The story was about the UK, but I doubt the situation is much different on this side of the Atlantic. Five medicines is a lot, folks! Isn’t it time to re-evaluate? Anyway, that’s the gist of today’s story.
It reminded me of the study earlier this year that was headlined with the words,
Statins save fewer lives than exercising and eating sensibly, say scientists
So, I thought I would delve into it further and connect the two stories. What I found kinda surprised me, but I suppose all that says is I’m really still naive enough to trust the people I think are the good guys.
Note to self: Trust no one. Check the facts. Recheck the facts.
Now, first off, I gotta admit that headline pissed me off once I read the actual journal article. So, please don’t get me wrong; I’m no lover of statins, believe me, and my purpose is not to defend them. But, my love of the truth exceeds my hate for big pharma and the entire bunch of lying, cheating parasites that feed off of and contribute to our current health crisis.
Just the facts, please
It’s the headline, dammit! The scientists didn’t say that: it isn’t in the press release and that’s not what the research showed.
The research was about using mathematic modeling within the context of making certain assumptions about risk factors and treatment uptakes and how they affected people in different socio-economic classes. The model apportioned the number of coronary heart disease deaths prevented or postponed (DPP) in England between 2000 and 2007 by dividing them between medications and lifestyle changes.
So what’s the problem with that?
To conclude from this study that “statins save fewer lives than exercising and eating sensibly” would be wrong because the apportionment depends on the probabilities entered into the modeling program. Those probabilities were derived from other studies and simply entered into the mathematical model.’
To be clear, to arrive at that conclusion based on this study is wrong because it essentially would be a case of assuming that which you wanted to prove. That’s not OK. It’s simply a lie to say this study shows that, and I seriously doubt that the scientists would say that. I find that statement nowhere in the press release. The press release simply compared the effects among the wealthy versus the poor:
The impact of statins was greatest among the most affluent in the population, suggesting that these drugs have helped maintain health inequalities between rich and poor, say the researchers.
The researchers wanted to quantify the contributions made by drug treatment (primary prevention) and changes in population risk factors (blood pressure and total cholesterol) to the falling rates of coronary heart disease deaths, stratified by socioeconomic background.
They used trial data, analyses of published evidence, national surveys, and official statistics to calculate the number of deaths postponed or prevented across the population of England.
The analysis showed that between 2000 and 2007 deaths from coronary heart disease fell by 38,000, of which 20,400 lives were saved as a direct result of reductions in blood pressure and total cholesterol.
In absolute terms, a higher proportion of lives were saved among the least affluent sectors of the population, which is to be expected given their much higher prevalence of risk factors, say the researchers.
The substantial fall in blood pressure accounted for well over half of the total, the calculations indicated, with around 13,000 deaths prevented or postponed.
But only a small proportion (1800) of these were attributable to drug treatment, with the rest accounted for by changes in risk factors at the population level.
Falls in blood pressure prevented almost twice as many deaths among the population’s poorest as among the richest.
Falls in total cholesterol accounted for some 7400 deaths prevented or postponed, of which (5300 or 14% of the total) were attributable to statins, with the remainder attributable to changes in risk factors at the population level.
Statins prevented almost 50% more deaths among the richest compared with the poorest, whereas changes at the population level prevented three times as many deaths among the poorest as among the richest.
So, is that your only point?
No! the lead paragraph in that same UK article from earlier this year also left me dissatisfied:
Researchers discovered that the wonder pills, taken by around seven million people in Britain, save around 750 lives a years by preventing fatal heart attacks and strokes.
Seven million people treated in order to save 750 lives? So your chance of winning this lottery is one in 10,000? While in the meantime, your chance of losing in the lottery, from just one, single, solitary side effect is 1 in 10 for myopathy (muscle weakness)? Doesn’t sound like a win to me for anyone but the drug companies.
But not so fast there. How did they get that 750 number? Well that’s why I bolded the phrase in the press release, “5300 or 14% of the total“. It took me a while to figure it out, but what they did was divide the total number of postponed deaths, 5300, by the 7 years of the study. This could be considered legit as it creates an annual rate, but it also has the effect of making the statins look even more pathetic than they really are. Because, in reality, you get a new chance to win that 750 person lottery for each and every year you are on the statins. And your chances increase for every year you age. And meanwhile, the vast majority of the people that are going to experience muscle weakness were weeded out in the 1st 3 months of usage.
But that’s minor compared to what really tells me they were trying to put a spin on this. Here’s how the numbers break down:
So where did they get 14% from? It took me a while to figure that out too.
In order to get that 14% number, they divided the total DPP (line 1), 38000, by total attributable to the cholesterol lowering due to statins (line 3), 5300. But the 38000 number includes the other category (line 4) which certainly must include DPPs due to reduced inflammation which is greatly facilitated by statins! So, in the press release, they don’t say which total they are talking about and they are actually comparing apples and, well, apples, oranges, bananas, cherries, papaya … You get it, right?
So these categories were created in a way such that they would obfuscate some of the benefit of statins. I’m not saying it was a deliberate obfuscation. Maybe it was,; maybe it wasn’t. But the effect is there, nevertheless. That third category in line 4 is huge! Almost half the total! Not only that, the primary benefit of statins is said to be in lowering inflammation, not in reducing cholesterol. So, a good chunk of those 17,600 DPPs belong to statins, also thanks to it’s anti-inflammatory effect.
See why it’s so hard to make sense out of medical research?
Where do I stand on all of this?
The truth is that if you are more interested in maintaining your health than in sitting on the couch and having a “party in your mouth”, as Oprah would say, there is no doubt that lifestyle changes beat the meds hands down. You just have to be willing to do whatever it takes.
But this study won’t prove that. And, I don’t condone lying even in the service of ultimate truth.
So if you are in that group that might be taking more meds than is optimal, replacing statins with lifestyle changes might be the change to consider.