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Medical Forum / Diseases and Disorders / Diabetes / December 2008Aggressive Cholesterol Lowering Has Benefits
http://www.diabetes.org/diabetesnewsarticle.jsp?storyId=19080392&filename=200812 12/reuters20081212health00000010reutershealthEDIT.xml or http://tinyurl.com/6affju (excerpt) NEW YORK (Reuters Health) - In people with type 2 diabetes, intensive drug therapy to significantly lower "bad" LDL cholesterol reduces the thickness of the carotid arteries, the major arteries in the neck that supply oxygen to the brain, research shows. The beneficial effect on the thickness of the neck arteries is similar in people who attain equivalent LDL cholesterol reductions by taking a statin drug alone or by taking a statin plus another cholesterol medicine called ezetimibe, the researchers found. Ezetimibe (Vytorin) pairs the statin drug Zocor with cholesterol fighter Zetia. However, the addition of ezetimibe may be required if a statin alone fails to lower LDL levels to target levels, they report in the Journal of the American College of Cardiology. The Stop Atherosclerosis in Native Diabetics Study, or SANDS, trial, tested the value of aggressively lowering LDL cholesterol to 70 milligrams per deciliter (mg/dL) or lower, and non-HDL cholesterol to 100 mg/dL or lower, versus lowering levels of these harmful lipids merely to "standard goals" (i.e., 100 mg/dL or lower for LDL and less than 130 mg/dL for non-HDL-C). >http://www.diabetes.org/diabetesnewsarticle.jsp?storyId=19080392&filename=200812 12/reuters20081212health00000010reutershealthEDIT.xml > [quoted text clipped - 8 lines] >thickness of the carotid arteries, the major arteries in the neck that >supply oxygen to the brain, research shows. Later, I'll take the time to analyse this one. For the moment my only comment is that it is amazing what you can discover when research is focused on maximising profits for a $27 billion annual sales product. Dr Davis' most recent blog also makes interesting reading: http://heartscanblog.blogspot.com/2008/12/statin-drug-revolt.html Cheers, Alan, T2, Australia. -- d&e, metformin 2000 mg Everything in Moderation - Except Laughter. http://loraldiabetes.blogspot.com (The Diabetes Diet Wars) http://loraltravel.blogspot.com (Two Indian Hotels: to Sleep, Perchance...) Well, that's exactly what the study does NOT show. It shows that taking statins has benefits, but the study does not show that lowering cholesterol has benefits, or that taking ezetimibe has benefits. Here's what it says: > The study involved 427 type 2 diabetic Native Americans > who were age 40 or older and who had no history of heart > attack or other heart-related event. There were 204 > people in the standard treatment group and 223 in the > aggressive treatment group -- 154 treated with statins > alone and 69 who received statin plus ezetimibe. > Ultrasound tests showed that neck artery thickness got > worse, or progressed, in the standard treatment group > and regressed, to a similar degree, in the two > aggressive treatment groups. > Nearly identical proportions of patients in the two > aggressive subgroups demonstrated no change or a > decrease in neck artery thickness during follow-up, Dr. > Wm. James Howard at MedStar Research Institute in > Hyattsville, Maryland, and colleagues report. > Comparable LDL and non-HDL cholesterol lowering > accomplished with a statin plus ezetimibe versus a > statin alone resulted in similar benefit, they say. It would appear that ezetimibe, which has none of the inflamation reduction benefits of statins, produces no additional outcome benefits from the additional cholesterol lowering it achieves. Didn't we just show that in the Vytorin study? And yet, the study authors end with this astonishing conclusion: > Ezetimibe "remains a viable therapeutic option for > patients who fail to reach their LDL cholesterol target > on a statin alone," they conclude. The study provides absolutely no support for that statement - the word "theraputic" means it has some benefit, I think. Further, the study does not show that statins achieve their benefits by lowering cholesterol. I think I need to go back and read Taubes' book to make sure I understand what's going on. Either I don't understand, or there is wholesale group-think going on among researchers. Well, these guys are smarter than me. Where have I gone wrong? > I think I need to go back and read Taubes' book to make sure > I understand what's going on. Either I don't understand, or > there is wholesale group-think going on among researchers. > > Well, these guys are smarter than me. Where have I gone > wrong? You haven't. Susan > > Ultrasound tests showed that neck artery thickness got > > worse, or progressed, in the standard treatment group > > and regressed, to a similar degree, in the two > > aggressive treatment groups. Of course if that happened to other blood vessels it could lead to stroke, aneurysm, etc. > > Nearly identical proportions of patients in the two > > aggressive subgroups demonstrated no change or a > > decrease in neck artery thickness during follow-up, Dr. > > Wm. James Howard at MedStar Research Institute in > > Hyattsville, Maryland, and colleagues report. NOW this is IMNSHO the kind of thing they need to look at more closely, statins only seem to work (well) for a sub-population, and they give unacceptable side effects in another sub-population, so if carefully targeted they might prove to be more cost-effective than throwing them at everyone to see who they stick to. Oh but that would reduce drug company profits so they wouldn;t even attempt to back such a study. >Well, these guys are smarter than me. Where have I gone >wrong? I agree with Susan, you haven't. > Well, these guys are smarter than me. Where have I gone > wrong? What makes you think they're smarter than you? An advanced degree depends more on money than on intelligence. And in some cases, also depends on one's willingness to avoid threatening the established dogma.  SignatureWes Groleau Yeah!! More jargon! That'll solve our problems! http://Ideas.Lang-Learn.us/barrett?itemid=440 > > Well, these guys are smarter than me. Where have I gone > > wrong? > > What makes you think they're smarter than you? > > An advanced degree depends more on money than on intelligence. I don't know about how smart I am, but I seem to remember that for my degrees it involved a helluva lot of work. :-) bj > I don't know about how smart I am, but I seem to remember that for my > degrees it involved a helluva lot of work. :-) Sure, but it doesn't take high intelligence to be hard working. Just sayinzall, not a characterization of you personally. Susan >>> Well, these guys are smarter than me. Where have I gone >>> wrong? [quoted text clipped - 5 lines] > degrees it involved a helluva lot of work. :-) > bj For sure. I had scholarships for the payments, but the hours and anguish were strictly on me. Dorothy > "Wes Groleau" <Groleau+news@FreeShell.org> wrote in message >> An advanced degree depends more on money than on intelligence. > > I don't know about how smart I am, but I seem to remember that for my > degrees it involved a helluva lot of work. :-) Well, yes, in a good school it depends more on money and/or hard work than intelligence. But in some schools, just money. SignatureWes Groleau Here I go....... again http://Ideas.Lang-Learn.us/barrett?itemid=566 >> "Wes Groleau" <Groleau+news@FreeShell.org> wrote in message >>> An advanced degree depends more on money than on intelligence. [quoted text clipped - 4 lines] > Well, yes, in a good school it depends more on money and/or hard work > than intelligence. But in some schools, just money. Certainly I had to pay tuition in getting my degrees, but that was the *least* of what was involved. Even free-tuition wouldn't have made the brain-work any easier. Maybe I know the wrong people, but I don't know anybody who got a degree just by "money". Some of us have to work harder than others, whether because of "smarts" or subject matter (& how well your brain & inclination are matched to your chosen subject :-)), and some courses are easier than others, but we all had to work plenty. bj > Well, that's exactly what the study does NOT show. It shows > that taking statins has benefits, but the study does not [quoted text clipped - 27 lines] > additional outcome benefits from the additional cholesterol > lowering it achieves. Your interpretation would be correct for the following ... "Comparable LDL and non-HDL cholesterol lowering accomplished with a statin plus ezetimibe versus a statin alone resulted in less benefit, they say." and not for what was originally written ... "Comparable LDL and non-HDL cholesterol lowering accomplished with a statin plus ezetimibe versus a statin alone resulted in similar benefit, they say." May this help you have a better understanding. GOD remains the Source of all knowledge, wisdom, and understanding. Therefore, praise Him when you have a better understanding. <>< http://groups.google.com/group/sci.med.cardiology/msg/3558812d72ab4e17? > GOD remains the Source of all knowledge, wisdom, and understanding. f.ck God. If he wanted to tell me something, why would he rely on you to tell me? Wouldn't he know I don't pay any attention at all to your "God" crap? Let him tell me what he wants, and - Butt out, Chung! It just annoys me, and makes me more resistant. SignatureMarshall Price of Miami d021317c@fastmail.fm http://marshallprice.wordpress.com/ > Andrew, in the Holy Spirit, boldly wrote: > > > http://groups.google.com/group/sci.med.cardiology/msg/d9938bab2eb2def6? > > f.ck God. It remains my personal choice to praise Him instead. > If he wanted to tell me something, why would he rely on > you to tell me? GOD does what He wants. > Wouldn't he know I don't pay any attention at all to > your "God" crap? Clearly He knows more than you. > Let him tell me what he wants... Wouldn't stop Him. <>< "... no one can say 'Jesus is LORD' except by the Holy Spirit." (1 Cor 12:3) http://groups.google.com/group/sci.med.cardiology/msg/035c93540862751c? What does Jesus want (WDJW) ? http://groups.google.com/group/sci.med.cardiology/msg/c805a3fe6c8c39c9? > I think I need to go back and read Taubes' book to make sure > I understand what's going on. Either I don't understand, or > there is wholesale group-think going on among researchers. Taubes' book is a grand example of group-think. I don't think it's stopped yet. :-( > Well, these guys are smarter than me. Where have I gone > wrong? I agree with Susan; you haven't. SignatureBest regards, Michelle C., T2 diet & exercise BMI 21.5 >> I think I need to go back and read Taubes' book to make sure >> I understand what's going on. Either I don't understand, or >> there is wholesale group-think going on among researchers. > >Taubes' book is a grand example of group-think. I don't think it's stopped >yet. :-( By that I presume you mean the bad examples he depicts such as Keyes et al, and not his own conclusions? >> Well, these guys are smarter than me. Where have I gone >> wrong? > >I agree with Susan; you haven't. Cheers, Alan, T2, Australia. -- d&e, metformin 2000 mg Everything in Moderation - Except Laughter. http://loraldiabetes.blogspot.com (Smoking and Diabetes ) http://loraltravel.blogspot.com >>> I think I need to go back and read Taubes' book to make sure >>> I understand what's going on. Either I don't understand, or [quoted text clipped - 6 lines] > By that I presume you mean the bad examples he depicts such > as Keyes et al, and not his own conclusions? Absolutely! I should have been more specific. ;-) SignatureBest regards, Michelle C., T2 diet & exercise BMI 21.5 In alt.support.diabetes Peabody <waybackNO784SPAM44@yahoo.com> wrote: > Well, that's exactly what the study does NOT show. It shows > that taking statins has benefits, but the study does not > show that lowering cholesterol has benefits, or that taking > ezetimibe has benefits. Here's what it says: > > The study involved 427 type 2 diabetic Native Americans > > who were age 40 or older and who had no history of heart > > attack or other heart-related event. There were 204 > > people in the standard treatment group and 223 in the > > aggressive treatment group -- 154 treated with statins > > alone and 69 who received statin plus ezetimibe. > > Ultrasound tests showed that neck artery thickness got > > worse, or progressed, in the standard treatment group > > and regressed, to a similar degree, in the two > > aggressive treatment groups. > > Nearly identical proportions of patients in the two > > aggressive subgroups demonstrated no change or a > > decrease in neck artery thickness during follow-up, Dr. > > Wm. James Howard at MedStar Research Institute in > > Hyattsville, Maryland, and colleagues report. > > Comparable LDL and non-HDL cholesterol lowering > > accomplished with a statin plus ezetimibe versus a > > statin alone resulted in similar benefit, they say. > It would appear that ezetimibe, which has none of the > inflamation reduction benefits of statins, produces no > additional outcome benefits from the additional cholesterol > lowering it achieves. Didn't we just show that in the > Vytorin study? And yet, the study authors end with this > astonishing conclusion: > > Ezetimibe "remains a viable therapeutic option for > > patients who fail to reach their LDL cholesterol target > > on a statin alone," they conclude. > The study provides absolutely no support for that > statement - the word "theraputic" means it has some > benefit, I think. Further, the study does not show that > statins achieve their benefits by lowering cholesterol. > I think I need to go back and read Taubes' book to make sure > I understand what's going on. Either I don't understand, or > there is wholesale group-think going on among researchers. > Well, these guys are smarter than me. Where have I gone > wrong? Don't forget when consulting research studies that two thirds of them are rubbish :-) SignatureChris Malcolm |
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