New Cholesterol Guidelines

March 7, 2014 

Latest guidelines advise more people should be using statins and at younger ages. Not so fast. Internationally, doctors are debating this intensely. Count me on the side of the skeptics because there is much to be suspicious of here.

Too many current recommendations are based on flawed data produced in studies commissioned by and for makers of drugs. Research is inherently unsound when it is designed to produce certain results, no matter which prominent names in the field of science are attached: if researchers are taking money from the drug companies, they are by definition biased. Most of the doctors who’ve come together in this paper to advise younger people and those with minimal elevations of cholesterol to take statins directly benefit financially from the giant pharmaceutical companies that make the drugs they are recommending.

What we do know is that statins as a class of drugs (lipitor, mevacor, zocor etc.) are effective in bringing down total cholesterol and LDL’s (one of the bad kinds of fat in the blood). We are also pretty sure that statins can reduce the amount of plaque already formed in some blood vessels and that these actions may stave off disease and death for some people at high risk of vascular disease (heart attack, stroke, etc). But the latest study does not tell us that low risk patients would benefit from using these drugs or at what levels or age they should start. There are poitential harms to using any drug and when your risk of disease is low then the risk of taking the drug is more likely to outweigh the benefit. As many as 23 people would have to take a statin for 10 years to prevent a heart attack in one person. That’s a lot of pills, a lot of side effects and a lot of money for 22 out of those 23 people. As previous blunders have proven before (think vioxx and heart attack as a recent example) drugs are often rushed to market before benefits and safety in widespread use are proven.

My advice: take a statin if your doctor recommends it based on your atherosclerotic disease risk – that is your lipid profile combined with your personal and family history, but don’t go on it just to make your numbers lower. Regardless of whether you would benefit from a statin, keep doing all those other things you are capable of to keep your cholesterol in line. Every personal intervention you can make (weight management, exercise, stop smoking) is better than any drug… in other words, an ounce of prevention is worth…

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