Statin Scandal

Ok, perhaps "scandal" is a bit of a rant, but if its not then it should be. Read on and decide for yourself.

Every year, doctors write about 240 million prescriptions in the USA for statin drugs in order to lower a patient's LDL (bad) cholesterol. This amounts to over $11 Billion in sales annually. There is just one problem with this. There is little evidence to support the belief that lowering LDL levels has any effect at all on the risk of heart disease.

A new research study published in the British Medical Journal concluded that 75% of people taking statins or other LDL-lowering drugs showed no reduction in rates of death from heart disease. In many of the studies analyzed large drops in LDL levels produced no reduction in heart attacks, strokes or deaths from cardiovascular disease (CVD). The researchers noted that in the USA, CVD deaths are rising despite the heavy use of statins and generally declining levels of LDL within the overall population. The only benefit noted from taking a statin drug was for men under 75 years old who had already suffered a heart attack or stroke. In this case the benefit was from the statin's  blood thinning action, not from lowering LDL levels.

In the face of this lack of measurable benefits, statin drugs come with a number of undesirableside effects, including muscle pain and (rarely) rhabdomyolysis, liver damage, increased blood sugar levels, memory loss or confusion, headache, insomnia, dizziness and low blood platelet counts. You get all these bonuses for taking a drug that lowers LDL just as claimed but has little or no impact on your CVD risk.

I have a fiend who was placed on Crestor to reduce his high LDL levels. Within 2 years he experienced "a problem with his liver enzymes" that caused his doctor to take him off the statin. In their place the doctor suggested "diet and lifestyle changes". My question was, why was that not the FIRST suggestion instead of Plan B?

For the answer, we need to go back to 1967 and the landmark study conducted at Harvard University and published in JAMA. At that time, the dietary underpinnings of CVD were still under debate. One camp proposed that cholesterol-raising saturated fats were the cause. The other suggested that it was the inflammatory effect of sugar on arteries that was responsible. The Harvard study reviewed the link between sugar and heart disease and concluded that sugar played no role.

Only much later was it learned that the study was discreetly funded, designed and directed by the Sugar Research Foundation, a trade group representing the sugar industry. If this were the only problem it would not be an issue. Regardless of the funding source, a study can still be credible, right? But it's not.

In the 1990s, statin drugs became available and were quite successful in lowering LDL levels, so they were heavily promoted as the best preventative for heart disease. However the results of research into the relationship between LDL levels and CVD were, to be charitable, greatly exaggerated by the pharmaceutical companies conducting it.

In contrast, the authors of the BMJ study concluded that using statins to reduce the risk of CVD is "a failed strategy". "Considering that dozens of randomly controlled trials of LDL-cholesterol reduction have failed to demonstrate a consistency of benefit," they wrote, "we should question the validity of this theory." They went to to critically note that, "In most fields of science the existence of contradictory evidence usually leads to a paradigm shift or, at least, a modification of the theory in question, but in this case the contradictory evidence has been largely ignored."

So then if LDL cholesterol is not the culprit, what is? 

So far, the best predictor of future CVD is insulin resistance, which has been show in research by Dr. Gerald Raven of Standford University to dramatically increase the risk of CVD. If this is true, the biggest threat to your heart is not saturated fats but... sugar. 

Now this in no way suggests that saturated fats are healthy or good for you. They are significant sources of cellular inflammation, which is a root cause of many chronic health issues. But it does suggest that taking statin drugs for heart health benefits nobody by the pharmaceutical companies that produce them.

If you are presently taking a statin to lower your LDL cholesterol, DO NOT stop taking them suddenly. But DO start doing your own research into the risks and benefits for you and then have a conversation with your doctor about it.

(On Monday I will discuss insulin resistance in more detail and suggest some dietary and lifestyle approaches you can adopt to address it.)