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Medical Forum / General / General / August 20053/4 of people taking statins no benefit: none. zilch
Low cholesterol level is just one of the heart's desires By Dr. John abramson Sunday, July 31, 2005 I've read that drugs such as Lipitor are overprescribed and that they don't help prevent heart attacks in healthy people. True or false? - C.D., Cambridge Overprescribed? You bet they are. About 15 million Americans are now taking cholesterol-lowering statins like Lipitor, making them the best-selling class of drugs. If the latest national recommendations are followed, more than 40 million soon will be taking statins. There's no question these drugs lower LDL (bad) cholesterol levels. But the real question is whether they reduce the risk of heart disease and improve the overall chance of staying healthy. The answer is - that depends. About one-quarter of the people currently taking a cholesterol-lowering drug already have heart disease or diabetes. For these folks, there is general agreement that statins reduce the risk of further heart disease and, at least for men, decrease the risk of death from heart disease. But about three-quarters of people taking statins don't have heart disease. For these people, especially women, there is no evidence these drugs reduce heart disease or prolong life. None. Zilch. But that hasn't stopped doctors from prescribing statins for healthy women. The reason: The 2001 National Cholesterol Education Program guidelines - which define the standards of good medical care - informed us doctors that statins are beneficial for healthy women who are at increased risk of developing heart disease - that is, women older than 50. These guidelines are based on six major clinical studies. But if you read closely, you'll find that none of the studies provides significant evidence that statins are beneficial for healthy women. Part of the problem is that, in general, we are paying too much attention to our cholesterol levels and not enough to our lifestyles. In fact, a study published in the Journal of the American Medical Association showed that elevated cholesterol does not significantly increase healthy women's risk of heart disease or overall mortality. Meanwhile, another study, this one in the New England Journal of Medicine, showed that women who exercise and maintain a healthy diet develop 83 percent less heart disease than those who don't. The sad news: Only 3 percent of women maintain healthy habits. If women want to decrease their risk of heart disease, these are the issues they should be discussing with their doctors, not cholesterol. Dr. John Abramson teaches at Harvard Medical School and is the author of ``Overdosed America.'' E-mail him at heraldfea{AT}bostonherald.com; put ``Mr. M.D.'' in the subject field; or write to Mr. M.D., Boston Herald Features Department, P.O. Box 55843, Boston > Low cholesterol level is just one of the heart's desires > By Dr. John abramson [quoted text clipped - 60 lines] > put ``Mr. M.D.'' in the subject field; or write to Mr. M.D., Boston > Herald Features Department, P.O. Box 55843, Boston Note that this says: "About one-quarter of the people currently taking a cholesterol-lowering drug already have heart disease or diabetes. For these folks, there is general agreement that statins reduce the risk of further heart disease and, at least for men, decrease the risk of death from heart disease." And this is where the debate should be - where to draw the line. Not if statins are good or evil. Bill > > Low cholesterol level is just one of the heart's desires > > By Dr. John abramson [quoted text clipped - 73 lines] > > Bill Yes indeed Bill. Zee >> Low cholesterol level is just one of the heart's desires >> By Dr. John abramson [quoted text clipped - 71 lines] > And this is where the debate should be - where to draw the line. Not if > statins are good or evil. Your reply is such a crock. You introduce "good or evil" so that you can pretend there is a debate and that it is specious. If you want to direct a debate, start a new OP thread and offer something that is an opinion, not a fact. The difference is obvious to us all, and those who want to debate opinions can weigh in on your thread. This post was quite straightforward. Published placebo controlled large public trials show no benefit for 3/4 of the people taking statins. Fact, not opinion. No debate. No brag, just fact. > Bill >>> Low cholesterol level is just one of the heart's desires >>> By Dr. John abramson [quoted text clipped - 76 lines] > debate, start a new OP thread and offer something that is an opinion, not a > fact. You have only posted on how evil statins are and never shown any balance by showing how they can help people. > The difference is obvious to us all, and those who want to debate opinions > can weigh in on your thread. [quoted text clipped - 4 lines] > > No debate. No brag, just fact. And did it not also say that it helped 1/4. Yes or no. Or do you only wish to state the negative side? Bill >> Bill >>>> Low cholesterol level is just one of the heart's desires >>>> By Dr. John abramson [quoted text clipped - 79 lines] > You have only posted on how evil statins are and never shown any balance > by showing how they can help people. Show me one post where I use the word "evil" in any context other than a quote from you. You are the one who insists on morphing reality into your own private morality play. Please stop misrepresenting my posts. People can read my posts. Statin adverse effects are fact. I post references to factual information on statin adverse effects. >> The difference is obvious to us all, and those who want to debate >> opinions can weigh in on your thread. [quoted text clipped - 7 lines] > And did it not also say that it helped 1/4. Yes or no. Or do you only wish > to state the negative side? Statin adverse effects are fact. I post references to factual information on statin adverse effects. Pfizer has a $10 billion per year incentive to portray the positive, and the rest of the statin industry has like funds for this. They can even purchase the services of newsgroup trolls who attempt to villify and humiliate and discredit any poster who has something to say that might negatively affect their sales! They can even pay to track every prescription ever filled, and trace it infallibly to the doctor who wrote that prescription by paying for that info from the AMA, and then correlate the rate of prescriptions to the last sales call and the 'gift' offered to that individual doctor. The FACT that 75% of all people taking statins derive no benefit, per the OP, indicates that Pfizer and the other drug companies are doing their job quite well. The FACT that 75% of all the people taking the most widely prescribed class of drugs in the world, and the most widely prescribed class of drugs in history, may not be aware of the risks is of concern. Particularly because the risks can include complete disability for people in their mid '50's or younger, rising from adverse effects including muscle damage, chronic excruciating pain, cognitive damage, amnesia, aphasia, short-term memory loss, neuropathy, fatigue, exercise intolerance, mitochondrial damage, and more. Then there is rhabdomyolysis. Then there is the risk of unmasking a serious condition such as Parkinson's Disease, Huntington's Disease, ALS, and others. These risks are not well understood by patients, and there is repeated evidence that prescribing doctors are not well aware of them. The damage that these adverse effects can do is long-lasting and there is no fully-effective treatment to date, and recovery is not complete. This is something I live with every day. This is something that is PREVENTABLE, and was PREVENTABLE in my husband's case, but it happened due to the lack of awareness of the prescribing and treating doctors and to the lack of information about statin adverse effects, even on the web. That lack of information on adverse effects still exists, in terms of studies, particularly studies that establish an effective and definitive diagnosis and a TREATMENT TO A CURE, but at least there is a growing body of knowledge on the net now that acknowledges these side effects. If it disturbs you that statin adverse effects are on my mind daily, all day, day and night, as they continue to disable my husband, then I suggest you find a way to fund research into a TREATMENT TO A CURE for statin adverse effects. Until that chronic excruciating pain, the daily muscle spasms, the muscle damage, mitochondrial respiratory chain damage, gout, memory loss and neuropathy, for example, start to alleviate to the point where my husband can do things like walk 100 yards in a day (from the car to the back shelf of Home Depot and back to the car, for example.) without doing severe damage to his muscles and experiencing extreme pain and needing 3 to 4 days to recuperate, maybe I won't be as interested in warning others away. Maybe you should get your keepers to release some of the adverse effects information they are sitting on, gathered from other studies and withheld so other researchers cannot get to it to work towards a treatment to a cure. With the money they make on other people's misery, they could toss a few crumbs in that direction. If the cure were successful, it might tend to make fewer people discuss the disabling adverse effects of statins, including Lipitor, Crestor, Mevacor, Pravachol, Zocor, Lescol, and Baycol, aka atorvastatin, rosuvastatin, cerivastatin, fluvastatin, lovastatin, pravastatin, and simvastatin; this class of drugs also known as HMG-CoAReductase Inhibitors, short for 3-Hydroxy-3-Methyl-Glutaryl Coenzyme A Reductase; and now also the combination drug, Vytorin, with both Zetia (Ezetimibe)and Zocor (simvistatin). > Bill >> >>> Bill >>>>> Low cholesterol level is just one of the heart's desires >>>>> By Dr. John abramson [quoted text clipped - 83 lines] > quote from you. You are the one who insists on morphing reality into your > own private morality play. I'll accept that. I don't know that you have used that word. You have however characterized the makers of statins that way and speak frequently about significant AE of statins but almost never mention they are rare. You do seem to think, in my opinion, that Pfizer has done and is doing something morally wrong do you not? So do you or do you not think this is a moral issue? > Please stop misrepresenting my posts. People can read my posts. I don't and they can see for themselves. For example, nowhere below do you mention that severe side effects from statins are rare. > Statin adverse effects are fact. I post references to factual information > on statin adverse effects. [quoted text clipped - 81 lines] > combination drug, Vytorin, with both Zetia (Ezetimibe)and Zocor > (simvistatin). None of which address the question. Did the original article say that it helped 1/4 of the people. Yes or no. Or do you only wish to address the negative side. Rather than focus on who should receive statins and who should not. The point I am making is that you do. Bill >> Bill >>> >>>> Bill >>>>>> Low cholesterol level is just one of the heart's desires >>>>>> By Dr. John abramson [quoted text clipped - 99 lines] > something morally wrong do you not? So do you or do you not think this is > a moral issue? I think it is time that people who have been damaged by statins have a chance for a treatment toward a cure. I think that it is time that not one more person should suffer PREVENTABLE muscle damage from statins. I think that it is time that not one more person should suffer PREVENTABLE nerve damage from statins. I think that it is time that not one more person should suffer PREVENTABLE cognitive damage from statins. I think that it is time that not one more person should suffer PREVENTABLE short-term memory loss from statins. I think that it is time that not one more person should suffer PREVENTABLE amnesia episodes from statins. I think that it is time that not one more person should suffer PREVENTABLE aphasia from statins. I think that it is time that not one more person should suffer PREVENTABLE chronic excruciating pain from statins. I think that it is time that not one more person should suffer PREVENTABLE confusion from statins. I think that it is time that not one more person should suffer PREVENTABLE unmasking of Parkinson's Disease by statins. I think that it is time that not one more person should suffer PREVENTABLE unmasking of Huntington's Disease by statins. I think that it is time that not one more person should suffer PREVENTABLE unmasking of ALS by statins. I think there should be a pre-test to screen out people who will be adversely affected by statins before that first statin pill is prescribed. I think that there should be a baseline NP Test required to measure the cognitive abilities of the person prior to the first statin pill being prescribed. I think that your perjorative attempts at impertinent questions that have nothing to do with the point of the post are absurd and deserve no notice. >> Please stop misrepresenting my posts. People can read my posts. > > I don't and they can see for themselves. For example, nowhere below do you > mention that severe side effects from statins are rare. Absolutely untrue in my experience. In my experience 100% of statin takers suffer adverse effects. In my family 100% of statin takers have been disabled by statin adverse effects. In my home 100% of statin takers have been disabled by statin adverse effects. Rare is not a word in any way associated with 100% disability, muscle damage 100% of the time, muscle wasting 100% of the time, mitochondrial respiratory damage 100% of the time, nerve damage 100% of the time, chronic excruciating pain 100% of the time, cognitive damage 100% of the time, memory loss 100% of the time and aphasia. >> Statin adverse effects are fact. I post references to factual >> information on statin adverse effects. [quoted text clipped - 90 lines] > should receive statins and who should not. The point I am making is that > you do. Your words betray the ignorance and insensitivity you continue to inflict upon those who have been adversely affected by statins. To address a problem and hope to achieve a solution is a positive endeavor. Your questions show a basic lack of understanding. The issue of adverse effects of statin drugs, including Lipitor, Crestor, Mevacor, Pravachol, Zocor, Lescol, and Baycol, aka atorvastatin, rosuvastatin, cerivastatin, fluvastatin, lovastatin, pravastatin, and simvastatin; this class of drugs also known as HMG-CoAReductase Inhibitors, short for 3-Hydroxy-3-Methyl-Glutaryl Coenzyme A Reductase; and now also the combination drug, Vytorin, with both Zetia (Ezetimibe)and Zocor (simvistatin), is not a debate, it is a FACT. The fact is that the problem needs to be addressed. There needs to be: Screening to prevent harm to those most likely to suffer statin adverse effects. Treatment to a cure for those who have suffered statin adverse effects. There are no "sides" to PREVENTABLE human suffering, simply a need to stop inflicting it on new patients, and an obligation to treat those patients who have already been harmed to a cure, and restore their quality of life. > Bill > >>> Bill >>>> >>>>> Bill >>>>>>> Low cholesterol level is just one of the heart's desires >>>>>>> By Dr. John abramson [quoted text clipped - 93 lines] >> something morally wrong do you not? So do you or do you not think this is a >> moral issue? None of the following seems to address the question above but rather goes OT. > I think it is time that people who have been damaged by statins have a > chance for a treatment toward a cure. [quoted text clipped - 41 lines] > I think that your perjorative attempts at impertinent questions that have > nothing to do with the point of the post are absurd and deserve no notice. Could you explain what you mean by impertinent and perjoritive. I don't think you can provide examples. You are doing exactly what you accuse me of doing and then trying to cover yourself. And why are you then noticing? >>> Please stop misrepresenting my posts. People can read my posts. >> [quoted text clipped - 3 lines] > Absolutely untrue in my experience. In my experience 100% of statin takers > suffer adverse effects. Do you think your personal experience is representive of what all people experience? That is, in what way is it relevant beyond providing one example? It seems your purpose here is to present that one example, not what people should expect in general. > In my family 100% of statin takers have been disabled by statin adverse > effects. In my home 100% of statin takers have been disabled by statin [quoted text clipped - 103 lines] > Your words betray the ignorance and insensitivity you continue to inflict > upon those who have been adversely affected by statins. I am saying there are two sides to statins. Positive and negative. I have agreed that there are negative. The reason I don't say it more often is that no one argues that there are not. You claim this shows that I show ignorance and insensitivity. In exactly what way. Please address the question for once rather than going off on another topic. > To address a problem and hope to achieve a solution is a positive endeavor. > Your questions show a basic lack of understanding. Which questions show a lack of understanding? Be precise. (I suspect you will not be able to answer the question.) > The issue of adverse effects of statin drugs, including Lipitor, Crestor, > Mevacor, Pravachol, Zocor, Lescol, and Baycol, aka atorvastatin, [quoted text clipped - 3 lines] > combination drug, Vytorin, with both Zetia (Ezetimibe)and Zocor > (simvistatin), is not a debate, it is a FACT. I have already agreed with this numerous times. > The fact is that the problem needs to be addressed. There needs to be: > [quoted text clipped - 5 lines] > inflicting it on new patients, and an obligation to treat those patients who > have already been harmed to a cure, and restore their quality of life. I agree we need to do a better job. You have simply avoided answer the original question I posed in this thread. Why are you afraid to answer? The question was: "Did the original article say that it helped 1/4 of the people. Yes or no." It is a simple question. Bill >> Bill >> >>>> Bill >>>>> >>>>>> Bill "Bill" <xxx@yy.zz> wrote in message news:wb% > "Sharon Hope" <shope@anet.net> wrote in message > You have simply avoided answer the original question I posed in this > thread. Why are you afraid to answer? The question was: [quoted text clipped - 3 lines] > > It is a simple question. Also waiting. My guess is that Sharon is the thing she pretends to hate. No reply. moo Why does the webpage http://www.lipitor.com/cwp/appmanager/lipitor/lipitorDesktop?_nfpb=true&_pageLab el=prescribingInformation#indicationsandusage list "prevention of cardiovascular disease" under "indications and usage," and say: "Lipitor is indicated to: Reduce the risk of myocardial infarction Reduce the risk for revascularization procedures and angina" and mention clinical studies supporting that under the heading "Clinical Studies. Prevention of Cardiovascular Disease," yet the webpage http://www.lipitor.com/cwp/appmanager/lipitor/lipitorDesktop?_nfpb=true&_pageLab el=moreFaqs&questionID=Lipitor/Consumer/Lipitor_FAQ_21.htm under "Important information" it says "it has not been shown to prevent heart disease or heart attacks"? > Why does the webpage > [quoted text clipped - 17 lines] > under "Important information" it says "it has not been shown to prevent > heart disease or heart attacks"? Perhaps just selling modern snake oil. It will cure what ails ya ! Trust me. Thanks Barry your post is a keeper! Bill  SignatureGarden Shade Zone 5 in a Japanese Jungle manner. FAIR USE NOTICE: This may contain copyrighted (© ) material the use of which has not always been specifically authorized by the copyright owner. Such material is made available for educational purposes, to advance understanding of human rights, democracy, scientific, moral, ethical, and social justice issues, etc. It is believed that this constitutes a 'fair use' of any such copyrighted material as provided for in Title 17 U.S.C. section 107 of the US Copyright Law. This material is distributed without profit. The FDA has reprimanded Pfizer several times for truth in advertising. Records of the letters to Pfizer are on the FDA website. > Why does the webpage > [quoted text clipped - 15 lines] > under "Important information" it says "it has not been shown to prevent > heart disease or heart attacks"? Well, I don't like double-talk, especially from drug companies, so I intend to mail the following letter to Pfizer. If anyone has an appropriate email address for them, maybe I'll email them instead. ---------------------------- Pfizer Inc 235 East 42nd Street New York, NY 10017 Dear Pfizer Inc: There's contradictary information on your website that I hope you can clear up for me. Can Lipitor prevent cardiovascular disease or not? If not, what can Lipitor be used for? The webpage: http://www.lipitor.com/cwp/appmanager/lipitor/lipitorDesktop?_nfpb=true&_pageLab el=prescribingInformation#indicationsandusage lists "prevention of cardiovascular disease" under "indications and usage," and says: "Lipitor is indicated to: Reduce the risk of myocardial infarction Reduce the risk for revascularization procedures and angina" That same webpage also mentions clinical studies under the heading "Clinical Studies. Prevention of Cardiovascular Disease." But all that seems to be contradicted in the webpage: http://www.lipitor.com/cwp/appmanager/lipitor/lipitorDesktop?_nfpb=true&_pageLab el=moreFaqs&questionID=Lipitor/Consumer/Lipitor_FAQ_21.htm under "Important information," which says "it has not been shown to prevent heart disease or heart attacks." > Well, I don't like double-talk, especially from drug companies, so I > intend to mail the following letter to Pfizer. If anyone has an [quoted text clipped - 33 lines] > prevent > heart disease or heart attacks." COMMENT: You're wasting your time. The "it has not been shown to prevent heart disease or heart attacks" is language left over from the days when Pfizer was permitted to make claims only to Lipitor's ability to lower cholesterol. For some reason, the FDA has not yet allowed them to change it (as has long happened with stains like pravachol) despite data from ASCOT and TNT trials that Lipitor does indeed prevent some fraction of heart attacks in male patients with multiple risk factors, especially diabetes and hypertension (which is where the "indication" statements come from). Perhaps FDA decided a general patient information statement about heart attack prevention would be misleading without a lot of qualification about risk groups which patients wouldn't understand. Who knows what the FDA thinks? It might just as well be beaurocratic delay, and soon the Lipitor patient info will look like Pravachol or Zocor's. Anyway, these sections are written by lawyers. Don't try to be a lawyer. Read the medical studies if you want to find out what the drug has and hasn't been shown to do. SBH > You're wasting your time. If they demean the FDA as much as you did, it would be interesting to hear it. Otherwise, they'd have to say one or the other thing on their website is wrong. I'm curious what they'd say. Saying: > > "Lipitor is indicated to: > > Reduce the risk of myocardial infarction makes it clear enough that Lipitor doesn't prevent heart attacks for everyone. Saying "it has not been shown to prevent heart disease or heart attacks" is either unnecessary or wrong. I think it's dangerous to say that. > Read the medical studies if you want to find out what the drug > has and hasn't been shown to do. I did, but Pfizer's lawyers and the FDA should too if they're going to make medical claims. >> You're wasting your time. > [quoted text clipped - 11 lines] > prevent heart disease or heart attacks" is either unnecessary or wrong. > I think it's dangerous to say that. I really don't want to get into a discussion on this but the following might be helpful: Main Entry: in·di·cate Pronunciation: 'in-d&-"kAt Function: transitive verb Inflected Form(s): -cat·ed; -cat·ing Etymology: Latin indicatus, past participle of indicare, from in- + dicare to proclaim, dedicate -- more at DICTION 1 a : to point out or point to b : to be a sign, symptom, or index of <the high fever indicates a serious condition> c : to demonstrate or suggest the necessity or advisability of <indicated the need for a new school> 2 : to state or express briefly <indicated a desire to cooperate> http://www.m-w.com/cgi-bin/dictionary?book=Dictionary&va=indicate Bill >> Read the medical studies if you want to find out what the drug >> has and hasn't been shown to do. > > I did, but Pfizer's lawyers and the FDA should too if they're going to > make medical claims. > I really don't want to get into a discussion on this but the following might > be helpful: [definition of indicate] I know what "indicate" means (though the wording "Lipitor is indicated to..." is unusual in the non-medical world). I don't remember if you're a pro or anti- statin guy, so I'm not sure what your saying, but I'll try to explain better. Saying "it has not been shown to prevent heart disease or heart attacks" isn't necessarily inconsistent with "Lipitor is indicated to Reduce the risk of myocardial infarction." The former could be argued to refer to all cases of heart disease, for everyone. Lipitor hasn't been shown to prevent all that, so the statement would just be misleading, or unnecessary considering the proper qualification of other claims, not untrue. Saying "Lipitor is indicated to Reduce the risk of myocardial infarction" isn't such a blanket statement because it only claims that Lipitor reduces--not prevents--the risk of myocardial infarction. I was trying to be fair to Pfizer by saying that the statement "it has not been shown to prevent heart disease or heart attacks" is "either unnecessary or wrong" as opposed to saying it's wrong. I hope you're not just picking out the part of Pfizer's page that you agree with and pretending the phrase "it has not been shown to prevent heart disease or heart attacks" doesn't exist. > >> Read the medical studies if you want to find out what the drug > >> has and hasn't been shown to do. [quoted text clipped - 8 lines] > ` > end I couldn't hear your audio. I just get the above garbled text in Google's archive of your post at http://groups-beta.google.com/group/sci.med/msg/702f4150dab0a362 . I'd try to find out my Verizon password again so I could access this through Outlook Express, but I'm switching to Optimum Online because Verizon sucks, so I won't bother. >> I really don't want to get into a discussion on this but the following >> might [quoted text clipped - 4 lines] > a pro or anti- statin guy, so I'm not sure what your saying, but I'll > try to explain better. It depends on the patient. > Saying "it has not been shown to prevent heart disease or heart > attacks" isn't necessarily inconsistent with "Lipitor is indicated to [quoted text clipped - 7 lines] > infarction" isn't such a blanket statement because it only claims that > Lipitor reduces--not prevents--the risk of myocardial infarction. I don't think it quite says that. It could be read that it says that "there are signs that" or "it suggests the necessity or advisability of" That was the point. And I said I did not want to get into this discussion. Bill > I was > trying to be fair to Pfizer by saying that the statement "it has not [quoted text clipped - 24 lines] > through Outlook Express, but I'm switching to Optimum Online because > Verizon sucks, so I won't bother. > > Read the medical studies if you want to find out what the drug > > has and hasn't been shown to do. > > I did, but Pfizer's lawyers and the FDA should too if they're going to > make medical claims. COMMENT: Pfizer's laywers have no choice but to do what the FDA tells them to do. Forget them. As for your idea that the FDA should read the medical studies before they allow various medical claims on products, you're preaching to the converted. However, this is your government. They have taken authority without responsiblity. Thus is it ever with power. Write them a complain letter. LOL. Don't forget to send another one to Bush on the stupid Iraq war, also. Let me know if they recognize your giant intellect and reputation and amount of power, and stop what they're all doing, and listen to you. SBH Same question to you: Have you finally stopped beating your wife? Yes or No? Simple question. I'm waiting for your yes or no answer. > "Bill" <xxx@yy.zz> wrote in message news:wb% >> "Sharon Hope" <shope@anet.net> wrote in message [quoted text clipped - 11 lines] > > moo > Same question to you: > [quoted text clipped - 3 lines] > > I'm waiting for your yes or no answer. As I said the premise of your question is wrong, so it can not be answered. Why are you avoiding the question that was asked? Bill >> "Bill" <xxx@yy.zz> wrote in message news:wb% >>> "Sharon Hope" <shope@anet.net> wrote in message [quoted text clipped - 11 lines] >> >> moo "Sharon Hope" <shope@anet.net> wrote in message > Same question to you: > > Have you finally stopped beating your wife? Yes or No? No. And now, >> "Bill" <xxx@yy.zz> wrote in message news:wb% >>> "Sharon Hope" <shope@anet.net> wrote in message [quoted text clipped - 6 lines] >>> >>> It is a simple question. Please answer the question. moo > "Did the original article say that it helped 1/4 of the people. Yes or > no." > It is a simple question. Also waiting. My guess is that Sharon is the thing she pretends to hate. No reply. COMMENT: Yep, she's a bigot. And it's pretty rare to find an honest bigot. Her husband is ostensibly (but unprovably) the sufferer of what IS provably a rare statin side effect, and she's nevertheless out crucading for people getting a statin to be given some kind of test to make sure nothing bad will happen to THEM. She figures her own rare personal experience should make policy for everybody; people who will almost certainly never see anything like she thinks she's seen. Narcissism on stilts, is what this is. You know, I wish there was a test we could give *everybody* to make sure nothing bad would happen to them that day. On the street, on the freeway, whatever. Alas, there isn't. We risk our lives to live as we choose. All of us, everyday. Some of us lose at the gamble. We get rear-ended and the gas tank burns and we end up covered with burn scars, and now we have to find a witch. It's got to be the maker of the Pinto or the Crown Victoria. This is pure Ralph Naderism of finding somebody to blame for every single bad experience in life, excepting maybe the weather. Witchhuntery. It's people who get a bad spin of the roulette wheel or casino slots of life, and are complaining to the casino manager that they've had bad really bad luck, unusually bad luck, and now want their money back. You can go through your entire life finding people who've had bad luck in casinos, but such is human nature most of them are too embarrassed to admit it. It takes a real egoist or paranoic to decide they've been *specially* victimized in a casino. Well, read the fine print at the bottom of your contract (or package insert). Your milage may vary. Your stock MAY LOSE VALUE. You may have a drug side effect, and if you're incredibly unlucky, it may be a very bad one. This is planet Earth. You are an adult. There are no guarantees here. Nobody gets out of it alive, and some people have a very bad ride. I beg your pardon, we never promised you a rose garden. GROW UP. If you lost money, you were not necessarily cheated. If your gizmo breaks, you were not necessarily swindled. If you have a bad medical experience, you were not necessarily the victim of incompetence or sloth. And if your car crashes, it is almost surely NOT because it was built to be "UNSAFE AT ANY SPEED." If you start thinking this way, here is my message to you: you are nuts. You are hysterical, you are paranoid, you are narcissistic, and you are still a child. We wish you would get some treatment, unless you really are under 18 years old (in which case we just wish you'd go someplace else until time fixes your problem of self-centeredness.) Thank you. SBH > > "Did the original article say that it helped 1/4 of the people. Yes or > > no." [quoted text clipped - 54 lines] > > SBH Life-altering disabling, often lethal but prventable side effects to drugs are not rare: Vioxx, PAXIL, statins and.... . It isn't one bad apple in the barrel. The system needs revamping. Zee "It isn't one bad apple in the barrel. The system needs revamping." ~ Zee "Is Paris still burning? By the way, seen Eileen ~ ?" ~ Twittering "zee" <outrider@despammed.com> >> GROW UP. If you lost money, you were not necessarily cheated. If your >> gizmo breaks, you were not necessarily swindled. If you have a bad [quoted text clipped - 9 lines] > Life-altering disabling, often lethal but prventable side effects to > drugs are not rare: Vioxx, PAXIL, statins and.... . And, wrong. Wrong as ever. With, IMO, surprisingly few exceptions, dangerous side effects incommensurate with the thing being treated are very rare. The more serious and / or otherwise untreatable the condition, the greater the justification for elevated risk in the therapy. This escapes you. You haven't been paying attention. > It isn't one bad apple in the barrel. The system needs revamping. So now it's the system, eh? You just can't figure out whom to blame once you start looking for witches. Is it the drugs? The doctors? The manufacturers? You take a turn on each of them and all. You're still an infant looking to be coddled by a vast machine funded by others' money. You're so used to whining for your needs (and defence against perceived enemies) that you want the *same* machine to turn on itself at your whim. Sort of like getting mommy angry at daddy. moo >> "Did the original article say that it helped 1/4 of the people. Yes or >> no." [quoted text clipped - 54 lines] > > SBH Wow. I just peeked my head in to see what was going on in the old newsgroup. Nice to see there are still some, like Steve, fighting the good fight but, really, sad to see the old conflagration is apparently still full speed ahead. The zee's and sharon's of the world have to hold on to their irrational agendas - without that....then what? Cheers. L. > Wow. I just peeked my head in to see what was going on in the old > newsgroup. Nice to see there are still some, like Steve, fighting the [quoted text clipped - 3 lines] > The zee's and sharon's of the world have to hold on to their irrational > agendas - without that....then what? COMMENT: Well, it's a helluvalot easier to backbite and kibitz the people trying to fix a problem, than it is to tackle the problem directly yourself, that's for sure. I've seen a lot of people criticising NASA who aren't rocket scientists (and some who are-- but let's keep them separate). I don't know what the Sharons and Zees would do without their drugs. I guess they'd be out looking for toxins or polution or bad cars and other bad tech, like the Naderites they inherently are. In this world, there are engineers, and there are social engineers. Both are needed in society, of course, but in my observation, only one of these groups gets itself regularly confused with the other. I've offered my opinion as to why that happens. In short, I think C.P. Snow was right, and of the two cultures, typified by expertise in math or language, only one has any real understanding of what the other does for a living, and (strangely) it isn't the one that thinks itself truly educated. But I can find you a lot more techies who can write a simple declarative sentence than I can find you "cultural elite" who can differentiate a simple function. In the modern world the elitism of the litterati is wrong. There is just as much education and high culture in knowing when to use a Torx screw driver, as there is in knowing who knives who and why at the end of Henry VI part III. Maybe more. SBH "Sbharris[atsign]ix.netcom.com" <sbharris@ix.netcom.com> > In the modern world the elitism of the > litterati is wrong. There is just as much education and high culture in > knowing when to use a Torx screw driver, as there is in knowing who > knives who and why at the end of Henry VI part III. Maybe more. The latter is much easier to fake. Look at the enrolment in hard science vs. everything else (with the possible exception of some music programs). Math, physics, engineering, medicine. Thankfully, acceptance into these programs is dominated people they *can't* keep out. You can't design a working cell phone network or enhance the GPS system by mandating them into existence. moo > > "Did the original article say that it helped 1/4 of the people. Yes or > > no." [quoted text clipped - 54 lines] > > SBH I am in awe of the respect you garnish from Zee and others. If I had said sharon was bigoted or anything like that I would and have been branded as insensitive, uncaring, drug pushing a.shole. Zee has many doctor friends she has dinner with and they just node their heads in a patronizing manner every time she gets on a tirade. I don't have a lot of doctor friends and don't want any. I have had my fair share of interactions with doctors and they are not at dinner parties. I think there are many people here that need medical and psychological help including Jason who likes to post here more than actually getting an accurate diagnosis of his mental cognitive problems. I find it hard to disagree with anything I have read from you although there has been a few. We see the same things from different professional positions. > I am in awe of the respect you garnish from Zee and others. COMMENT: Huh? > If I had said > sharon was bigoted or anything like that I would and have been branded as > insensitive, uncaring, drug pushing a.shole. COMMENT: Not if were true. If Sharon's husband had died in a airliner crash and her _cause célèbre_ was the supposed incompetence and unsafety of all airliners (or even Pan Am -- pick your subset), it would be obvious to you that she had some mental problem, and was an airline bigot. And also why. Ditto if her mate had been killed on the space shuttle and she was going on and on about how they didn't know what danger they were in (rather like MacAuliffe's husband did--- but hey, it WAS the *&%$ing SPACE SHUTTLE. If the thing wasn't dangerous there'd be no point admiring the people who ride it). Such people who cannot tolerate or understand risk do exist, and they are obviously politically effective. They're responsible for you having to take your shoes off at all airports. They grounded the shuttle for years, and would have it grounded now if it weren't up there already (and would keep it up there until it was proved safe and effective, except there's the little problem of life expectany if nobody does anything, which is what these people really desire out of life-- to keep anybody from doing anything interesting). But the problem in life is that LIFE is not perfectly safe. And some people aren't very safe, just sitting there breathing. If you happen to have heart disease and/or several risk factors for it, from diabetes to male gender to hypertension to high cholesterol, your life expectancy is shortened. In that case, it may well be lengthened by taking one of the statins, and studies do indicate this. However, as you subtract risk factors, the case for taking any of these drugs becomes less and less clear, until finally you get to a gray area where the answer to whether it is safer to take the drug or not to take it, is simply unknown. At that point, we need to stop and simply say that. However, this issue has gotten polarized. Sharon is claiming mental side effect rates for statins that they manifestly do not have, and when confronted with this, merely says that her husband's side effect rate was 100%. That's nutty thinking. We have people pointing out that statins haven't been shown to save lives in primary prevention, even though they must know the studies this judgement is based on, were deliberately stopped at secondary endpoints before this primary endpoint could be reached, so *by study design* it has been, and still is, impossible to *show* that statins save lives in primary prevention, even if they did. You can't handicap a drug and then claim it doesn't work. Even some medical publications are crazy. I am looking at British Columbia U therapeutics letter (yes, medical moroons from Canada, again-- maybe even some you know) which argues that even though there is an absolute 1.8% reduction in stroke and MI in 2 primary prevention trials, there is no reduction in the 44% "serious side effect rate," so that something might be "making up for" the stroke and MI. Duh. Do I have to point out to you that if these drugs had a 44% rate of any side effect at all *comparable* to a stroke or heart attack, that they wouldn't sell *at all,* let alone be a multibillion dollar industry? No? Thus, apples and oranges are being compared, and health professionals are doing it (albeit Canadian ones). And anybody standing in their way is labeled as a pharmacy shill. > Zee has many doctor friends she has dinner with and they just node their > heads in a patronizing manner every time she gets on a tirade. COMMENT: So? I too have had dinners with crazy people without telling them how crazy they were. Haven't we all? But this here (sci.med) is a different venue, and lives are at stake. Here, I call them as I see them, and you get no social credit for saying things that may well get somebody dead before their time. I'm going to call you on it, and if you disagree, you can get out your stats. But you'll probably lose. And if you win, you'll get to see me change my mind in public, as I did about many aspects of HRT. If you aren't a bigot, you are capable of changing your mind when faced with the evidence. If you ARE a bigot (bei Gott--person who thinks god is on their side and is intolerant of any but their own unreasoning and prejudiced opinion), it doesn't matter what evidence you're faced with. COMMENT: > I don't have a lot of doctor friends and don't want any. Another bigot. Shrug. Your loss if you automatically dismiss any class of people whatever. SBH Robert wrote: > I am in awe of the respect you garnish from Zee and others. COMMENT: Huh? Let's face it. They are afraid of you. > If I had said > sharon was bigoted or anything like that I would and have been branded as > insensitive, uncaring, drug pushing a.shole. COMMENT: Not if were true. If Sharon's husband had died in a airliner crash and her _cause célèbre_ was the supposed incompetence and unsafety of all Agree with the rest below that. COMMENT: > I don't have a lot of doctor friends and don't want any. Another bigot. Shrug. Your loss if you automatically dismiss any class of people whatever. Well Steve, at work I would not be able to call you Steve. It would be Dr Harris. It's that way for a reason. I agree with the medical issues you present. Let's just say it's not a fair playing field when it comes to doctors and other professionals. I can't tell you the amount of abuse we take from the doctors for no reason at all. Often the only reason is patient care mistakes by doctors trying to cover their a.s by having them blame everyone else. You want to hear childish rants over the phone? Doctor A orders a stent placed in a patient and nobody orders a CBC. A post procedure CBC was done because of complications and the platelet count was 10 K. He tells the nurse verbally to order followup labs she has trouble understanding because of the strong accent and infuse platelets only after the labs are drawn and she calls us to clarify the orders. There isn't anything written down. We call him and he does not return our calls. Four hours later he calls after my page and tells me I will be held personally responsible if that patient dies because I caused the delay and screams it over the phone before I get in one single question about what labs he wanted. It was a platelet antibody panel and not an antibody screen or HLA typed platelets. The patient refused to have an infusion after all of that. Let me tell you something straight up. I have never seen a doctor talk to the pathologist in charge with a raised voice or foul language the way they talk to other lab people. Never happens. We are hospital employees and doctors are not. The hospital needs doctors to bring in their patients. The more patients the doctor brings into the hospital the bigger the prima dona he is. The doctor fraternity is pretty unique and not all that palatable as the divorce rate is pretty high for them. The only other profession I can compare it to is law enforcement cops. They carry their guns around like doctors with beepers. That's why it's rough having doctor friends. I don't have to tell you what the toll is and price of being a doctor. > I am in awe of the respect you garnish from Zee and others. COMMENT: Huh? > If I had said > sharon was bigoted or anything like that I would and have been branded as > insensitive, uncaring, drug pushing a.shole. COMMENT: Not if were true. If Sharon's husband had died in a airliner crash and her _cause célèbre_ was the supposed incompetence and unsafety of all airliners (or even Pan Am -- pick your subset), it would be obvious to you that she had some mental problem, and was an airline bigot. And also why. Ditto if her mate had been killed on the space shuttle and she was going on and on about how they didn't know what danger they were in (rather like MacAuliffe's husband did--- but hey, it WAS the *&%$ing SPACE SHUTTLE. If the thing wasn't dangerous there'd be no point admiring the people who ride it). Such people who cannot tolerate or understand risk do exist, and they are obviously politically effective. They're responsible for you having to take your shoes off at all airports. They grounded the shuttle for years, and would have it grounded now if it weren't up there already (and would keep it up there until it was proved safe and effective, except there's the little problem of life expectany if nobody does anything, which is what these people really desire out of life-- to keep anybody from doing anything interesting). But the problem in life is that LIFE is not perfectly safe. And some people aren't very safe, just sitting there breathing (like the folks on the shuttle). If you happen to have heart disease and/or several risk factors for it, from diabetes to male gender to hypertension to high cholesterol, your life expectancy is shortened. In that case, it may well be lengthened by taking one of the statins, and studies do indicate this. However, as you subtract risk factors, the case for taking any of these drugs becomes less and less clear, until finally you get to a gray area where the answer to whether it is safer to take the drug or not to take it, is simply unknown. At that point, we need to stop and simply say that. However, this issue has gotten polarized. Sharon is claiming mental side effect rates for statins that they manifestly do not have, and when confronted with this, merely says that her husband's side effect rate was 100%. That's nutty thinking. We have people pointing out that statins haven't been shown to save lives in primary prevention, even though they must know the studies this judgement is based on, were deliberately stopped at secondary endpoints before this primary endpoint could be reached, so *by study design* it has been, and still is, impossible to *show* that statins save lives in primary prevention, even if they did. You can't handicap a drug and then claim it doesn't work. Even some medical publications are crazy. I am looking at British Columbia U therapeutics letter (yes, medical moroons from Canada, again-- maybe even some you know) which argues that even though there is an absolute 1.8% reduction in stroke and MI in 2 primary prevention trials, there is no reduction in the 44% "serious side effect rate," so that something might be "making up for" the stroke and MI. Duh. Do I have to point out to you that if these drugs had a 44% rate of any side effect at all *comparable* to a stroke or heart attack, that they wouldn't sell *at all,* let alone be a multibillion dollar industry? No? Thus, apples and oranges are being compared, and health professionals are doing it (albeit Canadian ones). And anybody standing in their way is labeled as a pharmacy shill. > Zee has many doctor friends she has dinner with and they just node their > heads in a patronizing manner every time she gets on a tirade. COMMENT: So? I too have had dinners with crazy people without telling them how crazy they were. Haven't we all? But this here (sci.med) is a different venue, and lives are at stake. Here, I call them as I see them, and you get no social credit for saying things that may well get somebody dead before their time. I'm going to call you on it, and if you disagree, you can get out your stats. But you'll probably lose. And if you win, you'll get to see me change my mind in public, as I did about many aspects of HRT. If you aren't a bigot, you are capable of changing your mind when faced with the evidence. If you ARE a bigot (bei Gott--person who thinks god is on their side and is intolerant of any but their own unreasoning and prejudiced opinion), it doesn't matter what evidence you're faced with. COMMENT: > I don't have a lot of doctor friends and don't want any. Another bigot. Shrug. Your loss if you automatically dismiss any class of people whatever. SBH Simple question: Have you finally stopped beating your wife? Yes or no? >>>>>>>> Low cholesterol level is just one of the heart's desires >>>>>>>> By Dr. John abramson [quoted text clipped - 341 lines] >>>>>> >>>>>>> Bill > Simple question: > > Have you finally stopped beating your wife? Yes or no? The premise of your question is false. So it can not be answered. Why do you continue to refuse to answer: > "Did the original article say that it helped 1/4 of the people. Yes or no." > > It is a simple question. Do Statins ever do anyone any good in any circumstances? Bill >>>>>>>>> Low cholesterol level is just one of the heart's desires >>>>>>>>> By Dr. John abramson [quoted text clipped - 331 lines] >>>>>>> >>>>>>>> Bill The premise of your question is false, and you are asking it of the wrong person. The "Have you stopped beating your wife? Yes or No" question is another perfect example of a loaded question. Your questions are cut from the same cloth, and have no relevance to the thread. >> Simple question: >> [quoted text clipped - 368 lines] >>>>>>>> >>>>>>>>> Bill > The premise of your question is false, and you are asking it of the wrong > person. What premise is false? Be precise. I asked >> "Did the original article say that it helped 1/4 of the people. Yes or >> no." The only premise is that there is an original article. And the relevance to the thread is obvious to anyone. The question is "Is the inverse of the subject line true." Why don't you just answer the question? It appears to be true that you are unable to say anything good about statins in any circumstance. > The "Have you stopped beating your wife? Yes or No" question is another > perfect example of a loaded question. [quoted text clipped - 368 lines] >>>>>>>>> >>>>>>>>>> Bill > >>>>>> Low cholesterol level is just one of the heart's desires > >>>>>> By Dr. John abramson [quoted text clipped - 280 lines] > inflicting it on new patients, and an obligation to treat those patients who > have already been harmed to a cure, and restore their quality of life. Sharon, Great post. I enjoyed reading it. I still wonder which of the advocates of statins are employees of statin companies or Public Relations companies working for statin companies. I don't think that the advocates of statins will "get it" until after they become the victims of statins. Keep up the great work. Jason SignatureNEWSGROUP SUBSCRIBERS MOTTO We respect those subscribers that ask for advice or provide advice. We do NOT respect the subscribers that enjoy criticizing people. >> >>>>>> Low cholesterol level is just one of the heart's desires >> >>>>>> By Dr. John abramson [quoted text clipped - 367 lines] > Keep up the great work. > Jason actually..and maybe nobody cares!! I agree that statins are overprescribed I argue this point a lot with my sister who works in cardiac rehab...but we have different perspectives...as I tend to think "prevention" and she (obviously) thinks "treatment" as ALL the folks she deals with..of all ages..HAVE already had a cardiac event... Seeing things (professionally) from two different avenues of experience..obviously.. can influence one's thinking... My "own" doctor does have himself on statins..he is about 54 and has hereditary high lipids..he is thin...eats correctly and is an exercise nut...he ALSO got myopathy from his first statin (not sure which one)..so took himself off..and later tried another..and has no AE on it... Ironically...he feels my hubby's LDL of 102 is "OK"..but hubby's cardiologist wants it around 70...go figure... > NEWSGROUP SUBSCRIBERS MOTTO > We respect those subscribers that ask for advice or provide advice. > We do NOT respect the subscribers that enjoy criticizing people. > But about three-quarters of people taking statins don't have > heart disease. For these people, especially women, there is no evidence > these drugs reduce heart disease or prolong life. > > None. Zilch. That's hard to believe, especially coming some someone selling a book on the topic. I wonder if he published anything that was peer reviewed. There's http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=1079844 which says: "Conclusion: ...among the many different types of high-risk individual studied, simvastatin 40 mg daily consistently produced substantial reductions in vascular (and, hence, all-cause) mortality, as well as in the rates of non-fatal heart attacks, strokes and revascularisation procedures." Anyway, cholesterol clogs arteries and statins lower cholesterol, right? That alone equates to more than "zilch" evidence that statins can prevent future heart disease among currently healthy people. > ...if > you read closely, you'll find that none of the studies provides > significant evidence that statins are beneficial for healthy women. > In fact, a study published in the Journal of the American Medical > Association showed that elevated cholesterol does not significantly > increase healthy women's risk of heart disease or overall mortality. Not significantly isn't zilch, but what studies is he talking about? Do I have to buy his book to find out? > > But about three-quarters of people taking statins don't have > > heart disease. For these people, especially women, there is no evidence [quoted text clipped - 4 lines] > That's hard to believe, especially coming some someone selling a book > on the topic. I wonder if he published anything that was peer reviewed. I would guess that Harvard profs have to publish. so what? Do you have anything to say based on his content or do you think I should ask about your pubs, first? > There's > http://www.pubmedcentral.gov/articlerender.fcgi?tool=pmcentrez&artid=1079844 [quoted text clipped - 5 lines] > vascular (and, hence, all-cause) mortality, as well as in the rates of > non-fatal heart attacks, strokes and revascularisation procedures." your reference started with "20,536 UK adults (aged 40-80 years) with vascular disease or diabetes". quote from zee's post "About one-quarter of the people currently taking a cholesterol-lowering drug already have heart disease or diabetes. For these folks, there is general agreement that statins reduce the risk of further heart disease and, at least for men, decrease the risk of death from heart disease." You left out the rest of the conclusion of the UK study: "These findings, which are based on large numbers of deaths and non-fatal cancers, provide considerable reassurance that lowering total cholesterol concentrations by more than 1 mmol/L for an average of 5 years does not produce adverse effects on non-vascular mortality or cancer incidence." IWO there was no benefit to be claimed in other than the high risk group. It didn't hurt them. your reference is in line with zee's post. You have made no point at all. > Anyway, cholesterol clogs arteries and statins lower cholesterol, > right? That alone equates to more than "zilch" evidence that statins > can prevent future heart disease among currently healthy people. " But about three-quarters of people taking statins don't have heart disease. For these people, especially women, there is no evidence these drugs reduce heart disease or prolong life. None. Zilch." quote from zee's post The zilch is for the three quarters, non-zilch is for the one quarter. Did you really not follow that? > > ...if > > you read closely, you'll find that none of the studies provides [quoted text clipped - 6 lines] > Not significantly isn't zilch, but what studies is he talking about? Do > I have to buy his book to find out? Maybe you can find his book in a library. 'not significantly' refers to the statistical test, not a subjective judgement. It means that the result didn't show *any* benefit beyond what might be statistical fluctuation. No, it didn't prove that there was a small benefit, nor did it prove the benefit is zero. That JAMA study didn't show *any* increased risk for women with elevated cholesterol. That doesn't that the increased risk is zero, but (maybe) that the test wasn't strong enough (I'll leave that detail go for now). (If I botched that explan., I'll get help shortly but I think get a C at least.) > your reference started with > "20,536 UK adults (aged 40-80 years) with vascular disease or [quoted text clipped - 6 lines] > that statins reduce the risk of further heart disease and, at least > for men, decrease the risk of death from heart disease." The conclusion from my reference said "among the many different types of high-risk individual studied..." I wonder what "many different types" refers to. > You left out the rest of the conclusion of the UK study: > "These findings, which are based on large numbers of deaths and [quoted text clipped - 5 lines] > IWO there was no benefit to be claimed in other than the high risk > group. I don't think that's what "the rest of the conclusion" that you quoted says. > > Anyway, cholesterol clogs arteries and statins lower cholesterol, > > right? That alone equates to more than "zilch" evidence that statins [quoted text clipped - 9 lines] > The zilch is for the three quarters, non-zilch is for the one quarter. > Did you really not follow that? I don't think statins lower cholesterol only for unhealthy people, and I think lowering cholesterol helps prevent clogged arteries for everyone. Sick people more likely to be given medication, so maybe that's why there's more evidence about how sick people are helped by it. The fact the statins lower cholesterol is evidence to me that they can help every group of people prevent heart disease. The absence of further evidence doesn't take away from that. If there are studies that say otherwise, I haven't heard of them. > 'not significantly' refers to the statistical test, not a subjective > judgement. It means that the result didn't show *any* benefit beyond > what might be statistical fluctuation. I have no clue what his use of "not significantly" meant or whether it was accurate because I still haven't seen a reference. Help every group of people prevent heart disease? Not according to the facts on Therapeutic Initiatives: "Do statins have a role in primary prevention?" This cardiovascular benefit is not reflected in 2 measures of overall health impact, total mortality and total serious adverse events. Therefore, statins have not been shown to provide an overall health benefit in primary prevention trials." http://www.ti.ubc.ca/pages/letter.html Your reference doesn't contradict what I said. The complete conclusions from the "theraputics letter" at http://www.ti.ubc.ca/PDF/48.pdf are: -------------------------- Conclusions: If cardiovascular serious adverse events are viewed in isolation, 71 primary prevention patients with cardiovascular risk factors have to be treated with a statin for 3 to 5 years to prevent one myocardial infarction or stroke. This cardiovascular benefit is not reflected in 2 measures of overall health impact, total mortality and total serious adverse events. Therefore, statins have not been shown to provide an overall health benefit in primary prevention trials. -------------------------- "Cardiovascular serious adverse events" were reduced, though there might be some side effect because "measures of overall health impact, total mortality and total serious adverse events" didn't reflect a benefit. I'd still like to see the "six major clinical studies" that Dr. John Abramson claims don't provide "significant evidence that statins are beneficial for healthy women." > Your reference doesn't contradict what I said. The complete conclusions > from the "theraputics letter" at http://www.ti.ubc.ca/PDF/48.pdf are: [quoted text clipped - 22 lines] > Abramson claims don't provide "significant evidence that statins are > beneficial for healthy women." That sounds like an worthy research project. Let us know what you come up with. Here's Therapeutics Initiative on statins for women, for Letter #48. Of interest, Therapeutics Initiative head James Wright is a member of the Cochrane Collaboration. CC will soon be bringing out their evidence based study on statins. http://www.ti.ubc.ca/pages/letter48.htm "A question to us about Letter #48: What is the evidence of benefit for primary prevention in women? There were 10,990 women in the primary prevention trials (28% of the total). Only coronary events were reported for women, but when these were pooled they were not reduced by statin therapy, RR 0.98 [0.85-1.12]. Thus the coronary benefit in primary prevention trials appears to be limited to men, RR 0.74 [0.68-0.81], ARR 2.0%, NNT 50 for 3 to 5 years." > Your reference doesn't contradict what I said. The complete conclusions > from the "theraputics letter" at http://www.ti.ubc.ca/PDF/48.pdf are: [quoted text clipped - 22 lines] > Abramson claims don't provide "significant evidence that statins are > beneficial for healthy women." 48 and 49 or of import Barry. No Contra indication. Bill who was a 49 kind of guy till the pain outweighed the risk. http://www.ti.ubc.ca/PDF/48.pdf http://www.ti.ubc.ca/PDF/49.pdf Bill SignatureGarden Shade Zone 5 in a Japanese Jungle manner. FAIR USE NOTICE: This may contain copyrighted (© ) material the use of which has not always been specifically authorized by the copyright owner. Such material is made available for educational purposes, to advance understanding of human rights, democracy, scientific, moral, ethical, and social justice issues, etc. It is believed that this constitutes a 'fair use' of any such copyrighted material as provided for in Title 17 U.S.C. section 107 of the US Copyright Law. This material is distributed without profit. > 48 and 49 or of import Barry. No Contra indication. Bill who was a 49 > kind of guy till the pain outweighed the risk. > http://www.ti.ubc.ca/PDF/48.pdf > http://www.ti.ubc.ca/PDF/49.pdf A better article to look at is probably Cardiol Clin. 2003 Aug;21(3):393-8 (Report of the Adult Treatment Panel III: the 2001 National Cholesterol Education Program guidelines on the detection, evaluation and treatment of elevated cholesterol in adults). The abstract is at: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=1 4621453&dopt=Abstract It claims to be "more tightly evidence-based than previous reports." Unfortunately, I can't access the full text. Here are the conclusions from the webpages you mentioned: ------------------ Conclusions from http://www.ti.ubc.ca/PDF/48.pdf: If cardiovascular serious adverse events are viewed in isolation, 71 primary prevention patients with cardiovascular risk factors have to be treated with a statin for 3 to 5 years to prevent one myocardial infarction or stroke. This cardiovascular benefit is not reflected in 2 measures of overall health impact, total mortality and total serious adverse events. Therefore, statins have not been shown to provide an overall health benefit in primary prevention trials. ------------------ ------------------ Conclusions from http://www.ti.ubc.ca/PDF/49.pdf: Statins provide a cardiovascular and total mortality benefit for patients with clinically evident occlusive vascular disease (secondary prevention) and a cholesterol of >3.5 mM. Large RCTs are required to test different statin dosing strategies for secondary prevention before making firm recommendations. ------------------ Also mentioned was http://www.ti.ubc.ca/pages/letter48.htm : ------------------ A question to us about Letter #48: What is the evidence of benefit for primary prevention in women? There were 10,990 women in the primary prevention trials (28% of the total). Only coronary events were reported for women, but when these were pooled they were not reduced by statin therapy, RR 0.98 [0.85-1.12]. Thus the coronary benefit in primary prevention trials appears to be limited to men, RR 0.74 [0.68-0.81], ARR 2.0%, NNT 50 for 3 to 5 years. ------------------ I still don't see evidence for what the top post says: "about three-quarters of people taking statins don't have heart disease. For these people, especially women, there is no evidence these drugs reduce heart disease or prolong life. None. Zilch." For woman, maybe there's some evidence to support the "zilch" statement (if you believe The Therapeutics Initiative), but I don't see it applying to men. I just searched letter 48 at http://www.ti.ubc.ca/PDF/48.pdf and the only reference to women is in a footnote referencing an article titled: "Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels" That article is from JAMA. 1998 May 27;279(20):1615-22, and says "These findings...suggest the need for reassessment of the National Cholesterol Education Program guidelines regarding pharmacological intervention." My Cardiol Clin. reference in my first paragraph sounds like reassessment of an even later version of the National Cholesterol Education Program guidelines. That JAMA article is way out of date. Anyway, it's not surprising to me that a statistically significant benefit to taking statins hasn't been found yet for women who don't even have high cholesterol. I was thinking of people with high cholesterol who don't have heart disease. According to the top post to this thread, there's no evidence that statins prevent heart disease if all he or she has is high cholesterol. I still say that the fact that statins lower cholesterol is evidence, and I still know of no evidence to the contrary. >> 48 and 49 or of import Barry. No Contra indication. Bill who was a 49 >> kind of guy till the pain outweighed the risk. [quoted text clipped - 11 lines] > It claims to be "more tightly evidence-based than previous reports." > Unfortunately, I can't access the full text. Suggestion: If you politely Email the author (Email and snail mail addresses are given) he may well Email you back a copy. Or if you send a snail mail, his secretary will probably put one in an envelope and send it to you. (They probably have a stack of them.) However, I think the guidelines have changed with the optional below 70% LDL now in play. Bill > Your reference doesn't contradict what I said. The complete conclusions > from the "theraputics letter" at http://www.ti.ubc.ca/PDF/48.pdf are: [quoted text clipped - 18 lines] > total mortality and total serious adverse events" didn't reflect a > benefit. COMMENT: Less than optimal thinking on that last paragraph. Total mortality *can't* be reduced in any trial which you stop prematurely, on ethical grounds, when you just reach statistical significance for life-threatening events. Do you see why this must be so? This is a negative finding which doesn't count, because they'd rigged the study design so that they can't find it, even if it exists. The second measure of overall health impact is "serious adverse events", which they counted so losely as to have it come out at 44% of people taking the drug. If the adverse event is as serious as a stroke or heart attack, 44% of people couldn't have it and have the drug still be on the market (dropout rate is typically 2% in such trial, similar to placebo--- does that sound as bad as the effects of a stroke or MI to you?). On the other hand, if adverse things counted here *aren't* nearly as serious as stroke or heart attack, then they shouldn't be compared with stroke or MI directly as "health measures." Which is what is being done here, in effect. One way or the other, somebody hasn't thought this through. SBH > You left out the rest of the conclusion of the UK study: > "These findings, which are based on large numbers of deaths and [quoted text clipped - 8 lines] > your reference is in line with zee's post. > You have made no point at all. COMMENT: Look, there IS evidence of prevention of strokes and MIs by statins in several primary trials. It's small, but it's statistically there, and in that sense, is real. About all you can really do about it is argue that it's not worth the money, or is counteracted by side effects--- not that it doesn't exist. Some have tried to argue that it exists but isn't important, that mortality isn't influenced, so that maybe statins are killing people by other mechanisms to make up for the lives saved in stroke and MI. I don't think anybody really believes that, looking at the mortality data from the very large secondary trials. If extra mortality from other causes was there, we'd see it THERE. We don't, as you yourself recognize. And we all know the primary trials were stopped early, so as to make this kind of mortality finding impossible to generate, even if it existed. I think that's sufficient for that argument. You CAN play the game of arguing that that the strokes and MIs in primary prevention aren't worth the MONEY and TIME and BOTHER. At least that's HONEST. It's also a valid argument on an individual basis (how much is YOUR time and money worth, vs a tiny risk-- only you can say), but it's one that socialists perhaps cannot come to grips with. If you're a socialist, your whole society has to come to some democratic decision on how much money and bother a few months of your life is worth. The idea that you might want to attempt such a judgement *yourself* makes many Europeans and Canadians dizzy. Their mental circuit breakers then blow, and they are required to make a virtue of necessity, if there's some reason they have no access to statins, or for some reason cannot take them. Finally, if you can't admit that perhaps MIs and strokes CAN be prevented in those majority of people who are taking them as a result of primary risk factors only (albeit at high cost), then there's only one place for you to run: the argument that side effects are so bad with statins that they're just as sick taking them (on average) as if they went ahead with their slightly larger risk of stroke and MI. We've seen this argument here. I've criticised it. The reduction in stoke and MI is on the order of 1 or 2%, and there's no evidence from any statin study of side effects as bad as a stroke or MI, at anything like that rate. Indeed, dropout rates are 2% typically in primary studies, and that looks like placebo dropout rates, and isn't significantly different from it. If we had *another* 1% or 2% of people having problems as bad as stroke or MI from their statin, WHERE ARE THEY? Dying of myopathy and dementia in institutions, but refusing to stop their pills, we're told. And not getting their data into the study side effect profile rates.... Say what? Having seen the dropout rate and compliance rate for blood pressure pills and diabetes meds, for side effects far less distressing than dementia and total asthenia, all I can say to such arguments, is that I've got a bridge in Brooklyn to sell ya. In short, I'm tired of the "I took statin pills still I looked like Stephen Hawking, but I could not stop" story. Sharon tells it well, but we've heard it. It doesn't work that way for any other primary preventive drug. For any other class of preventive medication or therapy, people quit their pills (or anything else they're doing in prevention) at the *least* excuse, when they don't feel well. If I had a nickel for every diabetic who told me they stopped their shots because they didn't feel good, I could retire. Statins are not NSAIDS or HRTs, where actual and tangible short-term benefits arguably might have blinded people to long-term problems with health caused by them. But we're told that the statin story is essentially the same one. Why? Why are we to think people are welded to *this* particular class of preventive, unlike any other in the history of medicine? I dunno. I rather doubt that statins are physically addictive or dependence-causing, and yet one cannot reconcile their continued very wide use and reported very wide spectrum of side effects, otherwise. :) Something certainly smells, there. You know where *I* think the truth problem is. SBH >You CAN play the game of arguing that that the strokes and MIs in >primary prevention aren't worth the MONEY and TIME and BOTHER. At least [quoted text clipped - 8 lines] >necessity, if there's some reason they have no access to statins, or >for some reason cannot take them. Again, you're setting up an evil "socialist" straw man. Do you have any evidence that Canadians are deprived of statins because of their government? I think you'll find that very much the same drugs are approved in Canada as in the US, and as in the US any doctor can prescribe any approved drug. Probably a larger fraction of Canadians have access to prescription drugs, because lower income people may have their drug costs subsidized. As in the US most people have private insurance plans through their employers to cover some of the cost of prescription drugs. Of course, any legally competent adult can make the decision not to seek health care or take prescribed drugs. I won't describe how prescription drug costs are subsidized because you clearly aren't interested in facts that contradict your concept of demonic nanny governments killing their citizens for their own good by making health care available to them whether they can individually afford it or not. Note also that the same drugs are generally cheaper, sometimes much cheaper, in Canada and Europe, than in the US. The pharmaceutical companies have made the business decision to sell to a larger market at a lower profit per sale. That's the free market for you. > >You CAN play the game of arguing that that the strokes and MIs in > >primary prevention aren't worth the MONEY and TIME and BOTHER. At least [quoted text clipped - 12 lines] > any evidence that Canadians are deprived of statins because of their > government? They are deprived of free choice in deciding if they want to be a member of the Canadian system or not. They have outlawyed alternative systems. Not only is that evil but in the long run as most socialist systems have proven to have no longivity and become bankrupt. Public ownernship in Canada was not new when everything was under the government. They learned that the welare state does not deal with economic problems. It robs initiative and responsibility. I would suggest the program by PBS, "Heaven on Earth, the raise and fall of Socialism". It mentions Canada, the CCF and the start of the medical system. > I think you'll find that very much the same drugs are approved in > Canada as in the US, and as in the US any doctor can prescribe any [quoted text clipped - 4 lines] > drugs. Of course, any legally competent adult can make the decision > not to seek health care or take prescribed drugs. It is not legal to have alternatives so how can they have alternatives? > I won't describe how prescription drug costs are subsidized because you > clearly aren't interested in facts that contradict your concept of > demonic nanny governments killing their citizens for their own good by > making health care available to them whether they can individually > afford it or not. So it is morally acceptable to you that people be allowed to die while waiting in order to make health care affordable to all? You are morally bankrupt. The Canadian Supreme Court found otherwise. > Note also that the same drugs are generally cheaper, sometimes much > cheaper, in Canada and Europe, than in the US. The pharmaceutical > companies have made the business decision to sell to a larger market at > a lower profit per sale. That's the free market for you. Let's see here. Canada has cheaper heart surgeries by 80% and the cost for drugs is about half? Why is Canada having problems then? Your system has become something Canadian's have said they hated about the US system, one based on money. I say people are dying up there and living in pain and you say it is cheaper there. The Canadian health system is not a free market so I don't know what you are talking about. |
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