Statin's raise BG

RoyG wrote
They are even telling us that statin's raise blood glucose now on DUK web site

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I've read more than once (trying to leave the house, so no links ) that in the non-diabetic statin use raises the risk of developing diabetes, which might fit in with what you're saying.

Geoff

There's a difference between statistical significance and practical significance.

The results showed that statin users experienced a 0.08 mmol/l increase in fasting blood glucose levels

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That is to say, if your fasting BG is normally 5.00 mmol/l (good), it will be 5.08 mmol/l (still good) if you take statins; if it's borderline it will still be borderline, etc.

To put it bluntly, I don't care whether you believe the "cholesterol hypothesis". I don't even care if it's true. Fact is that taking statins makes people die less. That's an outcome you want:

A meta-analysis of all placebo-controlled trials (primary and secondary
prevention studies) that published data in a usable form indicated that
therapy with a statin was associated with a statistically significant reduction
in risk of all-cause mortality (relative risk [RR] 0.83, 95% confidence interval
[CI] 0.78 to 0.90), cardiovascular mortality (RR 0.79, 95% CI 0.74 to 0.85),
CHD mortality (RR 0.77, 95% CI 0.72 to 0.83) and fatal MI (RR 0.54, 95% CI
0.44 to 0.67), but not of stroke mortality (RR 0.92, 95% CI 0.74 to 1.14).

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NICE does explain what they're decisions are based on, so you can read it yourself if you want to.

A plausible mechanism of action (or, since we're Pans Narrans, a story) is a nice bonus, but it's neither necessary nor sufficient. Remember Semmelweis? He had this mad theory that doctors were causing deaths by not washing their hands! Despite the fact that his intervention dramatically cut patients deaths, his ideas were ignored and he died in an insane asylum because people had all the answers

AMBrennan wrote
NICE does explain what they're decisions are based on, so you can read it yourself if you want to.

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A 45-page PDF with no charts ? I tried it but it made my head hurt.

Do you know how to access the data they based their conclusions on ?

A meta-analysis of all placebo-controlled trials (primary and secondary
prevention studies) that published data in a usable form indicated that
therapy with a statin was associated with a statistically significant reduction
in risk of all-cause mortality

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Well lumping figures for people with heart disease together with people with no heart disease will certainly distort the overall result.

Fact is that taking statins makes people die less.

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That's a blanket statement I can't agree with.
Only in isolated populations do statins help. Otherwise they seem to change what you die of, rather than overall mortality.
I lent my Cholesterol Con to a friend, so can't answer that right now.

... his ideas were ignored and he died in an insane asylum because people had all the answers

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Well, I certainly don't have all the answers, and what you'll find when you read Taubes, Kendrick etc is that they are also calling for answers, and not claiming to have them all.

Geoff

Page 40 tells you where and who supplied the evidence.
This is the Health Technology Assessment 2
http://www.hta.ac.uk/fullmono/mon1114.pdf

Fact is that taking statins makes people die less.

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That's a blanket statement I can't agree with.

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Well, that's what those funny brackets "(relative risk [RR] 0.83, 95% confidence interval
[CI] 0.78 to 0.90)" mean

AMBrennan wrote
Well, that's what those funny brackets "(relative risk [RR] 0.83, 95% confidence interval
[CI] 0.78 to 0.90)" mean

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I'm busy flogging through the hundreds of pages, provided by NICE and other sources, to find the relevant detail.
You'll have to bear with me. It's not quite like reading a published study.

Perhaps you could explain, for my benefit, and any other reader of your reply, what your quoted line means, and with relevance to what and whom.

I don't deny statins are helpful for a few populations. I don't believe they work by lowering cholesterol.
They work in another way. That's why I won't be taking any. I want my cholesterol where it is.

Geoff

I've had no explanation from my GP as to what statins will actually do for me, and I have a friend who had a stroke and was put on statins. She took them religiously and went on to have two more strokes after that plus the side effects.

I myself have a history of drug sensitivities including severe joint pains which with one medication which took two years to leave my system so I'm not risking that again with another medication that I have flipping idea whether it will help me or not. I just don't see the point of taking a drug and ending up worse off than you were originally.

GraceK wrote
I'm not risking that again with another medication that I have flipping idea whether it will help me or not

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Not according to Dr Kendrick.

Here's what I posted back in May :

viewtopic.php?f=15&t=29480&p=275440&hilit=+kendrick#p275440


Geoff

AMBrennan said:

Fact is that taking statins makes people die less

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The 6 or so studies that NICE analysed amount to just under 50000 people. It misses out a study that is slightly bigger than all of the NICE ones added together namely the Norwegien HUNT 2 study that was carried out over a ten year period. It comes to a different conclusion on statins. For men it says the lowest all cause death rate is when those men have a total cholesterol of around 5.5 and for women it basically says statins have no effect what so ever in fact their mortality rate rises as cholesterol levels drop.

Read it here.

http://www.ncbi.nlm.nih.gov/pubmed/21951982

The relevant chart from the study is below. It shows that if this study is correct then taking statins at dosages that gps are told to recommend, namely to get you under 5 if you are non diabetic and under 4 if you are diabetic would be causing more deaths not less. Consequently your assertion "Fact is that taking statins makes people die less" would not be the case at all.

It misses out a study that is slightly bigger than all of the NICE ones added together namely the Norwegien HUNT 2 study that was carried out over a ten year period

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That might be because the study has nothing to do with statins - a person with naturally low cholesterol is not the same as a person with naturally high cholesterol taking statins. It's interesting but really not relevant here.

NICE did not recommend statins because they think that high cholesterol is bad and statins lower cholesterol (both these things may well be true though): They recommend it because fewer of the people treated with statins died compared to those treated with a placebo. If your doctor recommends statins then that's probably because you are like the people in those studies, leading him to expect you to benefit from the drug.

We have a theory about how cholesterol affects mortality. Whether it's correct is an academic question; perhaps useful for developing new treatments but not relevant to the question at hand - should I take this drug? Maybe a lower dose would be even best but that still leaves a high dose better than nothing at all.

AMBrennan said:

It misses out a study that is slightly bigger than all of the NICE ones added together namely the Norwegien HUNT 2 study that was carried out over a ten year period

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That might be because the study has nothing to do with statins - a person with naturally low cholesterol is not the same as a person with naturally high cholesterol taking statins. It's interesting but really not relevant here.

NICE did not recommend statins because they think that high cholesterol is bad and statins lower cholesterol (both these things may well be true though): They recommend it because fewer of the people treated with statins died compared to those treated with a placebo. If your doctor recommends statins then that's probably because you are like the people in those studies, leading him to expect you to benefit from the drug.

We have a theory about how cholesterol affects mortality. Whether it's correct is an academic question; perhaps useful for developing new treatments but not relevant to the question at hand - should I take this drug? Maybe a lower dose would be even best but that still leaves a high dose better than nothing at all.

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I see this in much the same light as recommended hBA1c values. The average healthy (if such a person exists) non diabetic hBA1c is around 4.6% yet diabetics get told do 6.5% to 7.5%. If it were fine we would have evolved so that the average healthy non diabetic persons hBA1c would be 7%.

The same can be argued for cholesterol levels which I agree is a subtly different thing to statins acting on those levels. What HUNT 2 tends to shows is that the NICE recommendations for ideal cholesterol levels are actually different to what ideal levels may well be. The outcome still has a physical effect though doesn't it? You may well be right that statins save more lives than a placebo but if the target level were set correctly then they would save more lives.

If for one moment we agree that there is an ideal level then how you achieve that ideal level statins, plant sterols, that juice someone posted about the other day or whatever is immaterial.

My issue isn't really with statins its that NICE maybe setting the wrong targets just as the do with HBA1c in my opinion.

I was put on simvastatin when I was dx.. It slowed me down and I was mentally fuzzy.
I stopped taking it after about 6 months and feel so much better.
My doctor suggested a new statin, and I refused. Needless to say, he wasnt amused.