crestor

Statins and Your First Heart Attack

March 10, 2015 by James Bogash

IS THIS THE BEGINNING OF THE END OF STATINS (LIPITOR, CRESTOR, ZOCOR, VYTORIN, etc…)?

It should come as no surprise to regular readers of my posts that the research just does not support the use of statins to prevent a first heart attack. The data is very, very weak. Which would be fine if it didn’t cost the US alone some $20 BILLION per year. Talk about money wasted. And not a shred of evidence to suggest that they help prevent a heart attack, and plenty to suggest they harm. But, despite the evidence, our country and medical system is absolutely convinced that statins are the savior for heart disease.

This meta analysis, reviewing over 65,000 patients over 11 studies with patients at a HIGH RISK of heart disease (forget those with only elevated cholesterol…), found NO EVIDENCE FOR THEIR USE IN PREVENTING THAT FIRST HEART ATTACK!!! Seriously. What more information do we need? Any why do I have to spend hours educating patients that the drug they are taking is worthless to them? Help!!

Cataract Lens Problems? Blame Your Cholesterol Lowering Drug

September 14, 2012 by James Bogash

We’re visual creatures; eyesight is critical to us. Cataract lens problems disrupt vision, so if a common drug ups your risk of cataracts, this is important.

I’m not going to ramble on and on about how ineffective statins are at preventing heart attacks (you have to treat 1,000 for 5 years to prevent 11 heart attacks). Or about the long litany of side effects (diabetes, heart problems, muscle problems, liver problems).

But I do want to take this opportunity to illuminate the attitude of medicine and medical researchers today when it comes to your health.

This particular study finds a disturbing link between statins and your eye health:

56% of those with type 2 diabetes took statins
Type 2 diabetic had an 86% higher risk of developing cataracts (not new news)
Statin use increased the risk of developing age related cataracts by 57%

So, diabetics are at a much greater risk of developing cataracts. The risk of developing diabetes is actually increased with the use of statin drugs like Lipitor and Crestor. Statin drugs, by themselves, increase the risk of cataracts.

In summary, cholesterol lowering drugs increase your risk of both cataracts and developing diabetes and, if you’re lucky enough to be a diabetic (possibly from your Lipitor) AND on a statin, you can begin to SEE a problem.

But here’s where it gets interesting (or rather, MORE interesting–because you were already on the edge of your seat…).

Dr Richard Karas of the Tufts University School of Medicine commented on Heartwire.org, “Without belittling the development of cataracts, which he added are a “life-altering event,” MI, stroke, and diabetes are nevertheless significantly more damaging to health and quality of life.”

In other words, it’s ok if vision loss disrupts your quality of life and ability to drive because preventing a stroke or heart attack is much more important.

All this from a drug, that, to put it in medical terms, sucks.

It’s not like this is a miracle drug saving lives in droves. Less than 1 in 100 people who take the drug will see a benefit in 3+ years. I just don’t understand mainstream medicine’s dedication to such a near-worthless drug with an increasing litany of side effects.

The attitude is so pervasive that academia and physicians everywhere think that developing diabetes, losing your eyesight, developing rheumatoid arthritis and muscle weakness are acceptable costs for a modicum of prevention against heart attacks.

So, knowing the small benefits and the growing list of concerns with this class of drugs, was this a factor in your deciding not to take statins when offered by your physician?

Side Effects of Statins Worth the Cholesterol Reduction?

September 11, 2012 by James Bogash

We’ve been brainwashed to believe that cholesterol = heart disease and thus statins like Lipitor are the answer. But what about the side effects of statins?

I’ll admit it. I’m no fan of the statin class of drugs to lower cholesterol (collective gasp!).

What I will further admit is that I remain absolutely stumped as to why this class of drugs even exists. There are times that I seem to be the sole dissenter and that mainstream medicine puts them in cereal boxes and has them in the candy dish next to the sign in sheet in the office.

Trust me–I’ve looked at the data. Again and again and again. But I just don’t see it.

This particular study should, yet again, put things into perspective. Given the recent concerns that the statin class of drugs increases the risk of diabetes, researchers looked at the risk / benefit of statins with the risk of diabetes in mind.

Here’s what they determined:

In those with 1+ risk factors for diabetes, statins gave a 39% reduction in a cardiovascular event
A 17% reduction in dying
A 28% increase in diabetes

Putting this into perspective, this resulted in:

134 vascular events or deaths avoided
54 new cases of diabetes diagnosed

Keep in mind that, in the Jupiter trial that was reviewed here, almost 2/3 participants were already at risk for diabetes. However, the researchers did NOT include those with an HDL : triglyceride ratio > 3, which may have sent the number of participants at risk much higher.

The percentage numbers above are relative numbers, not absolute reductions because the absolute numbers are not so fantastic.

So, following the absolute numbers of statin effectiveness, we treat 1,000 people for 5 years and we have 11 less cardiac events, but about 4.5 new cases of diabetes (who will likely later die of cardiovascular-related complications).

This is considered good medicine and is the best that cardiology has to offer for “prevention.”

Prevention is no way, shape or form should increase the risk of ANYTHING. In contrast, true preventative measures would cut across disease labels to lower the risk for EVERYTHING.

To offer a drug…worse–to spend tens of billions of dollars annually–that has such a paltry effect at preventing something while almost half the numbers “saved” will get another dangerous diagnosis is just plain ludicrous to me.

But maybe I’m just overly sensitive.

So what have you done to successfully lower your cholesterol?

Heart Disease Prevention With Sweets Instead of Lipitor

July 31, 2012 by James Bogash

prevent heart disease cholesterol drug Heart disease remains the #1 killer. Prevention doesn’t take massive changes and does NOT require cholesterol lowering drugs like Lipitor or Crestor.

As a matter of fact, these drugs are likely to make your condition worse. The latest numbers suggest that medicine needs to treat 1,000 for 5 years to prevent a measley 11 heart attacks. For this society pays about $2400 / year per person in the US for Lipitor (yes, your copay may be less, but this is closer to the total costs). I cannot begin to describe how incredibly inefficient this method is.

This particular study provides an interesting alternative.

Chocolate has already shown to be quite protective for the heart. To review:

Clearly, these results relate to dark chocolate, NOT milk chocolate. The darker the better. For those of you who think dark chocolate is too bitter, consider finding chocolate with berries and / or nuts mixed in such as those made by Endangered Species. You should be able to find one that is perfect for you.

Back to this study…

Researchers did some number crunching on how many heart attacks could be prevented by consuming 100 grams of dark chocolate per day. First, 100 grams is a LOT of chocolate to consume in a day (ok…maybe not that hard to consume…). I usually recommend a few squares per day coupled with some walnuts, pecans or almonds.

The conclusion?

8.5 less heart attacks per 1,000 patients treated (1.5 of which were deaths prevented). Not too far off from the statins, and when you consider the estimated cost of $42 per year vs $2400, we begin to get a clearer answer. And, given the demonstrated protective effects of dark chocolate on second heart attacks, the benefits may be stronger over the long haul.

In addition, other than enjoyment and possibly choking on a chocolate bar, I’m not sure I’ve come across any studies on the side effects of dark chocolate consumption. And really…if your cardiologist looked you in the eye and said, “Now Ms. Jones, I’m going to need you to take your dark chocolate every day to protect your heart…” just how high would YOUR compliance be with dark chocolate vs medications?

So, settle in for some dark chocolate and a glass of red wine after dinner and know you’re protecting your heart in some powerful ways.

Please share in the comments how YOU prefer to eat your dark chocolate…

High Cholesterol Drug Side Effect on Energy Very Common

July 11, 2012 by James Bogash

The list of side effects of cholesterol drugs like Lipitor or Crestor continues to lengthen. Most problems are due to the lowering of a molecule called CoQ10.

The statin class of cholesterol lowering drugs block an enzyme called HMG-CoA reductase. This is the enzyme that produces cholesterol in our bodies. However, this enzyme also produces a tiny little compound called Coenzyme Q10. CoQ10 is critically important for every cell in our body to generate energy to function. Block this with a drug and there’s going to be a price to pay. A more complete list of side effects can be found in previous posts.

One part of our body that requires lots and lots of CoQ10 is the muscles. When statins are used to lower cholesterol, the most notorious side effect is a condition called rhabdomyolosis. Essentially, in some patients (and we can’t predict who they will be), statins lower CoQ10 to critical levels and the muscles can’t function and literally begin to melt. The debri from the dead muscles floats in the bloodstream and clogs up the kidneys, frequently leading to death from kidney failure. Not a pleasant way to go, especially when it is due to a drug for a condition that can very easily be managed with lifestyle changes.

But what about those who don’t suffer the most severe end of the spectrum of muscle damage?

Turns out, very few people who take these cholesterol lowering drugs escape muscle damage.

This particular study looks at energy levels and the desire to be more active in patients taking statins to lower cholesterol. Basically, researchers found that those taking the drug (vs a placebo) where much more likely to report complaints of general lack of energy and / or fatigue with exertion.

Given that exercise is a powerful way to lower your risk of heart disease, stroke, cancer, osteoporosis and diabetes, this is NOT a good thing.

Please feel free to comment on how taking statin drugs to lower your

Cholesterol High? If You Take Lipitor, Then You Need to Know This

June 19, 2012 by James Bogash

Statins are drugs used to lower cholesterol numbers. Lipitor, Crestor and Zocor are just a few. They are given out like candy. But just how well do they work?

Lipitor was the first drug to ever break $20 billion in annual sales. Make no mistakes, this class of drugs has been one of the most successful financial windfalls that the pharmaceutical companies have ever experienced, with Pfizer leading the pack with Lipitor sales. And well it should, because it cuts heart attack rates by 50%.

I would imagine that, for the uninformed doctor who does not read medical literature, a 50% reduction in the rates of heart attacks in his or her patients sounds like a great idea. No wonder it’s sitting on the checkout counter right next to the mints.

But, let’s look at this from another angle. Let’s say there’s a very rare type of cancer that attacks the tip of the pinkie. 2 people in the US get this cancer every year. Windfall Pharmaceuticals develops a drug that can lower the rate of the cancer every year. But you have to treat everyone in the US who has a pinkie to see this benefit. So, we treat some 300 million people for years and years to prevent a single case of pinkie cancer per year.

For those of you good with math, this is a 50% reduction.

Kind of sucks for the 299,999,999 other people who won’t actually get a benefit, especially when their is a very long list of side effects associated with this particular medication. Windfall Pharmaceuticals, however, could not be happier.

So back to the statin story.

We have already established that statins cut the rates of heart attacks by 50%. But this is the RELATIVE risk, not the ABSOLUTE risk. The absolute risk refers to how many actual people will be saved from having a heart attack when a group of people take a statin. The numbers may surprise you.

The most recent numbers are highlighted in this particular study. When 1,000 patients with high cholesterol are treated with a statin for 5 years, a mere 11 heart attacks will be avoided. Doing simple math, this equates to a cost of some $$3,650,000 to prevent 11 heart attacks, or $331,818 per heart attack prevented.

So, for those of you who think organic food and a gym membership is expensive, I’m thinking that $66,364 per year will buy a lot of produce and your own personal trainer (and chef, for that matter) to come 3 times per week.

The real kick in the gluts is the article’s conclusion, which states, “This benefit greatly exceeds any known hazards of statin therapy. Under present guidelines, such individuals would not typically be regarded as suitable for LDL-lowering statin therapy. The present report suggests, therefore, that these guidelines might need to be reconsidered.”

Basically, this panel thinks we need to stop giving statin pills and just dump the stuff in the water supply because we aren’t using it enough. I’m not sure what fairy tale would they happen to be living in, but I’d place some bets on what type of companies they own stock in.

This, of course, takes none of the side effects of statins into account, which have gotten quite lengthy, and can include:

Potential increase in the risk of cancer
Increased risk of chronic muscle diseases
Problems with the functioning of the heart
Reduction in cognitive function
Increases the risk of your muscles melting, a condition called rhabdomyolosis
Increases risk of long term muscle damage, even after discontinuation
Nullifies–YES, nullifies, the positive effects of exercise on the heart

So, the next time your doctor suggests you should take a statin, ask him or her for 5 solid recommendations to help you lower your cholesterol naturally. (For a pretty solid list, check my recommendations) Then, ask him what the absolute risk reduction would be for you.

If either of these answers fall short, maybe it’s time to find a new doctor.

What have you done to lower your cholesterol naturally?

Can Your Cholesterol Drug Destroy Arteries?

May 14, 2012 by James Bogash

Your doctor checks your cholesterol and it comes back high. You try walking around the block for 2 days and cutting back from 7 days to 6 eating McDonalds. Alas…it does not work. You can almost feel your arteries harden. Medication is the ONLY answer to your plight. Cholesterol drugs protect the arteries, right?

The clear answer to this question is….Maybe.

Regular readers of the Rantings know how little of a fan I am of the entire statin class of drugs. Clearly, this class of drugs, for primary prevention of deaths related to heart attacks, is just a hair above worthless. If they didn’t have a long list of potentially fatal side effects and cost the healthcare system 10’s of billions of dollars per year AND they’re weren’t more effective alternatives available (Dr. Dean Ornish proved that lifestyle could reverse plaquing in the coronary arteries in the 70’s), then their paltry effectiveness wouldn’t be a big deal.

Back to the issue at hand. Will this class of drugs protect my arteries?

I guess it just depends. On what, you ask? It’s not really a question anyone can answer right now. What we can say, from this particular study, is that half show some very mild improvement in blood vessel diameter (3.2%) while the other half show larger losses (-5.3%) in the diameter of the blood vessels.

So it’s basically a crap shoot until researchers can spends hundreds of millions of research dollars to figure out who gets better and who gets worse, keeping in mind that “better” translates into a negligible improvement in overall mortality rates. Sheeeeezzz…

Called me biased, but wouldn’t the right lifestyle changes to pull back from diabetes and improve your entire lipid blood panel be a safer, cheaper and better idea??