series of studies has suggested relationships between statin usage and increased diabetes and cognitive impairment (dementia to you and me). And a significant independent analysis of the trials, conducted in 2011 by the ever reliable Cochrane Review, concluded that becasue of this doctors to be cautious in prescribing statins to people who hadn’t already had a heart attack.

Statins are powerful drugs that alter the function of important liver enzymes, and the evidence suggests that the only class of people who benefit are younger men who’ve already had a heart attack. The only people who should be given statins should be this very small group (and then only if their doctor feels the benefit outweighs the risk of diabetes and dementia).

The US regulators are ringing the alarm bells.  But here the Australian Heart Foundation is more concerned that not enough people are taking preventative medication.  The Australian Medical Association is much more cautious.  They say statins should only be prescribed to high risk patients.  Good advice, but clearly someone isn’t listening.  Heart disease rates are high but don’t come anywhere near needing to put a third of the over fifties on statins.

Meanwhile millions of Australians continue to take a drug they don’t need and which the evidence says significantly increases their chronic disease risks.  We need to stop slavishly following the drug marketing agenda.  The practise of mass (and accelerating) prescription of statins must stop immediately.

Note: Parts of this blog post were ‘borrowed’ from my new book Big Fat Lies.

Image courtesy of Paul / FreeDigitalPhotos.net

Join the discussion 19 Comments

  • tootired says:

    I’m asked when I donate blood whether I’m on any medications. After answering no ( female, 58), I ask is this common in my age group. Oh yeah, is the reply. No doubt statins the go.

  • Steven Shaw says:

    > Note: Parts of this blog post were ‘borrowed’ from my new book Big Fat Lies.

    Ah, I thought it sounded familiar. My wife just finished your new book and seemed to stop every 5 minutes to read some interesting tidbit out to me. Interesting stuff. All the best with your sales!

  • This is an on-going barney with our GP – I am a fit and healthy (and very bloody-minded) female (68), with no family or personal history of heart disease, lifelong non smoker,low/normal BP, active but slightly o’weight (less of a problem since I dropped sugar). My only ‘indicator’ is that I have somewhat elevated cholesterol.

    I have read a fascinating book called “Love your Disease” that suggests that those of us with distant (very distant) Northern European ancestry developed higher cholesterol levels to help our systems cope with lower sunlight levels and consequent lower Vit D.
    Apparently the evil cholesterol helps us to absorb what Vit D there is more effectively.

    Gae, in Callala Bay.

  • Hi David
    My mother inlaw is going sugar free for just this reason. I have a question about substituting glucose. I have been sugar free for about 6 weeks and am now making some of your cake recipes. I have removed a lot of sugar from my 8 yr olds diet but he still has some from other people outside my control. Instead of hiving him three different fructose snacks in his lunch I give him one glucose home made snack. Is this ok? What advise do you have on getting teenagers onboard? My family are blessed with fast matabilism so they don’t have weight as an incentive.

  • Andy – the snacks are fine. How about telling a teenager about the link between acne and fructose?

    Cheers
    David.

  • David,

    You might recall that several years ago on your blog you engaged in a debate with several prominent nutritionists, including the man in charge of “sugar for our troops”.

    I, along with several others, chimed in to support your position. I am therefore very happy that the scientific and popular debate is turning in your direction.

    A good example is the USA CBS 60mins 15m segment, plus supporting web collateral, aired this last weekend, at:

    http://www.cbsnews.com/video/watch/?id=7403942n&tag=contentBody;storyMediaBox

    I am willing to bet that Dr Rosemary is changing her story as we speak. Of course she will say, she always advocated fructose in moderation!

  • just finished reading Big Fat Lies (in one day) and what a read it was! Thank you David for the invaluable information written in language that a layman can understand. I have been avoiding margarine and most seed oils for years, but there was much I learned from this excellent book, particularly about the deadly combination of sugar and polyunsaturated fat. I am now convinced that my husband who is only 55 and a fit man should not have been put on statins 5 years ago. Deborah, Melbourne.

  • Julie says:

    Big Fat Lies made me cry by page 179 ‘…, our own liver.’ It is like it is a person and it is being abused without us knowing it. I have looked after mine and grateful that I have but it made me sad picturing all you were saying. Can you get 2 clear life size models showing all the body parts and show kids (those little trucks of fluffy LDL etc) what happens in one when the food eaten is good and the other when people take what hurts us. Let the kids see it so they can see how wonderful the body is and the stewardship they have of it.

  • Julie says:

    This comment has been removed by the author.

  • Julie says:

    Can you also expose the change in containers – how hard it is becoming to get things in glass (instead of plastic) and the dangers of the white coated tins. Also on A Current Affair abt 2yrs ago they had about the yoghurt containers being so thin that light got in and destroyed a percentage of the goodness. The containers that came on top was the thick Jalna ones. I have eaten sensibly all my life and I have reaped the benefits in every way. I have all your books. Thank you David so much.

  • John Doyle says:

    I haven’t yet read your books on sugar as poison except I have read “Big Fat Lies” which should be required reading for all the medical and nutritional professions and related associations. Someone should sue the Heart Foundation!. Plain evil, they are.
    My question is about substituting glucose for sugar.
    How does that count regarding addiction?
    What about Xylitol? Or a mix of the two?
    I notice my “sweet tooth” is happy with less sweet substitutes. Is that anything to do with a reduced sugar addiction.
    A lot of tinned food, like tuna has 1 or2% sugar. Does that interfere with sugar addiction?
    John Doyle

  • Tammas says:

    Have had a heart attack. Arteries at the back of the heart were shown to be blocked. Stents inserted. Cholestoral only slightly elevated.Cholestoral immediately blamed and was put on statins. However my uncle had by-pass surgery done on his heart because his arteries were blocked not with cholesteral but CALCIUM.As far as I know blood samples were the only tests done on me, it just seems too convenient to blame cholesteral in every case.

  • Margaret says:

    I heard too much about statins but I really don’t know who is telling t he truth right now. I also read in one article that if you’re in statin drugs you really need coq10. Here’s the article I’m talking about – http://articles.mercola.com/sites/articles/archive/2010/07/20/the-truth-about-statin-drugs-revealed.aspx

  • What we have here is a classic case of picking your own poison. To make matters worse, either way, you’ll likely end up needing personal live in care sussex.

  • JohnN says:

    David – I’d like to send this to my heart specialist. Could I please have the reference to:

    A comprehensive review published in 2007 of all of the major high-quality trials on statins concluded that for these not-sick people (who make up the overwhelming majority) taking statins did not alter the overall risk of dying at all.

  • Bridget Hall says:

    No wonder the best online pharmacy reviews I saw around that time said statins had risky side effects. Have they already found any reliable alternatives to this?

  • earthgirl says:

    re “new research suggests statins significantly increase the risks of Type II Diabetes and dementia.”

    David. can you provide this research evidence, as i am always being asked by friends who dont believe me….

  • I cut out sugar, switched from margarine to butter, minimised the polyunsaturates, ate more red meat and used more animal fat for cooking. After 6 months I had my bloods repeated. The result was a 25% decrease in my LDL and a 33% decrease in my trigycerides. My HDL stayed the same. No need for statins now which is something my GP was concerned about. Im convinced about sugar. My doctor did say I was a very small sample of a trial to draw conclusions on,but, as I told him, it is the only sample I am really interested in

  • ellisbarren says:

    Cholesterol needs to be under control. Exercise, right eating habits, smoking and alcoholism can help bring down cholesterol, but apart from that one can also reduce cholesterol with supplements too. But before taking any of the supplement consult your doctor first.

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