Tag Archives: statins

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

Posted on by Carolyn Thomas
10

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 medication – oops, 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?

Posted on by Carolyn Thomas
16

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?

Posted on by Carolyn Thomas
8

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 →

Can statin drugs really save your life?

Posted on by Carolyn Thomas
12

When I was hospitalized after my heart attack, cardiologists immediately prescribed Lipitor, a statin drug which happens to be the biggest-selling drug on earth, made by Pfizer, which happens to be the biggest drug company on earth. My LDL (bad) cholesterol numbers went from 4.1 while still in the Coronary Care Unit down to 1.9 a few short weeks later.

(These are Canadian readings, by the way: to convert from Canadian to American readings, just multiply by 40). That’s quite a spectacular result for lowering one’s LDL cholesterol levels – but the question remains: do I really need to take this powerful cholesterol drug every day for the rest of my life?

Dr. Mark Ebell, a professor at the University of Georgia and deputy editor of the journal American Family Physician, says:

“High-risk groups have a lot to gain. But patients at low risk benefit very little if at all. We end up over-treating a lot of patients.”

Continue reading →

When medical research is funded to favour the drug, not the facts

Posted on by Carolyn Thomas
18

Here’s a cardiac research story so confusing that the average dull-witted heart attack survivor like me can barely keep up with the plot. So let’s try telling the tale in pared-down plain English to see if we can figure out how two well-respected “experts” can have such viciously opposing interpretations of the same research, and what factors might just be at work to influence those opinions – financial and otherwise.

But before even looking at the story’s details,  let’s do what everybody should do before evaluating any study results: fast-forward to the end of the research report until you find the teeny tiny fine print revealing researchers’ conflict of interest disclosures. And it turns out that each of the opposing researchers in this story has plenty of reason to trash the other’s interpretation.  Continue reading →

Harvard cozies up with Big Pharma

Posted on by Carolyn Thomas
6

It was like something out of the movie Michael Clayton – only with Big Pharma as the villain: a Pfizer drug rep sporting a severe black suit and taking cell phone pictures of students protesting Harvard Medical School’s ties to the drug industry. Staged last October, the Boston gathering was sparsely attended, with a few students holding signs and a petition delivered to an empty office (the dean was out of town).

But the photographer’s appearance was notable enough to merit a story in the New York Times, which eventually led to a U.S. Senate committee investigation.

And so it goes for Harvard Medical School, according to a report in Boston Magazine that reveals Harvard has actually been under increasingly intense scrutiny since 2008, when a series of incidents put a spotlight on the venerable university’s symbiotic –  if awkward –  relationship with drug companies.

The trouble started that summer, after Dr. Joseph Biederman, a child psychiatrist and Harvard Medical School professor, was found to have taken more than $1.6 million in payments (which he apparently failed to fully disclose to the school as required) from the maker of a major anti-psychotic drug he’d been prescribing.  Continue reading →