Better news on statins....

Today's Post: Thursday, 3-1-2012

It’s in the current health news that the FDA is now requiring a bit more disclosure about memory problems and increased risk for type two diabetes from taking statin drugs.

These two side effects join the risks of feeling less energetic and far older; increased risk of heart failure, muscle damage, and kidney failure and death from massive muscle damage that are other less likely risks from taking statin drugs.

The more common side effect I’ve read is that 3% of statin users get cataracts who otherwise would not.

Given this list of rather undesirable risks and side effects, why do so many doctors now prescribe statins?

Three reasons for this are:

1. Something like half of all deaths and a lot of health care costs are caused by heart attacks and related heart disease.

In a large study, that studied the effects of a statin called Crestor, called the JUPITER study, 252 of the people who got placebo pills had a major cardiovascular event such as a heart attack and of the people taking that statin, 142 did.

So doctors decided that taking statins to prevent major cardiovascular events and heart attacks, was a good idea.

The people taking statins did look to have some protection after all.

The first problem was that they forgot to notice was how many people were in each group. There were 8901 people in each of the two groups.

That means that to prevent the 110 major heart problem events sending people to the hospital (252-142) all 8,901 people had to take statins.

And, that means that out of about 80 people taking the statin, one got protected.

Not 75 or 79 of the 80 people but only one.

Meanwhile if 3% of the 8901 people got cataracts they could have avoided, about 267 people got cataracts.

Even without the more serious side effects, this is NOT good; but it went mostly unnoticed.

Doctors wanted something they knew might help that was simple for them to give patients to do to prevent heart attacks.

2. The doctors then did NOT know that how effective statin drugs are in helping an individual person to prevent heart disease depends on the genetic pattern that person has.

In most people, statins do far less good in preventing heart disease than just having people take moderate amounts of the vitamin niacin. For most people, I don’t know the fraction but it sounds like about 6 sevenths of us, statins are something like 41 times less effective than niacin!

And, of course, niacin has several advantages. It is dramatically cheaper. It’s far safer to take. And people taking niacin have been found to lower their death rate which has never been found with statins.

However there is one group where statins actually are as good as or better than niacin. (I suspect niacin is more effective for even this group than statins are for everyone else. But statins are clearly much more reasonable to use with patients in this one group where it actually works well. (It’s protective to lower LDL cholesterol and triglycerides and to increase HDL. Niacin does all three!)

So, given that, you’d think doctors would test first to see if their patient was in this less common group before considering statins at all.

And there is recent good news too, instead of having to do the whole Berkeley Heart Lab genetic analysis for $600 or more, I found out in an article by cardiologist, Arthur Agatson, MD that the test for just being in this less common group or not is only about $150.

Initially doctors had never heard of this test or why they should do it. That’s understandable.

But, now it’s been widely publicized, most doctors should know this information. Many cardiologist do I suspect. But given what I’ve read it’s still the case at this time that at least 9 out of 10 doctors who know prescribe statins have ever heard of all this.

That means that your doctor may well prescribe a statin for you because he or she doesn’t know this set of things at all.

So, if you want better results at lower risk, it looks like to me you would do well to decline to take statins until you find out at least & get the test first to see if you are in the less common group of people they actually help.

Even then, if you are in the group statins help, you would have lower risk of side effects and lower costs if you took niacin.

3. Notice that in the group that took statins, 142 people were not protected and had a serious heart disease episode anyway.

Isn’t there something else that you could do that would cut that to 25 people or less without using statins?

Yes indeed there is!

But the third reason that doctors prescribe statins is they don’t know enough about this other way to protect you.

Or what they do know, they’ve found they were ineffective or expected to be in talking their patients into using this method.

So, they have reasoned, they could at least prescribe statins.

For, example, most doctors know that smoking causes heart disease. But they often don’t ask if their patients smoke and often don’t know that having a doctor prescribe they quit is somewhat effective in causing many smokers to quit. That one I’ve read is improving somewhat.

But the other things are more complex and you have to know them in detail and how to get into them to do well in helping people to use them to protect their heart.

Most doctors have not had that training nor do they have people who do know to refer their patients to. So they still prescribe statins.

In outline these things are relatively simple. But it helps to have a source of more detailed information.

We have been working to provide that here in these posts.

a) Besides not smoking or staying in rooms where people smoke, it’s heart protective to:

b) Stop drinking soft drinks both regular and diet largely because they boost triglyceride levels significantly. And high levels of triglycerides mean a very high risk of heart disease. Plus soft drinks cause obesity and help cause type 2 diabetes. Heart disease caused by type 2 diabetes is more deadly and harder to treat than regular heart disease.

c) Similarly, it helps to discontinue buying or eating anything with high fructose corn syrup or artificial sweeteners besides soft drinks for the same reasons.

d) Similarly, it helps to cut back even on regular sugar to a few tablespoons a week instead of the 7 tablespoons a day the average American ingests now.

e) Building up safely to doing vigorous exercise most days of every week is one of few things more heart protective than niacin. And doing so has remarkable benefits protecting and enabling you in dozens of other ways too.

f) Cutting out any intake of trans fats and hydrogenated oils is also protective against both heart disease and stroke.

h) Limiting your intake of processed meats such as bacon, sausage, hot dog, lunch meats, and pepperoni to a few times a month or less helps prevent both heart disease and strokes recent research found.

i) Eating vegetable, beans, or whole grains and virtually eliminating eating refined grain foods is protective in the same ways as not drinking soft drinks since refined grains have virtually no fiber and boost your blood sugar more than sugar does.

But refined grains also usually contain excessive amounts of omega 6 oils which boosts chronic inflammation which in turn causes heart disease.

(The one grain that can help heart disease is oatmeal from steel cut or rolled oats. Eating it reduces your LDL cholesterol. Oatmeal is high in the soluble fiber that is also high in beans and lentils and black eyed peas.)

j) Use extra virgin olive oil instead of oils like canola, soy, corn, and safflower oils. Olive oil is monosaturated, omega 9, oil and does not boost omega 6 and inflammation as these other oils all so.

k) Eat less meat, and if it comes from grain fed animals, eat the leanest most fat trimmed versions only. Their fat contains massive amounts of omega 6 from the grains they are fed and is excessively high in saturated fat too. Both of those boost your risk of heart disease.

Or, eat less meat, and when you do eat it eat only meat from animals 100 % fed on grass only.
They have dramatically less omega 6 oils, some omega 3 oil, and about half the saturated fat.

l) Eat more beans, lentils, black eyed peas and if you aren’t allergic raw, unsalted tree nuts.
These have fiber and sterols that lower LDL cholesterol and provide a protein source free of animal fats. The beans, lentils, and black eyed peas also cost much less than meat and cheese.

m) Eat wild caught fatty fish high in omega 3 oils. (Farmed are too high in pollutants to be safe to eat.) Wild caught salmon, herring, small mackerels, and sardines all work for this. This helps lower chronic inflammation, improve your mood, protect your brain, and lower triglycerides. This works even better if you cut back on things with omega 6 oil as well.

l) Eat lots of onions and some garlic. These also help prevent cancer and increase HDL cholesterol and reduce excess blood clotting and help lower triglycerides all of which are heart protective.

m) The spices turmeric and the curry blends it is in and ginger lower chronic inflammation and LDL cholesterol to protect your heart. And if you add black pepper when you eat turmeric and the curry blends it’s in, it also helps prevent cancer AND Alzheimer’s disease!

The bad news is that making all those upgrades takes a bit of work if you’ve not been doing it.

The much better news is that this set of things dramatically protects all of your health in many other ways too.’

If you do these things you will be far less fat than you otherwise would be with no other hunger or calorie cut backs needed.

You will avoid high blood pressure or lower it significantly.

You will cut your risk of all cancers and Alzheimer’s disease almost as much as you cut your risk of heart disease.

And, particularly if you do the regular and vigorous exercise you will age more slowly.

It’s very likely that you’ll not only live more years but you will be healthy and mobile for far more of them than would happen otherwise.

Between this set of things and niacin, statins and their side effects are NOT needed to prevent heart disease for most people.