Are Statin Drugs Over Prescribed?

Statins – those ubiquitous drugs used to lower
cholesterol levels – are big business!

steve_chaneyOver 20 million Americans are currently being treated
with statin drugs at a cost that runs into billions of
dollars every year.

Some of my cardiologist friends are so convinced that
statin drugs prevent death from heart attacks that they
have said, only half-joking, that we should just add
statins to the water supply.

Is their faith in the power of statin drugs to prevent
death from heart disease justified? One recent study
says that it just might not be.

Now, I don’t want anyone to misinterpret what I am
going to say next.

If you have already had a heart attack, there is good
evidence that statins will reduce the risk of dying
from a second heart attack.

In the technical jargon of the scientific world that is
referred to as secondary prevention.

But what about those millions of Americans who are
being prescribed statin drugs who have never had a
heart attack? This is something we scientists refer to
as primary prevention.

You might be surprised to learn that nobody had actual
asked previously whether statin drugs were effective in
the primary prevention of dying from a heart attack.

All of the previous clinical trials showing beneficial
effects of statin drug therapy were done only with
secondary-prevention populations (people who had
already had a heart attack) or with a mixture of
secondary-prevention and primary-prevention (people who
had not previously had a heart attack) populations.

That is what makes this recent study so interesting!

Dr. Kausik Ray and colleagues from Cambridge University
in England performed a meta-analyis of 11 clinical
studies involving over 65,000 participants. They
focused on those participants in the studies who had
not previously had a heart attack (the primary
prevention group) and reported their results in the
June 28, 2010 issue of Archives of Internal Medicine.

They found that the use of statins over an average of
3.7 years had no statistically significant effect on
all cause mortality
. In short, statins had no effect on
the risk of dying from heart disease or any other
cause.

Dr. Sreenivasa Sechasai, one of the doctors involved in
the study, said “We didn’t find a significant reduction
in death despite having such a huge sample size. This
is the totality of evidence in primary prevention. So
if we can’t show a reduction with this data, it is
unlikely to be there.”

Does this mean that you should discontinue statin use
without consulting your physician? Absolutely not!

There is some evidence that statins may reduce the
incidence of non-fatal heart attacks in people who have
not previously experienced a heart attack.In addition,
many experts still feel that statins are likely to
reduce the risk of death from heart disease in certain
high risk individuals.

But, you may want to initiate a conversation with your
physician about your continued statin use in light of
this recent study. He or she can best evaluate your
overall risk of heart disease and advise you whether
statin use ie still appropriate for your level of
heart disease risk.

To Your Health!
Dr. Stephen G Chaney

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