Statins for Blood Cholesterol
I subscribe to Dr. Jeffry Bland’s Functional Medicine Update monthly CD with several other RDs. For any RDs reading this, I highly recommend it! This month’s issue interviewed Dr. James M Wright, who has been questioning the benefits of prescribing blood cholesterol drugs for prevention of heart disease. When the lipid-lowering guidelines were updated in 2001, it increased the number of Americans who ‘should’ be taking statins from 13 million to 36 million. Wow! I have had clients whose physicians have recommended medication for this very reason.
However, Dr. Wright’s analyzed the research that supports this guideline and actually found no support for this policy. They found that most of the research on statins is for people, who have already been diagnosed with heart disease, but that clinicians decided to extrapolate that information to suggest that if it helps when already diagnosed, it should help prevent disease.
What Dr. Wright and his colleagues did find, however, was that for high-risk men between the ages of 30-69, that 50 of them being treated for 5 years might see a benefit. Two problems here (if you don’t already see a problem): First, these statistics mean, in research terms, this is INSIGNIFICANT. Second, we are discounting the problems statins cause!
Statins tend to cause a high frequency of muscle damage. And that frequency increases with exercise. So, if you had a 50 year old man who had some weight to lose and his cholesterol is 200, and he has no other risk factors, he may decide to improve his diet and start an exercise program at the time his doctor put him on a statin. Although he quickly starts to see improvement as a result of the exercise, he also starts to see a complication because of his medication. So, traditionally, the doctor will tell him to stop exercising! Research repeatedly shows the health benefits from diet and exercise, but does not show benefit from taking a statin as a preventative measure. I won’t point out the obvious.
What is the answer, then? If you have no other risk factors or have not been diagnosed with any heart disease, when your doctor suggests starting a medication to lower your cholesterol, do your research and come back with questions for him/her before you agree. It’s your body, it’s your life. It’s your choice and you should have all the information.
If you are interested in the analyses that Dr Wright conducted, here are the details:
Are lipid-lowering guidelines evidence-based?
J Abramson, JM Wright
The Lancet - Vol. 369, Issue 9557, 20 January 2007, Pages 168-169
Statins for primary prevention of coronary artery disease – Authors' reply
James M Wright, John Abramson
The Lancet - Vol. 369, Issue 9567, 31 March 2007, Page 1079
However, Dr. Wright’s analyzed the research that supports this guideline and actually found no support for this policy. They found that most of the research on statins is for people, who have already been diagnosed with heart disease, but that clinicians decided to extrapolate that information to suggest that if it helps when already diagnosed, it should help prevent disease.
What Dr. Wright and his colleagues did find, however, was that for high-risk men between the ages of 30-69, that 50 of them being treated for 5 years might see a benefit. Two problems here (if you don’t already see a problem): First, these statistics mean, in research terms, this is INSIGNIFICANT. Second, we are discounting the problems statins cause!
Statins tend to cause a high frequency of muscle damage. And that frequency increases with exercise. So, if you had a 50 year old man who had some weight to lose and his cholesterol is 200, and he has no other risk factors, he may decide to improve his diet and start an exercise program at the time his doctor put him on a statin. Although he quickly starts to see improvement as a result of the exercise, he also starts to see a complication because of his medication. So, traditionally, the doctor will tell him to stop exercising! Research repeatedly shows the health benefits from diet and exercise, but does not show benefit from taking a statin as a preventative measure. I won’t point out the obvious.
What is the answer, then? If you have no other risk factors or have not been diagnosed with any heart disease, when your doctor suggests starting a medication to lower your cholesterol, do your research and come back with questions for him/her before you agree. It’s your body, it’s your life. It’s your choice and you should have all the information.
If you are interested in the analyses that Dr Wright conducted, here are the details:
Are lipid-lowering guidelines evidence-based?
J Abramson, JM Wright
The Lancet - Vol. 369, Issue 9557, 20 January 2007, Pages 168-169
Statins for primary prevention of coronary artery disease – Authors' reply
James M Wright, John Abramson
The Lancet - Vol. 369, Issue 9567, 31 March 2007, Page 1079
posted by Margie Geiser, MBA, RD, NSCA-CPT at
6:02 AM
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