From Daily Mail January 16, 2014
Everyone agrees that eating more fruit and vegetables is beneficial but experts strongly disagree about to whom it is worth giving statins. When it came to making their calculations about the benefits of statins, the Oxford researchers used a study published last year.
This found that even patients at low risk of heart disease benefited from statins, and the known side-effects, such as serious muscle problems and diabetes, happened to fewer than one in 1,000.
But many other researchers are not convinced this is realistic. And if it is over-optimistic, that would mean the difference between the number of lives saved by statins compared with those saved by fruit and veg could be even smaller than the Oxford researchers found.
An article in the BMJ recently strongly criticised the study favourable to statins (known as the Cholesterol Treatment Trialist, or CTT, collaboration).
‘This analysis was based on results from trials run by the drug companies, which are likely to be excessively favourable,’ wrote Dr John Abramson, of the department of healthcare policy at Harvard Medical School.
Independent studies suggest that you have to treat as many as 5,000 low-risk patients over 60 years of age to prevent just one death from heart disease.
‘If you massively expand statin use among people at low risk, all you are going to do is to drive a huge increase in the number of people suffering side-effects,’ Dr Abramson told Good Health.
His paper estimated the risk of type 2 diabetes from statins to be five times higher than that claimed in the CTT study.
I have high cholesterol, so do I need a statin?
Statins are certainly effective at lowering cholesterol, but questions are being asked about whether that actually affects heart disease risk.
Studies show that 75 percent of people admitted to hospital with their first heart attack have normal levels of cholesterol. Drugs that only lower cholesterol, unlike statins which have other effects such as reducing inflammation, have never been shown to cut heart disease.
This approach is reflected in the latest guidelines from two of the big American cardiovascular societies. Their advice, which surprised many, was that driving your LDL (bad) cholesterol down as low as possible with statins was no longer thought to be a good idea.
Statins should be used to treat people at real risk, said the US. bodies. They now recommend paying special attention to diabetics (who are at higher risk of heart disease); they also lower the level of risk at which others should be treated.
Under UK guidelines, you are meant to be treated with statins if your risk of heart disease over ten years is above 20 percent; the U.S. organisations reduce that to 7 percent or more over ten years.
‘Many experts now think cholesterol is a sign that there is a problem but is not the cause of it,’ says Aseem Malhotra, a cardiology registrar at Croydon University Hospital. ‘Statins can help after a heart attack but probably because of their anti-inflammatory effect.’
http://www.iol.co.za/lifestyle/can-lifestyle-save-your-heart-1.1632426
