Statins - good or bad - what does the research say?

[JohnEGreen]

My biggest problem with statins is where to put them all I'm running out of space.

 

[GrannyAnnie]

I was on Atorvastatin and when I went for my appointment with the DN, I told her that I was not going to take them anymore as I don't believe in all this cholesterol rubbish! She tried and tried to make me take them but I still said no!
When I had my next appointment, 6 months later, my cholesterol had gone DOWN! I rest my case.

 

[Mike d]

@GrannyAnnie

Good. They are (in my experience) just downright dangerous

 

[Daphne917]

I was on Atorvastatin and when I went for my appointment with the DN, I told her that I was not going to take them anymore as I don't believe in all this cholesterol rubbish! She tried and tried to make me take them but I still said no!
When I had my next appointment, 6 months later, my cholesterol had gone DOWN! I rest my case.

Well done! I have the statin conversation at every review but still do not take the DN on her kind offer!!

 

[Sid Bonkers]

If anyone wants to know about the factual evidence regarding Statins rather than the often bias Youtube video presentations and anecdotal evidence then the only place to look is the Cockrane Reviews.

The Cockrane reviews are NOT cherry picked and give ONLY the best un-biased reviews of medical research .


Statins for the primary prevention of cardiovascular disease
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004816.pub5/full

Statins for preventing major vascular events in people with hypertension
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004933.pub2/full

Source and more statin reviews here http://onlinelibrary.wiley.com/cochranelibrary/search/

 

[Mike d]

Not interested. And don't call it unbiased. Everything is

Read up on thalidomide and how that was once praised

 

[Oldvatr]

If anyone wants to know about the factual evidence regarding Statins rather than the often bias Youtube video presentations and anecdotal evidence then the only place to look is the Cockrane Reviews.

The Cockrane reviews are NOT cherry picked and give ONLY the best un-biased reviews of medical research .


Statins for the primary prevention of cardiovascular disease
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004816.pub5/full

Statins for preventing major vascular events in people with hypertension
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004933.pub2/full

Source and more statin reviews here http://onlinelibrary.wiley.com/cochranelibrary/search/

One important thing to take account of is that most of the studies I have seen use the PETO statistical analysis method, which has been thoroughly debunked as being 'open to misinterpretation and bias' The front sheet of the PETO academic textbook has a disclaimer that the method is NOT to be used for new reports, but is still available for 'historical research'. I personally found serious bias on two 'reputable' studies for statin use before I found out that the method had been revoked and 'shamed'.

I am not a statititian but I used to use statistics in my job, so have some experience using them and reading them. I was totally unable to see how the companies funding the study were making claims that were not backed up by the data.

In 2006 this ban was made official policy for all new reports, but the earlier reports have not been reviewed or retracted.

 

[DavidGrahamJones]

Statins for the primary prevention of cardiovascular disease
http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD004816.pub5/full

I did actually try to read the first reference and got as far as the statement "High blood cholesterol is linked to CVD events and is an important risk factor".

They don't say what "High" actually means which is part of the issue, also The British Heart Foundation who I consider to be a reputable organisation in no way influenced by big pharmaceutical industry, have data which shows that Low cholesterol (which I'm defining as below 5.4) has a similar effect to high cholesterol (above 5.4).

I've always maintained that if your body tolerates it, go for it. I just got fed up with the pain, poor sleep and brain fog (anecdotal observations recognised by the NHS as side effects) and at certain points felt suicidal. I tolerated the ******** sarcasm from so called work colleagues who seemed to think it entertaining that I grimaced when I stood up and at times also made the noise of someone in pain, I can only hope and pray that their old age (I was 45 at the time) is just as painful if not more so. I wonder where suicide would come on their graphs.

 

[Sid Bonkers]

One important thing to take account of is that most of the studies I have seen use the PETO statistical analysis method, which has been thoroughly debunked as being 'open to misinterpretation and bias' The front sheet of the PETO academic textbook has a disclaimer that the method is NOT to be used for new reports, but is still available for 'historical research'. I personally found serious bias on two 'reputable' studies for statin use before I found out that the method had been revoked and 'shamed'.

I am not a statititian but I used to use statistics in my job, so have some experience using them and reading them. I was totally unable to see how the companies funding the study were making claims that were not backed up by the data.

In 2006 this ban was made official policy for all new reports, but the earlier reports have not been reviewed or retracted.

The Cocrane reviews are totally un-biased and have been quoted before on this forum many times mainly by those strongly against the use of statins, whats changed?

 

[bulkbiker]

The Cocrane reviews are totally un-biased and have been quoted before on this forum many times mainly by those strongly against the use of statins, whats changed?

Mainly because their main premise "high cholesterol causes CVD" is currently being questioned. When the recently retired President of the World Heart Federation starts to question this hypothesis then any previous study relying on it has to be questioned as well.

 

[Oldvatr]

The Cocrane reviews are totally un-biased and have been quoted before on this forum many times mainly by those strongly against the use of statins, whats changed?

If you read the first report you posted, and then the follow on commentary. you can plainly see that there was an attempt to identify bias, and several of the 19 reports they used show bias. So I dispute your claim that 'The Cocrane reviews are totally un-biased' However, they have acknowledged this in the main body of their report.

The main criticism of Cochrane is that in most cases the drug manufacturers (OEM) who actually carried out the trials, regard the raw data as commercial confidential, and refused to release any primary data. The independant reviewers thus had to review redacted and possibly filtered data tables and graphs and there was NO means of checking the OEM claims for their drug on trial. So, what were they reviewing?

Finally, The issue 1 of the report contains a major claim for All Clause Mortality that was included in the Press release, that has since been shown to be a misinterpretation of the truth. It has been retracted by a notice on the Cochrane website, but who would know to read that. No public correction seems to have been published yet. Certainly the RR=1.0 for that result does indeed imply this.

Many of the stats quoted in the sumaries have CI intervals that you can drive a tank though, and this implies wide variations in the data, which should weaken any conclusions drawn, The use of Relative Risk instead of absolute risk is a technique used to conflate small differences in results, and may give incorrect interpretations.

So, Cochrane is an attempt to bring order and confidence in these types of study, but it is still using old statistical methods that have long been kicked into touch by the engineering industry. IMHO it still fails this test. If they had taken raw data and re-analysed it with modern methods, then it could be more believable, but as it stands it has shortcomings that our lives depend on which can lead to cries of FIX / Cover Up. When interested parties pay for and carry out these studies but withold the raw data so that true independant critique cannot be made, then we are on a hiding to nothing.

 

[Sid Bonkers]

Mainly because their main premise "high cholesterol causes CVD" is currently being questioned. When the recently retired President of the World Heart Federation starts to question this hypothesis then any previous study relying on it has to be questioned as well.

If you read the first report you posted, and then the follow on commentary. you can plainly see that there was an attempt to identify bias, and several of the 19 reports they used show bias.

"Cochrane Reviews are systematic reviews of primary research in human health care and health policy, and are internationally recognized as the highest standard in evidence-based health care resources."

The Cockrane Library is the gold standard of evidence based reviews but if you chose not to believe that then thats entirely your prerogative, although it is generally accepted that they are.

Edit: You might like to read this thread from a few years ago http://www.diabetes.co.uk/forum/thr...th-about-cholesterol.30571/page-2#post-287263

Strange that on that occasion Cockrane was quoted to back up your theories. I guess guess new evidence must have come to light.

 

[Resurgam]

Even if there were proven and unchallengeable benefits for taking statins, I could never endorse their use.
Granted, I took Metformin and the statin at the same time so I can't be certain of which caused what, but now my memory is so bad, I forgot that we should have been visiting my daughter, and I have to read my diaries to discover how I used to live.
The ache which is still in my lower leg from time to time I can live with, but not the mental distress.
Not being able to think of words when I need them is annoying too - I didn't mean to write unchallengeable in the first line but the word I wanted didn't present itself. Good thing I have a wide vocabulary.
Indisputable - that's the one I wanted.
The effects are from just over a month of taking the tablets, a single dose each day. I stopped before Christmas last year, and there has been some improvement, but I think that I will be a bit lost for the rest of my life.

 

[bulkbiker]

"Cochrane Reviews are systematic reviews of primary research in human health care and health policy, and are internationally recognized as the highest standard in evidence-based health care resources."

The Cockrane Library is the gold standard of evidence based reviews but if you chose not to believe that then thats entirely your prerogative, although it is generally accepted that they are.

Edit: You might like to read this thread from a few years ago http://www.diabetes.co.uk/forum/thr...th-about-cholesterol.30571/page-2#post-287263

Strange that on that occasion Cockrane was quoted to back up your theories. I guess guess new evidence must have come to light.

That thread is from 4 years ago.. the speech I mentioned is from January 2017 and is a preview of the PURE study the results of which haven't been published yet.

 

[Art Of Flowers]

If you watch the films Statin Nation and Statin Nation II you will get a good understanding of statins, their actual benefits and the risks. It does appear that they have no benefit to women and only marginal benefit to men who have had a heart attack.

Life expectancy does not seem to be improved by lowering cholesterol, in fact low cholesterol is associated with higher mortality rates. Countries with high cholesterol such as Japan and Korea have lower risk of dying from heart disease than most western countries. In the UK, people who have heart attacks have lower cholesterol than average, not higher.

For those with slightly high cholesterol they have no benefits and a risk of severe side effects. In short, they should be avoided in most cases. Statins do raise blood sugar levels, so not a good idea for diabetes sufferers and in some cases statins may cause diabetes in the first place.

 

[DavidGrahamJones]

Granted, I took Metformin and the statin at the same time so I can't be certain of which caused what

I beg to differ, if in 1991 Merck Pharmaceutical had been able to work out from their clinical trials that their own statin prevented the uptake of CoQ10 and that was causing muscle pain, it's no conspiracy theory that statins will cause certain side effects in some people who take them.

I also believe that the FDA in the U.S. are worth noting in the warnings that they have had the manufacturers put on the drug. Even the NHS warn that muscle pain, brain fog and poor sleep are recognised side effects.

What is interesting is that they don't seem to affect everybody the same way but if you consider that in 2003, Allen Roses, worldwide vice-president of genetics at GlaxoSmithKline (GSK), said fewer than half of the patients prescribed some of the most expensive drugs actually derived any benefit from them, maybe . . . . . He's got access to a lot of clinical trials data so hopefully he knew what he was talking about. Something else to consider about prescribed drugs is have you ever heard a doctor start by saying "We'll try so and so and if that doesn't work . . . . . . . .". Only anecdotal, I know, but I know I've heard that several times.

If you are affected by taking statins may I recommend that you tell your GP exactly that and if your GP tries the old "there's no proof . . . . . etc etc" remind them that even the manufacturer knew about the side effects to the extent they applied for a patent for their statin to include CoQ10. There are also countries where CoQ10 is routinely prescribed alongside the statin, unfortunately the effects of ingested CoQ10 aren't very clear.

 

[Daphne917]

If you are affected by taking statins may I recommend that you tell your GP exactly that and if your GP tries the old "there's no proof . . . . . etc etc" remind them that even the manufacturer knew about the side effects to the extent they applied for a patent for their statin to include CoQ10. There are also countries where CoQ10 is routinely prescribed alongside the statin, unfortunately the effects of ingested CoQ10 aren't very clear.

I tell my DN everytime we have the dreaded 'Statins' conversation but all she says is that 'other ones are available and may be ok' I always decline her kind offer - it saves the NHS money and me grief!!

 

[Oldvatr]

"Cochrane Reviews are systematic reviews of primary research in human health care and health policy, and are internationally recognized as the highest standard in evidence-based health care resources."
.

Sorry Sid, I stll have issue with what you are posting here. The un-attributed quote you make above is the sort of Management Speak that might appear in the introduction to an Annual General Meeting *AGM) report, and means nothing to me since I have experienced it too much in my life. Who originated that quote?

Cochrane collate and hold other people's scientific papers such as RCT trials. They do not actually do any research in their own right, so the evidence they present depends on how good the original report data and interpretations are. So a bum or corrupted trial can still get a Cochrane badge of honour. What Cochrane does is provide oversight review of trials to make sure that the trial was (a) performed ethically, and (b) reported in a complete form that is as unbiassed as the currently available analysis tools will allow. What is new is output from them in the new phenomenon of Meta Studies, where they collate and digest many such studies to see if new conclusions can be drawn out of the data. They do trending analysis to see if researchers have missed links to other outcomes. and they have developed a new set of statistical tools to apply. This is their major contribution - The Meta Study, and they do exercise Due Diligence.

Now meta studies take data from what is often very disparate data sets and they are looking for links that they can connect together, but these links have varying population characteristics and different eligibility criteria, and differing test methods. So whilst useful, these studies are NOT Gold Standard by any means. The true Gold Standard you refer to is an RCT double blinded trial with large sample sizes, The study you linked to in the post I replied to only contains a few trials that actually meet these criteria, so I would say only a couple of them could be claimed to be Gold Standard.

To make this report fully believable and [almost] independant would be for the study team to work from scratch on the raw trials data that was collated by the Drugs Manufacturers. In this subject of Statins, the OEM's all appeared to have witheld access to their database content, so the Cochrane team had to use summary data which may be tables or graphs of results that the nanufacturer wants to be published. Nowhere in this report is there any indication that primary data was used.

I am afraid that while Cochrane is a useful source of data, I do not put them on a pedestal, nor do I worship the ground under their feet. Like most things clinical, a pinch of very salted fairy dust is often needed. And I try to take off my rose tinted specs.

 

[Mike d]

I don't appreciate being directed to studies when I know **** well what they did to me

 

[Oldvatr]

Edit: You might like to read this thread from a few years ago http://www.diabetes.co.uk/forum/thr...th-about-cholesterol.30571/page-2#post-287263

Strange that on that occasion Cockrane was quoted to back up your theories. I guess guess new evidence must have come to light.

Yes, there has been a change to the Report since it was first published. Issue 1 of the original report indicated that mortality risk increased when not only LDL went above a magic figure, but ALSO when it dropped below that figure, thus identifying a 'sweetspot' to aim for.

In the follow up report we are discussing, this has changed. Low LDL is still showing an increased risk, but the explanation for why has changed.
There was a tendancy among some, myself included, that made an assumption that if you take statins to lower LDL below the sweetspot, then this is good i.e. lower the better. The data apparently does not support this assumption; there are several clinical conditions [now listed in this follow up addendum] that Cochrane are sayng the increased fatal events are as a direct result of the clinical condition rather than the statins. This is plausible. However, it seems LDL being too low is still unwelcome news.