Statin guidelines we love to hate – and the docs who write them

Here at Ethical Nag World Headquarters, it’s been quite the week ever since the American Heart Association and the American College of Cardiology released their new cardiovascular disease treatment guidelines, which I have taken the liberty of sub-titling:

“If you have a detectable pulse, you need to be taking statins!”

For more specifics on the guidelines – including the list of four newly-identified  groups of people whose heart health will benefit from taking cholesterol-lowering medicationoops, I mean statins only – every day for the rest of their natural lives, read yesterday’s Ethical Nag post, Can Statins Prevent My Head From Exploding?

What happens next? Your doctor will now review all 284 pages of the new guidelines, and then, in a bonding moment of shared decision-making, the two of you will soon sit down together to decide upon just the right course of action – oops, I mean drug prescription – based on what the guideline authors have recommended, in turn based on an (allegedly) flawed risk calculator that’s predicted to significantly increase the very large pool of daily statin-using drug takers, even among healthy individuals formerly considered low-risk for future cardiovascular disease.

But first, let’s set off for a behind-the-scenes visit to the people who actually write these treatment guidelines.  Continue reading

Can statins prevent my head from exploding?

I’m exhausted. My hair hurts. My head’s about to explode, singed by the firestorm of media coverage about new cardiovascular disease treatment guidelines – specifically, the newly-expanded recommendations to prescribe the cholesterol drugs called statins to just about every middle-aged person who still has a detectable pulse.

Five years ago, I was told by my cardiologist that, as a freshly-diagnosed heart attack survivor, I was most definitely in the right demographic to benefit from taking a statin every day for the rest of my natural life (along with a fistful of other cardiac meds).  Statins, he explained, would help prevent another heart attack by controlling my specific target levels of low-density lipoprotein cholesterol, commonly known as LDL, or ‘bad cholesterol’.  Lots of studies (at least, those paid for by the folks who make statins) seemed to indicate that lower LDL numbers would decrease both my risk of suffering a future cardiac event as well as death.

But now, these new treatment guidelines are essentially telling us and our doctors not to obsess at all on those target LDL numbers in favour of expanding the pool of potential statin-users out there.

Continue reading

Universal cholesterol screening for little kids?

November 11, 2011 was a happy day for Big Pharma. That’s the day when The National Heart, Lung and Blood Institute issued new guidelines recommending that every child’s first cholesterol check should occur before the kid hits puberty, between the age of 9-11.  As the Wall Street Journal reported at the time, the guidelines also come amid broad concern about growing numbers of children who are overweight or obese (as about 17% of the little darlings are, triple the level from three decades ago).

These children, say those who wrote these guidelines, are thus potentially on course for diabetes, high blood pressure, heart disease and other serious health problems as adults.

With all due respect to the very smart doctors who came up with what amounts to a resounding high-five victory for marketing-based medicine, I feel compelled to ask:

“What were you thinking?”

Even though the new guidelines contain a mandatory cautionary note (“Drugs? What drugs?”) the corporate pharmaceutical windfall that’s implicit in them is worth celebrating if you happen to own stock in Big Pharma.   Continue reading