The Statin Scams

A couple of interesting and unrelated articles in the popular press this week got me to thinking: What if - instead of an innocent kid- it had been the emperor from the kingdom next door shouting "that dude's got no clothes on"?

I'm guessing no one would have listened.

A thought-provoking piece by Hanna Rosin on breastfeeding published in the April 2009 Atlantic Monthly sparked my little reverie. Rosin's not a doctor (i.e. not a member of the emperor club), nor a PhD, just an ultra-smart journalist who combed through the supposedly irrefutable evidence in favor of breast feeding and found it... well, let's just say "wanting". Her piece was all the more credible because she didn't "debunk" or "dismiss" the evidence in favor of breastfeeding but rather thoughtfully reexamined much of what "everyone knows is true" and found it to be based on very ambiguous research which was far less definitive than everyone imagines.

I then happened upon Sharon Begley's piece in Newsweek this week titled "The Myth of Early Detection". Begley, one of the best science reporters in the country, shot holes in another "accepted" pearl of wisdom: that early detection of cancers always saves lives.

All of which got me wondering.

Maybe it's time for one of these really smart investigative reporter types -- outsiders not from the hallowed halls of academia -- to take on the cholesterol establishment.

The myth that high cholesterol causes heart disease and that lowering cholesterol prevents it is even more entrenched than the two sacred cows taken on by Rosin and Begley. Sure there's a handful of scientists like Uffe Ravnskov, MD, PhD and The International Network of Cholesterol Skeptics that's been taking this one on for years. These guys have enough intellectual bandwidth that if you assembled them all in one place and Paul Krugman accidentally wandered in, there's actually a chance he might not be the smartest guy in the room.

But sad to say they're boring as hell, and no one's listening. For all the American public knows, these folks are about as credible as Holocaust Deniers. Besides, they're doctors -- and people don't pay attention to emperors who throw stones at other emperors. It starts to look like one big snooze of a squabble on CSPAN and everybody just tunes out.

So maybe it takes an outsider -- albeit a really smart one -- to take a close look at this. We need the equivalent of a full-throated high IQ kid with really big eyes and the soul of a whistle-blower, one with no connection to the drug or medical establishment and no compunction about saying "Dude, where's the beef?" to take this one on.

Because when the truth about the house of cards that is the cholesterol-lowering establishment really gets out, it'll make credit default swaps look like a 1st grade prank.

Sharon Begley, are you listening?

Comments

[PalMD]

@bnavot, the cholestero­l-lowering effect seems clearly related to the benefits of statins, but so does some sort of pleiotropic anti-inflammatory effect. It's not clear what "antioxidant" effect there may or may not be.

The tone of the entire piece is bizarre and fraught with logical fallacies.

For ex.,
Maybe it's time for one of these really smart investigative reporter types -- outsiders not from the hallowed halls of academia -- to take on the cholesterol establishment.
Is most good science done by "outsiders"? Have the medical advances that have us living longer and better (and fatter) come from "outsiders"? Are they the ones doing the yoeman's work in labs all over the country?


And then, after calling for an objective re-examination of the evidence, you make the telling assumption:

The myth that high cholesterol causes heart disease and that lowering cholesterol prevents it is even more entrenched than the two sacred cows taken on by Rosin and Begley

It's a rather horrid piece. (I hope i didn't just violate your ad hom guidelines!)

[DennyCrane]

I'm still waiting for someone to prove the myth about eggs raising cholesterol. I eat eggs everyday and my cholesterol is fine. How bout the one about too much protein being bad for your kidneys? I eat 1.5 g per pound of bodyweight and I have no kidney problems. There are so many myths out there that doctors themselves don't want challenged. A little humility would be a good thing. The smartest statement in the field of science is "I don't know" but too many doctors and scientists are surprisingly anti-science in their attitude. Real scientists welcome challenges to accepted fact. But today's doctors seem to fear it.

[SteveMDFP]

The thinking presented here seems to boil down to "the drug companies are making a lot of profit from statins. Therefore, their widespread use must be just a scam; surely these drugs must be worthless."

The argument is irrational, dangerous, and stupid. Yes, there are those who question whether cholesterol lowering is the true MECHANISM by which these compounds benefit many patients. However, no review of the evidence can dispute the RESULTS of benefit in high-risk individuals. Benefits among high-risk individuals is indisputable for stroke and heart attack, and highly suggestive for diabetes, alzheimer's, osteoporosis and others.

You don't need to have Krugman's IQ to see this. Any generally well-educated, literate person can perform a search of the medical literature at pubmed.gov and search the words statin and mortality. You'll find careful, thoughtful analyses like:
http://www.ncbi.nlm.nih.gov/pubmed/17408535

Now, the drug companies do play some games with their marketing in this area. There probably isn't much difference in effect between new / expensive / profitable agents and the older / generic / cheap ones, like Mevacor/Lovastatin. The health care system is, indeed, pouring needlessly vast sums of money into the pockets of pharmaceutical companies' shareholders. But fixing this problem is a matter of healthcare reform, not eschewing the use of highly effective, cost-effective treatments.

[bnavot]

Good doctors know that it is unclear what effect cholesterol has on heart health. however, it is clear that statins have a beneficial effect on heart health. there is recent evidence that it has more to do with anti-oxidant effects than with cholesterol lowering.