I had a couple of interesting items land in my inbox recently. One was an article about an analysis of statin trials. Specifically, the investigators (who reported their findings in the British Medical Journal) looked at the statistics on all-cause mortality.
That, of course, is the figure that matters – or should matter – more than any other. It’s also a figure the makers of statins don’t like to announce. They’d much rather talk about those tiny reductions in heart-attack rates. But if people on statins don’t live any longer on average despite having fewer heart attacks, you ought to be very suspicious. Here’s why:
Suppose I develop a new drug that’s basically rat poison in pill form. Then I conduct a trial in which one group takes the drug and another group takes the placebo. In which group will fewer people die of heart attacks?
The rat-poison group, of course. The poison will kill them before a heart attack can. But if I want to sell my drug, I’d trumpet the reduction in heart-attack deaths.
Anyway, let’s see what the BMJ analysis says about all-cause mortality in statin trials:
6 studies for primary prevention and 5 for secondary prevention with a follow-up between 2.0 and 6.1 years were identified. Death was postponed between −5 and 19 days in primary prevention trials …
I haven’t taken a math class in quite some time, but I’m pretty sure if death is postponed by -5 days, that means the statin-takers died five days sooner. On a positive note, statin-takers lived an average of 19 days longer in one trial.
Well, the statin enthusiasts like to tell us that while statins may not be all that with a side of fries for primary prevention (that is, preventing a first heart attack), they’re just awesome for preventing a second heart attack. So let’s continue.
… and between −10 and 27 days in secondary prevention trials. The median postponement of death for primary and secondary prevention trials were 3.2 and 4.1 days, respectively.
The statin enthusiasts are clearly correct. The results are better for secondary prevention. Compared to primary prevention, death was postponed by nine-tenths of an extra day! That certainly justifies taking a powerful prescription drug with a low incidence of side effects, as the statin-makers assure us.
Which brings us to the second item to land in my inbox. The subject line of the email was New Boob Statins Toxic Side Effects.
Holy crap, I thought, you mean statins cause toxic boobs now too?
Turns out I was confused by a typo. The email was from author and science junkie David Evans, letting me know his new book (not boob) Statins Toxic Side Effects is available.
I told him about my confusion in a reply, and he responded with some links to studies showing that statins probably contribute to man-boobs. That might not be a toxic effect, but it’s not a pretty one, either. (Well, I suppose somewhere in the world there’s a female impersonator who looks better with the statin-induced boobs, but you get my point.)
Anyway, on to the book.
The subtitle is Evidence From 500 Scientific Papers. Yes, 500. On the off chance that you have any lingering doubts whether statins produce nasty side-effects, this book will convince you.
The format is the same as in Evans’ other two books, Low Cholesterol Leads To An Early Death and Cholesterol And Saturated Fat Prevent Heart Disease. (He also has an outstanding blog called Healthy Diets And Science, with a gazillion studies organized by topic.)
The studies are organized into chapters with titles such as The common association between statin use and muscle damage and Statins exacerbate asthma and inhibit lung function and exercise. For each of the 500 studies, there’s a consumer-friendly title written by Evans, a citation so you can look up the study yourself, and a summary of the study’s findings, with occasional commentary by Evans.
Thumbing through this thick book and reading some study summaries, I kept shaking my head, thinking of all the people I know who are on statins because the doctor said so. When my doctor suggested thinking about a statin because of my “elevated” (read: normal) cholesterol, I replied, “I wouldn’t take a statin unless you had a gun to my head and I was convinced you’d pull the trigger.” He didn’t argue.
Chapter 20 provides citations and summaries of articles written by health professionals who dare to question the statins-for-everyone trend. There are titles (again, the consumer-friendly versions by Evans) like UK doctors virtually compelled to write prescriptions for statins against their better judgment and Doctors’ low awareness of statin side-effects.
Chapter 21 is a bullet-point summary of the negative side-effects attributed to statins in studies. It runs on for two-and-half pages. That should tell you everything you need to know about a drug that by gosh might just extend your life for up to four days.
This isn’t, of course, a book you’ll sit down and read for pleasure while nursing a glass of red wine and a side of bacon. It’s a reference that will save you lord-only-know-how-many hours of research on the internet. I’ll be glad it’s on my bookshelf the next time some statin-pushing doctor sends me an email telling me I’ve just GOT to stop scaring people away from those wunnerful, wunnerful life-saving drugs.
You should be scared. Be afraid. Be very afraid.
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