Health Tips - do cholesterol-lowering drugs reduce risks of heart diseases?
We would say ‘yes’ to that. Most of us with high cholesterol levels would start taking pills rather than change our life-style.
We have all been sold with that belief. That’s why the giant statins drug industry is happily wallowing in deep pools of pure liquid gold. It is cashing in on lots of research showing statin drugs are effective in lowering cholesterol levels. We all seem to jump to the conclusion that those drugs necessarily protect us from dying of heart diseases.
But let’s look at the other side of the coin. We don’t have to look hard for some evidence that cholesterol-lowering drugs are not the silver bullet we imagine them to be. There is some evidence that lowering cholesterols does not necessarily reduce our risks of getting heart diseases.
One example is a significant US study in 2002 known as the ALLHAT-LLT trial.[1] It involved 10,355 patients in 513 clinical centers. The participants were aged 55 years or older, with low cholesterol levels.[2] The six year study was reported in the 2002 Journal of American Medical Association.[3]
It found that:
(a) cholesterol levels were effectively reduced by a well-known cholesterol-lowering drug (pravastatin);[4]
(b) lowering the cholesterol level did not make much difference to incidents of heart diseases and death rates – over a six year period, there were 9.3% cases of heart disease problems (CHD events) amongst those who took the drug as compared with 10.4% for those who did not take the drug.[5]
Yes, the statins drug industry and its supporters would love to bury this evidence.
Questions:
Ø What inferences can you draw from this piece of evidence?
Ø Do you think the multi-billion dollar drug industry will just take it lying down? If not, what can they do about it?
Ø Would this persuade you to try changing your life-style as a means of lowering your high cholesterol levels instead of taking those drugs?
Ø Would you also take into account risks of side-effects from taking these drug?
Gim Teh/Saturday, August 13, 2011
[1] http://www.ncbi.nlm.nih.
[2] Amongst the participants, the mean age was 66 years, 49% were women, 38% black and 23% Hispanic, 14% had a history of CHD, and 35% had type 2 diabetes. Some technical details: The low-density lipoprotein cholesterol levels (LDL-C) were of 120 to 189 mg/dL (100 to 129 mg/dL if known CHD) and triglycerides lower than 350 mg/dL. 5,170 of them were given pravastatin and the others just given usual care. Baseline mean total cholesterol was 224 mg/dL; LDL-C, 146 mg/dL; high-density lipoprotein cholesterol, 48 mg/dL; and triglycerides, 152 mg/dL.
[3]
The Allhat-LLT Officers And Coordinators For
The Allhat Collaborative Research Group, (2002).
"Major outcomes in moderately hypercholesterolemic, hypertensive
patients randomized to pravastatin vs usual care: The Antihypertensive and
Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT)". JAMA
288 (2998–3007); http://jama.ama-assn.org/
[4]
‘Pravastatin (marketed
as Pravachol or Selektine) is a member of the drug class of statins, used for
lowering cholesterol and
preventing cardiovascular
disease’: http://en.wikipedia.org/wiki/
[5] The conclusion was Pravastatin did not reduce either all-cause mortality or heart disease cases (CHD) significantly. For the technical-minded: All-cause mortality was similar for the 2 groups. There were 6-year mortality rates of 14.9% for pravastatin vs 15.3% with usual care. CHD event rates were not significantly different between the groups, with 6-year CHD event rates of 9.3% for pravastatin and 10.4% for usual care.