Going Under

[Guest guest]

" HSI - Jenny Thompson " <HSIResearch

HSI e-Alert - Going Under

Thu, 09 Jun 2005 09:38:51 -0400

HSI e-Alert - Going Under

 

Health Sciences Institute e-Alert

****************************************************

June 09, 2005

 

 

Dear Reader,

 

" This is rich. The headline says 'Statin Drugs Underprescribed.' "

 

Arthur Johnson, one of my favorite writers, sent me that comment in an

e-mail that included a news item claiming that doctors are not writing

enough prescriptions for cholesterol-lowering statin drugs.

 

Statin drugs? UNDERprescribed? Could this article be joking? After

all, statins have been the MOST prescribed class of drugs in the U.S.

for more than 15 years. And the leader in this class is Lipitor, with

yearly sales of about $10 billion. (For perspective consider this:

Last year, more than 30 U.S. states had tax revenues less than $10

billion.)

 

But even though it seemed like there should be a punch line, it was no

joke. According to research from Stanford University, U.S. citizens

are suffering from an inadequate intake of statin drugs.

 

-----------

Guy with high cholesterol walks into a bar...

-----------

 

Should we dwell on the finer points of this study? Sure...why not?

Even though the Stanford team isn't joking, it'll still be good for a

laugh or two.

The researchers analyzed data from two large national databases

compiled from medical care surveys. Changes in statin treatment and

current clinical practice were compared for ten years: 1993 to 2002.

 

Results showed that patients at high risk of coronary heart disease

(CHD) who used statin drugs jumped from 14 percent to 50 percent over

the decade. No surprise there; during that ten year stretch, many

millions of advertising dollars were devoted to scaring the lipids out

of nearly everyone by demonizing cholesterol. The number of statin

users with only moderate CHD risk rose from nine to 44 percent during

the same period.

 

Writing in the May 2005 issue of the Public Library of Science

Medicine, the researchers state that, " education should be aimed " at

doctors so they'll " adhere to evidence-based medicine and published

guidelines for cardiovascular risk reduction. "

 

Translation: It's not enough that nearly half of all patients who are

at moderate or high risk of CHD are taking statins. Doctors need to be

" educated. " They need to " adhere. " For goodness sakes, HALF the market

for statin drugs is going unprescribed!

 

Of course, the " published guidelines for cardiovascular risk

reduction " cited by the researchers refers to recommendations from the

medical mainstream. In recent years the recommended ideal LDL

cholesterol level has dropped steadily, creating an expanding pool of

" at risk " patients.

 

If this study sounds a little bit like a sales pitch, that could have

something to do with the fact that it was funded by Merck & Co., the

drug giant that manufactures not one but two brands of statins: Zocor

and Mevacor.

 

-----------

Education reveals all

-----------

 

The Stanford research provides a perfect tunnel vision view of statin

usage. It doesn't take into account the valid reasons why a doctor

might avoid prescribing a statin or a patient might refuse to accept a

prescription.

 

Maybe the doctor wisely disagrees with the concept that LDL should be

pushed to absurdly low levels. Or maybe the patient has liver or

kidney problems - two very good reasons to avoid statin use. Or maybe

the patient has a friend who has experienced muscle pain associated

with statin use - why risk that side effect when there are safe

alternatives to the drug?

 

Or maybe the patient is an HSI member who has come to recognize the

medical mainstream's unsupportable fixation on lowering cholesterol at

any cost.

 

It doesn't seem to have occurred to the Stanford team that there are

doctors and patients out there who avoid statin prescriptions

precisely because they HAVE been educated about the drug.

 

 

****************************************************

 

....and another thing

 

One more note on cholesterol...

 

A new study has associated high cholesterol in elderly subjects with a

lowered risk of dementia.

 

Yes, you read that correctly: lowered risk.

 

A team of U.S. and Swedish researchers analyzed medical data collected

on more than 380 elderly residents of Goteborg, Sweden. Over a period

of nearly two decades, subjects underwent physicals, blood tests,

chest x-rays, EKGs, CT scans and neuropsychiatric examinations.

 

Researchers found that elevated levels of total cholesterol recorded

while subjects were in their early 70s were linked with reduced

dementia risk in their later 70s. Furthermore, elevated total

cholesterol throughout their 70s was associated with reduced dementia

risk throughout their 80s.

 

In an interview with HealthDay News, one member of the U.S. team -

Johns Hopkins researcher Michelle M. Mielke - noted that the results

of the study " raise more questions than they give answers, " and I

agree. Previous studies have shown that high cholesterol may increase

Alzheimer's risk (see the e-Alert " Clear as a Bell " 6/26/02). But

other research in this area has been conflicting.

 

Ms. Mielke added that we can no longer rely on over simplified

answers, " for example, that high cholesterol is always bad and low

cholesterol is always good. "

 

And that brings to mind another simple concept that should not be

relied on: That statin drugs are as universally protective as drug

company sponsored trials might lead us to believe.

 

To Your Good Health,

 

Jenny Thompson

Health Sciences Institute

 

 

 

 

Sources:

" Patterns of Statin Prescribing " Public Library of Science Medicine,

Vol. 2, No. 5, May 2005, medicine.plosjournals.org

" Statin Drugs Underprescribed, U.S. Study Finds " Reuters Health,

5/31/05, reutershealth.com " Could High Cholesterol Ward Off Dementia? "

HealthDay News, 5/24/05, rednova.com

 

******************