15 years ago a new class of prescription drugs burst on to the scene. They were drugs designed to lower cholesterol called statins. At this point more than 18 million Americans take them. And statins are a $21 billion per year cash cow for the pharmaceutical industry. But do all the people taking them really need to be?
At times it does seem as if there is an almost narrow-minded focus on cholesterol numbers. If your number's high, take a statin drug, is the potent message. The thing is, the target keeps moving. What's high cholesterol now was a normal value 3 years ago. In the meantime millions more people are taking these drugs at a big cost to insurance plans and a nice profit for the drug companies.
It's so easy to take a pill and think you are fighting heart disease. The ads say that if you take Lipitor, the most popular statin drug, you can reduce your risk of heart attack by 36%. That seems like such a large reduction. But if you look into where this number-the 36% reduction in heart attacks comes from-it's not as simple as it's made out.
The study quoted in the ad split people into two groups. For over three years one group took Lipitor, the other took a placebo. For every 100 people in the placebo group, there were three heart attacks; in the Lipitor group there were two. This means that 100 people had to take Lipitor for more than three years to spare just one person from a heart attack.
Statins do one thing; they lower cholesterol-especially LDL cholesterol. If you already have heart disease it would be a good idea to lower this risk factor. The question is, how about the millions of people with elevated cholesterol who are taking statins but have no heart disease or other risk factors?
"We have no evidence that taking a cholesterol-lowering medication like a statin will present them from getting heart disease," said Elizabeth Nabel, director of the National Heart, Lung, and Blood Institute. Even though guidelines say don't use statins in patients with low risk factors unless their bad cholesterol goes over 160, in the real world, many doctors prescribe statins anyway.
But statins have side effects and cost money. What's more, they may give a false sense of security. Statin users may be tempted to neglect other risk factors, like high blood pressure, lack of exercise, and poor diet. Everyone wants a quick fix, but in this case, your better off increasing exercise and working with diet and other lifestyle factors.
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