heart disease

Statin Rage

David Mendosa Health Guide November 12, 2008
  • People seldom make me angry any more. When another driver cut me off yesterday, I didn't even flip him the finger or honk my horn. I just figured that he was in a bigger hurry than I was.

    Recently doctors have determined that when we are younger and when we are older we are happier than when we are middle-aged. That can't be generally true, because I still remember my miserable youth.

    My life instead has been one of increasing happiness. I'm much more likely to shed tears of joy, as I did on the evening of November 4, than to weep with rage.

    But our doctors still infuriate me. Especially those physicians in league with the pharmaceutical companies that keep pushing the statins at us.


    As a patient I know the statins all too well. Years ago when my doctor prescribed them, I tried to tolerate four of them. But each of them caused terrible muscle pains in my right leg.

    I can't therefore imagine anything more reckless to our health than for everyone to have to take a statin. Yet that is precisely what an appropriately named doctor in the U.K. suggests.

    "
    Maybe people should be able to have their statin, perhaps if not in their drinking water, with their drinking water," Dr. John Reckless told BBC News four years ago. Apparently not an idiot, he is chairman of Heart UK and a consultant endocrinologist at Bath University.

    That was four years ago. But they keep pushing these drugs at us. And now they are pushing them at more and more of us.

    Just this week the prestigious New England Journal of Medicine published the results of the "JUPITER Trial." Jupiter stands for "Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin."

    They named the trial a "justification"? That's open minded? Not. This "translates to by God we're going to prove that statins prevent something," comments one of my favorite bloggers.

    The JUPITER study group concluded that men over 50 and women over 60 with normal LDL-cholesterol levels (less than 130
    mg per deciliter) and highly-sensitivity C-reactive protein levels of 2.0 mg per liter or higher who took one of the statin drugs minimally reduced their risk of developing heart disease or dying of any cause as compared to those who took placebo. That's it.

    But the drug pushers and their allies in the mass media all jumped up and down over the study. Even The New York Times on Sunday reported that, "A large new study suggests that millions more people could benefit from taking the cholesterol-lowering drugs known as statins, even if they have low cholesterol, because the drugs can significantly lower their risk of heart attacks, strokes and death."

    What's the big deal? We have known for years that C-reactive protein "is a general marker for inflammation and infection, so it can be used as a very rough proxy for heart disease risk, as Wikipedia says. But, the encyclopedia continues, "Since many things can cause elevated CRP, this is not a very specific prognostic indicator."

    Four physicians from Northwestern University's Feinberg School of Medicine in the Annals of Internal Medicine two years ago reviewed how well CRP predicted heart attacks. They found "no definitive evidence that, for most individuals, CRP adds substantial predictive value above that provided by risk estimation using traditional risk factors for CVD [cardiovascular disease]."


  • For people with diabetes the lesson of the JUPITER Trial isn't to swallow statins. It is to know our CRP level so we can control inflammation.


    Diabetes has a direct link to inflammation. The better we control inflammation the better we can control our diabetes.

    That's why it is especially important for those of us with diabetes to prevent gum disease, which is chronic inflammation of the tissues surrounding and supporting our teeth. Inflammation also plays a central role in another complication of diabetes, peripheral arterial disease.

    The test known as highly-sensitive C-reactive protein may not be a good guide for us to take a statin drug. But it is a good guide to the general level of inflammation in our body.

    Do you known your CRP level off-hand? I didn't and had to look mine up. It's 0.4 mg per liter. I will skip the statins.

    The great poet Dylan Thomas would have us, "Rage, rage against the dying of the light." Certainly. But we must also rage against what's not right.

     

    Related posts:

    Be sure to check out Bill Quick's commentary, "Statins for Everyone?" and Gretchen's post, "The JUPITER Trial"