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Joining the statin love-in?

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If you’re over the age of 50, healthy and have no history of heart disease, you probably should be taking a cholesterol-lowering statin (viz. our health guardians). And if your risk for heart disease is above 10 percent—because of lifestyle habits, diabetes or family history, for example—you definitely should be taking one, as the ultimate just-in-case remedy that can “save your life” (viz. every conventional health site).

The 10 percent risk guideline was introduced in 2016, and instantly almost everyone over the age of 50 became eligible for a statin prescription. According to the 1987 guidelines, around 8 percent of those over 50 were in line for a statin; the new guidelines put 61 percent into the statin net.  Put another way, if 40 people were considered statin-ready in 1987, 400 are now.

As a result, statins are among the most frequently prescribed drugs, with sales set to hit $1 trillion (that’s one thousand billion dollars to you and me) this year.

The trouble is that this statin love-in isn’t supported by the science. If you’re healthy and haven’t had heart disease, you shouldn’t be taking a statin. In fact, the risks of side-effects outweigh any benefits, a major new study has concluded.1

It’s worth pointing out that the researchers, from the National University of Ireland, were independent and didn’t get any funding from a statin manufacturer.

Most research is paid for by drug companies, and the studies almost always produce a favorable result to demonstrate the life-enhancing qualities of the drug. 

One seminal study concluded that giving statins to 10,000 people would result in 1,000 fewer heart attacks in those who already had heart disease and 500 fewer attacks in people at risk because of their age. What wasn’t so apparent was that the researchers had received over $120 million over the years from one statin manufacturer alone.2

Despite these financial ties—which may or may not have influenced the results, and the researchers stressed that the facts speak for themselves—the paper has helped shape statin policy around the world. 

And when it comes to facts, they come in all shapes and sizes. Aside from pleasing their benefactors, researchers use a variety of statistical techniques to produce a headline-grabbing finding that will boost their own careers and raise their profile in medicine     and academia.

For instance, you could read that new research has found statins reduce the risk of heart disease by 27 percent, and, from that, reasonably assume the drugs will lower your risk by, well, 27 percent.

A fact? Yes, sort of. One of the favored statistical sleights of hand (especially if the drug company is paying) is a calculation called “relative risk.” When all that people care about is the effectiveness of a drug, relative risk hems and haws, and throws in your age, general health, lifestyle and any other factor besides.

If you were to stop smoking—and thus instantly reduce your risk—the drug would take the credit.

What you actually want is the straight-talking, no-nonsense “absolute” risk. In 2014, researchers pulled back the Wizard’s curtain to an expectant world: take a 65-year-old male who smokes and has high cholesterol levels and raised blood pressure—he would see his risk of a major coronary event over the next 10 years drop by 24 percent if he took a statin. 

That’s worth a shift in health policy, for sure. But that’s the relative risk, with all sorts of other factors taken into account. The absolute risk, with everything else stripped away, shows that a statin, on its own, reduces his risk by only 9 percent.

Or take the case of a 45-year-old woman who doesn’t smoke, has high cholesterol levels and slightly raised blood pressure—she would see a 41 percent reduction in relative risk if she took a statin. But the absolute risk reduction is just 0.6 percent. 3

So, even someone at high risk of serious heart disease will see their chances drop by just 9 percent if they take a statin. Worth it? Maybe not if you then factor in the possible side-effects of statin drugs, which include muscle weakness, diabetes, memory loss and, paradoxically, stroke.

And that is a fact.

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