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Old 08-05-2018, 06:47 PM
 
575 posts, read 140,668 times
Reputation: 1046

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Quote:
Originally Posted by Good4Nothin View Post
There is a lot of pro-statin publicity, and lots of deceptive and confusing research. There is no simple way to prove one side or the other, but there definitely is an ongoing controversy.

You can find articles claiming that statins prevent cancer and dementia, in addition to heart disease and stroke, and that they have no real side effects.

You can also find articles claiming that statins have no benefit for most of the people who are taking them.

And you can find many experts who say that the small benefit statins do have for heart disease patients, is not from lowering cholesterol but from reducing inflammation.

It is very much a confusing controversy.

But it is a known fact that drug company sponsored research tries hard to make statins look good, but showing relative risk reduction. So a tiny benefit is made to look impressive.
Interesting article
https://blogs.scientificamerican.com...tatin-therapy/

 
Old 08-05-2018, 07:38 PM
 
3,027 posts, read 1,206,807 times
Reputation: 5985
Quote:
Originally Posted by Good4Nothin View Post
SuzyQ,

Why don't you show us some research that shows unambiguously that statin drugs have improved health and extended life for patients taking them? I have not seen anything that shows any meaningful benefit.

Heart disease has decreased, but we don't know how much is because of less smoking, or better awareness of nutrition and exercise.

Why don't you show something that proves it conclusively? That there is a real meaningful benefit, and no meaningful damage, over long periods of statin use?

It does not exist.
This is not a topic about statins. You have started numerous topics about them. This is about longevity generally and have been provided with plenty of data to support that modern medicine has increased longevity.
 
Old 08-05-2018, 08:45 PM
 
Location: Georgia, USA
21,481 posts, read 26,078,274 times
Reputation: 26426
Quote:
Originally Posted by Good4Nothin View Post
I posted this one several times.

https://bmjopen.bmj.com/content/6/6/...1-a3278160ca49

"High LDL-C is inversely associated with mortality in most people over 60 years. This finding is inconsistent with the cholesterol hypothesis (ie, that cholesterol, particularly LDL-C, is inherently atherogenic). Since elderly people with high LDL-C live as long or longer than those with low LDL-C, our analysis provides reason to question the validity of the cholesterol hypothesis. Moreover, our study provides the rationale for a re-evaluation of guidelines recommending pharmacological reduction of LDL-C in the elderly as a component of cardiovascular disease prevention strategies."
Yes, you posted it before, and it has been rebutted.

https://www.bhf.org.uk/informationsu...ol-and-statins

"Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said: 'As we get older, many more factors determine our overall health, making the impact of high cholesterol levels less easy to detect.

'The evidence from large clinical trials demonstrates very clearly that lowering LDL cholesterol reduces our risk of death overall and from heart attacks and strokes, regardless of age. There is nothing in the current paper to support the authors’ suggestions that the studies they reviewed cast doubt on the idea that LDL cholesterol is a major cause of heart disease or that guidelines on LDL reduction in the elderly need re-evaluating.' ”


Quote:
Originally Posted by Good4Nothin View Post
There is a lot of pro-statin publicity, and lots of deceptive and confusing research. There is no simple way to prove one side or the other, but there definitely is an ongoing controversy.

You can find articles claiming that statins prevent cancer and dementia, in addition to heart disease and stroke, and that they have no real side effects.

You can also find articles claiming that statins have no benefit for most of the people who are taking them.

And you can find many experts who say that the small benefit statins do have for heart disease patients, is not from lowering cholesterol but from reducing inflammation.

It is very much a confusing controversy.

But it is a known fact that drug company sponsored research tries hard to make statins look good, but showing relative risk reduction. So a tiny benefit is made to look impressive.
Did you know there is no perfect drug? The ideal drug would benefit every person who took it. However, even very effective treatments do not help everyone who takes them. Some people with high blood pressure will never have a stroke or heart attack, for example. However, since we have no way to know in advance who will benefit - have a heart attack or stroke prevented - and who will not, we recommend that everyone be treated for high blood pressure, with lifestyle changes and medication, depending on the severity of the BP elevation.

There is a calculator that can estimate your risk of cardiovascular disease.

ACC/AHA ASCVD Risk Calculator

Lets run the numbers for a 65 year old white male non-smoker with diabetes, a blood pressure of 130/90 (untreated), total cholesterol of 200, and an HDL of 40. His ten year risk of heart attack or stroke (compared to a similar demographic) is about 27%.

ACC/AHA ASCVD Risk Calculator

Look at the recommendations and the comments at the bottom of the page. One of those is, "Before initiating statin therapy, clinicians and patients ought to engage in a discussion which considers addressing risk factors such as smoking and optimal lifestyle, the potential for ASCVD risk reduction benefits, adverse medication effects, drug-drug interactions, and patient preferences for treatment."

If you were that patient you would be free to say all you wanted to do is exercise an hour per day and not eat any carbs at all.

Many other folks would want to do all they could, including meds, to lower that 1 in 4 risk.


By the way, why is the anti-inflammatory effect of statins a bad thing?
 
Old 08-06-2018, 03:21 AM
 
Location: Georgia, USA
21,481 posts, read 26,078,274 times
Reputation: 26426
Quote:
Originally Posted by Good4Nothin View Post
"High LDL-C is inversely associated with mortality in most people over 60 years."
And I gave you a source that questions the study you are quoting, the author of which is a cholesterol denialist who cherry picked data to prove his preconceived bias.

https://sciencebasedmedicine.org/the...erol-skeptics/


Quote:
Originally Posted by Good4Nothin View Post
You can always find different studies contradicting each other, SuzyQ. It depends what data you look at and how you look at it. You think because you find an article supporting drugs it's conclusive. No, many experts have been questioning the cholesterol hypothesis, and there is no good evidence supporting it.

And as I have explained, the absolute risk reduction for heart attacks with statins is tiny and not clinically significant.
No single study can support any given concept. The entire body of evidence has to be considered.

The absolute risk reduction depends on what the relative risk reduction is, and the risk for an individual patient depends on assessment of all his risks, not just cholesterol levels.

This article explains how the decision making process works. It includes references supporting that process.

https://www.acc.org/latest-in-cardio...n-older-adults

Quote:
Originally Posted by Good4Nothin View Post
SuzyQ,

Why don't you show us some research that shows unambiguously that statin drugs have improved health and extended life for patients taking them? I have not seen anything that shows any meaningful benefit.

Heart disease has decreased, but we don't know how much is because of less smoking, or better awareness of nutrition and exercise.

Why don't you show something that proves it conclusively? That there is a real meaningful benefit, and no meaningful damage, over long periods of statin use?

It does not exist.
You have been given the references before. You just refuse to accept them.

There are 25 references at the ACC link above just about statins in the elderly.

There are 695 references here, with the current lipid management guidelines and the rationale behind them. That is the body of evidence I am referring to.

https://www.aace.com/files/lipid-guidelines.pdf

Go to pages 32 and 33. The treatment section starts with a discussion of exercise and nutrition.

"Regular physical activity helps to increase strength and flexibility, maintain bone density, and improve insulin sensitivity. Physical activity is also associated with reductions in hsCRP levels and improvements in risk factors such as obesity, waist circumference, hypertension, and dyslipidemia (366 [EL 4; NE]). Specific lipid-level improvements associated with regular exercise include reduced VLDL-C, increased HDL-C, and, in some individuals, decreased LDL-C levels (10 [EL 4; NE]).Numerous published guidelines identify exercise regimens as an essential approach for dyslipidemia control and cardiovascular risk factor reduction."

"Research has shown that diet can have a substantial effect on lipid levels and may be an important determinant of ASCVD risk. Therefore, medical nutrition therapy provides an important tool for the management of dyslipidemia."

Long term?

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5418248/

"In summary, long term follow up of WOSCOPS patients out to 20 years provides new evidence to support the long term cardiovascular benefits and safety of pravastatin, when used in the primary prevention setting."

https://www.washingtonpost.com/natio...=.aae67882c2d3
 
Old 08-06-2018, 06:55 AM
 
575 posts, read 140,668 times
Reputation: 1046
In spite of you all this has been a very interesting thought provoking discussion. One of the better ones Ive seen. For that I thank you all and the moderator.
 
Old 08-06-2018, 07:15 AM
 
Location: Central IL
13,348 posts, read 7,115,490 times
Reputation: 31038
Quote:
Originally Posted by Good4Nothin View Post
There is a lot of pro-statin publicity, and lots of deceptive and confusing research. There is no simple way to prove one side or the other, but there definitely is an ongoing controversy.

You can find articles claiming that statins prevent cancer and dementia, in addition to heart disease and stroke, and that they have no real side effects.

You can also find articles claiming that statins have no benefit for most of the people who are taking them.

And you can find many experts who say that the small benefit statins do have for heart disease patients, is not from lowering cholesterol but from reducing inflammation.

It is very much a confusing controversy.

But it is a known fact that drug company sponsored research tries hard to make statins look good, but showing relative risk reduction. So a tiny benefit is made to look impressive.
Why do you characterize the research itself as deceptive and confusing? That implies an explicit intent to deceive or obfuscate - is that what you're really saying?

Much more likely is that you are either attempting to read professional medical journals and do not understand them - after all, they are intended for trained clinicians or researchers; or you are consulting disreputable popular media sources that aren't qualified to comment or are doing so irresponsibly.
 
Old 08-06-2018, 08:38 AM
 
575 posts, read 140,668 times
Reputation: 1046
Quote:
Originally Posted by suzy_q2010 View Post
Yes, you posted it before, and it has been rebutted.

https://www.bhf.org.uk/informationsu...ol-and-statins

"Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said: 'As we get older, many more factors determine our overall health, making the impact of high cholesterol levels less easy to detect.

'The evidence from large clinical trials demonstrates very clearly that lowering LDL cholesterol reduces our risk of death overall and from heart attacks and strokes, regardless of age. There is nothing in the current paper to support the authors’ suggestions that the studies they reviewed cast doubt on the idea that LDL cholesterol is a major cause of heart disease or that guidelines on LDL reduction in the elderly need re-evaluating.' ”




Did you know there is no perfect drug? The ideal drug would benefit every person who took it. However, even very effective treatments do not help everyone who takes them. Some people with high blood pressure will never have a stroke or heart attack, for example. However, since we have no way to know in advance who will benefit - have a heart attack or stroke prevented - and who will not, we recommend that everyone be treated for high blood pressure, with lifestyle changes and medication, depending on the severity of the BP elevation.

There is a calculator that can estimate your risk of cardiovascular disease.

ACC/AHA ASCVD Risk Calculator

Lets run the numbers for a 65 year old white male non-smoker with diabetes, a blood pressure of 130/90 (untreated), total cholesterol of 200, and an HDL of 40. His ten year risk of heart attack or stroke (compared to a similar demographic) is about 27%.

ACC/AHA ASCVD Risk Calculator

Look at the recommendations and the comments at the bottom of the page. One of those is, "Before initiating statin therapy, clinicians and patients ought to engage in a discussion which considers addressing risk factors such as smoking and optimal lifestyle, the potential for ASCVD risk reduction benefits, adverse medication effects, drug-drug interactions, and patient preferences for treatment."

If you were that patient you would be free to say all you wanted to do is exercise an hour per day and not eat any carbs at all.

Many other folks would want to do all they could, including meds, to lower that 1 in 4 risk.


By the way, why is the anti-inflammatory effect of statins a bad thing?
Those clinical trials and studies almost never included significant numbers of women or ethic grps like African Americans. Most of the work on statins was done on middleaged white male populations. Drs then took those studies and said hey lets use it on women and blacks. Difference doesnt matter. Except it does. And you want those of us who understand how the system really works to trust that the drug cos and drs know how their product will affect us? Hogwash! Doesnt matter if its statins or cipro or any other drug.
https://academic.oup.com/qjmed/article/94/3/127/1524028
 
Old 08-06-2018, 08:42 AM
 
575 posts, read 140,668 times
Reputation: 1046
Quote:
Originally Posted by reneeh63 View Post
Why do you characterize the research itself as deceptive and confusing? That implies an explicit intent to deceive or obfuscate - is that what you're really saying?

Much more likely is that you are either attempting to read professional medical journals and do not understand them - after all, they are intended for trained clinicians or researchers; or you are consulting disreputable popular media sources that aren't qualified to comment or are doing so irresponsibly.
Because much of the research concentrated on white middle aged males. Perhaps not a deliberate attempt to decieve but a cultural attitude that men are more important and thus our studies and trials will be conducted on them, not lesser members of society.
 
Old 08-06-2018, 09:08 AM
 
Location: Central IL
13,348 posts, read 7,115,490 times
Reputation: 31038
Quote:
Originally Posted by Williepaws View Post
Because much of the research concentrated on white middle aged males. Perhaps not a deliberate attempt to decieve but a cultural attitude that men are more important and thus our studies and trials will be conducted on them, not lesser members of society.
I agree that later trials should expand the test groups to more diverse populations. In general, the reasons for keeping it constrained is to reduce the variability that would make it more difficult to assess results without having much larger test samples. At some point that becomes necessary if those populations are intended to also get the medication. Medical research has been slowly adding women and other ethnic groups to drug trials, but not fast enough.
 
Old 08-06-2018, 09:18 AM
 
3,330 posts, read 919,781 times
Reputation: 2570
Quote:
Originally Posted by Luckyd609 View Post
Your explanation doesn't mean anything if you do not have some peer reviewed research to back it up.

With so many 'experts' there must be some verified data you can present.
I did.
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