I’ll turn 59 in November. That means in just 15 months, I should start taking a statin. That’s the conclusion of a new study reported in the U.K. Independent online:
Almost every older person should be taking statins, a new study has found. Almost all men over 60 and women over 75 should be taking the drugs, the research found. And more than a third of people between 30 and 84 should be allowed to do so.
Sure, let’s put all older people on statins. Society would really benefit by having more older folks with memory problems and damaged muscles.
The sweeping findings could suggest that GPs will be asked to prescribe the drugs to the majority of their patients, leading to huge strain on doctors.
That was, of course, my first concern as well. Oh my goodness! If we start giving statins to all older people, won’t that be a strain on doctors?!
The research looked to investigate the effects of guidance that was set by the National Institute of Health and Care Excellence (Nice) in 2014. That controversial ruling allowed many more people to receive statin therapy on the NHS, since it suggested that anyone with cardiovascular disease should be given the drug, and anyone with a more than 10 per cent chance of developing it in the next 10 years should take it too.
The latest study, published in the British Journal of General Practice, examined the algorithm endorsed by Nice for the assessment of CVD risk and compared it to data from the 2011 Health Survey for England to estimate the number of people who are eligible for statin therapy under the guidance.
Let me explain how that algorithm works: if you’re a male older than 60 or a woman older than 75 and still have a pulse, statistics say there’s a decent chance you may have a heart attack at some point in the future, so the algorithm says you should be on statins. The actual health of your heart doesn’t figure into it much.
Last month, I admitted that I’m a member of the anti-statin cult that Dr. Steve Nissen (America’s Statinator-In-Chief) blames for scaring people away from these wunnerful, wunnerful, life-saving drugs. So you won’t be surprised that I’m under orders from the cult leaders to explain why guidelines that would put nearly all older people on statins are complete nonsense. (I’m also under orders to smack myself in the head with my t-post hammer if the post doesn’t draw at least a thousand views, but I’m negotiating on that one.)
Advertisements for statins throw out impressive-sounding claims, such as reduces the risk of heart attack by 33 percent! If you didn’t know any better, you’d think a third of the people taking statins are saving themselves from a heart attack.
But of course, that’s not the case. That figure is derived from results like this: in a statin trial lasting some number of years, two of every 100 patients with known heart disease who took the statins had a heart attack, while three of every 100 patients with known heart disease who took a placebo had a heart attack. Two is one-third less than three, so the relative reduction is 33 percent.
But in absolute terms, it means for every 100 patients who took the drug, one was saved from a heart attack. So the number needed to treat (NNT) is 100. That’s the figure that matters.
There’s a site called The NNT that provides exactly those kinds of figures. Here’s what it says on the home page:
We are a group of physicians that have developed a framework and rating system to evaluate therapies based on their patient-important benefits and harms as well as a system to evaluate diagnostics by patient sign, symptom, lab test or study.
We only use the highest quality, evidence-based studies (frequently, but not always Cochrane Reviews), and we accept no outside funding or advertisements.
The b.s. guidelines suggested by the new study say almost everyone over a certain age should be on statins, whether they actually have heart disease or not. Here’s what The NNT tells us about statin trials conducted on people who don’t already have heart disease:
None were helped (life saved)
1 in 104 were helped (preventing heart attack)
Compare the statin groups to the placebo groups, and the combined results say not a single death was prevented by the statins. The statins prevented an average of one non-fatal heart attack for every 104 people who took them for five years.
Wowzers. Doesn’t that make you want to run out and fill that statin prescription as soon as you turn 60?
But wait, let’s not forget to look at the other side of the equation:
1 in 50 were harmed (develop diabetes)
1 in 10 were harmed (muscle damage)
And keep in mind, these figures are mostly from studies published by the makers of statin drugs. In other words, they’re the most positive studies. We don’t know how many studies conducted by Big Pharma were simply dumped because the results were less-than-positive. Here’s what the gang at The NNT says on the subject:
Virtually all of the major statin studies were paid for and conducted by their respective pharmaceutical company. A long history of misrepresentation of data and occasionally fraudulent reporting of data suggests that these results are often much more optimistic than subsequent data produced by researchers and parties that do not have a financial stake in the results.
The combined results of these mostly-positive studies say 10% of the people on statins suffered muscle damage. I’ll bet you dollars to donuts (and you can keep the donuts) the figure in the real world is much higher. When Big Pharma conducts these studies, they screen out patients who report side effects from other drugs. So the population that goes into the study is less likely to experience side effects than the population at large.
But what the heck, let’s suppose the figure is actually the 10% reported in the studies instead of the 25% or greater I suspect we’d find in the real world. And let’s suppose you’re a man 60 or older, or a woman 75 or older, with no previous heart attacks or known heart disease. Let’s put you in a group of 100 of your peers and give you all statins. Here’s what would happen, according to the most positive data Big Pharma can produce:
- One of you will be prevented from having a non-fatal heart attack, but none of you will be prevented from actually dying. (And preventing the one non-fatal heart attack will likely only apply to the men.)
- Two or more of you will develop diabetes you wouldn’t otherwise have had (which increases the odds of heart disease or stroke down the line).
- Ten or more of you will end up with damaged muscles, thus seriously reducing your quality of life.
I think we should ignore this latest edition of the Statins For Everyone! guidelines.
At least that’s what the cult leaders told me to say.