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Old 08-06-2018, 03:31 PM
 
4,627 posts, read 10,500,588 times
Reputation: 10314

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Quote:
Originally Posted by Good4Nothin View Post
No it might not work exactly the same. But we are the same species, and it will probably work similarly.

Maybe it is a problem, but it is a very small problem compared with all the other problems with drug research.

For one thing, the drugs have not been shown to work to prevent heart disease in people who don't have it. Yet, millions of these people have been given the drugs.

I think it's better to focus on the really serious problems, and there are plenty. For example, drug company research says that statin side effects are imaginary. Somehow they made it look that way, and this was broadcast all over the internet. So when patients complain of severe pain and weakness, their doctors won't believe them.

And this is EVEN THOUGH the mechanism for statins damaging muscle cells is known.
You keep making this erroneous claim apparently believing if you say it enough times people will actually believe it to be true.

I also think it is better to "focus on the really serious problems" such as the fact that cardiovascular disease is the number one killer of americans so focusing on THAT would seem to make more sense than the minority of patients that experience side effects from the medication...

Bottom line, the overwhelming majority of research on cholesterol supports the "cholesterol theory" of CVD and the use of statins in the appropriate patients absolutely aids in primary prevention of CVD

"In adults at increased CVD risk but without prior CVD events, statin therapy was associated with reduced risk of all-cause and cardiovascular mortality and CVD events, with greater absolute benefits in patients at greater baseline risk."
https://jamanetwork.com/journals/jam...rticle/2584057

 
Old 08-06-2018, 04:08 PM
 
Location: Georgia, USA
21,499 posts, read 26,102,510 times
Reputation: 26471
Quote:
Originally Posted by Williepaws View Post
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.
In the past women were sometimes excluded because of the risk that they would get pregnant. There is info on women:

https://www.sciencedirect.com/scienc...35109711049898

And minorities:

https://www.medscape.com/viewarticle/714598_9

Note that the risk calculator includes sex and differentiates African Americans

ACC/AHA ASCVD Risk Calculator
 
Old 08-06-2018, 04:35 PM
 
Location: Georgia, USA
21,499 posts, read 26,102,510 times
Reputation: 26471
Quote:
Originally Posted by Good4Nothin View Post
If the (small) benefit of statins is because they are anti-inflammatory, that tends to contradict the cholesterol hypothesis. It is important to have some idea of what is going on.

And anti-inflammatory drugs are generally bad for health. Inflammation has a purpose, and is necessary for health. Some of inflammation is destructive, but the CAUSE of that destructive inflammation should be targeted, NOT inflammation in general.

The cause of destructive inflammation, very often, is metabolic syndrome. You can target metabolic syndrome with lifestyle changes.

About HALF of Americans have diabetes or pre-diabetes, which is related to metabolic syndrome and high insulin levels. These conditions result from the typical modern lifestyle.
Part of the benefit of statins is anti-inflammatory. Part is due to reducing the amount of cholesterol deposited in the arterial wall.

Cholesterol crystals are the cause of the inflammation in atherosclerosis:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3623938/

"Cholesterol crystals can activate a multimolecular signaling complex of the innate immune system, the NLRP3 inflammasome, resulting in a caspase-1 mediated activation and secretion of proinflammatory interleukin-1 family cytokines. Furthermore, crystalline cholesterol is thought to induce plaque rupture by physical disruption of the fibrous cap covering atherosclerotic lesions."

https://www.ncbi.nlm.nih.gov/pubmed/26705388

"Cholesterol crystals initiate inflammation via NLRP3 inflammasome leading to interleukin-1β (IL-1β) production inducing C-reactive protein. Eventually, crystals growing from within the plaque and associated inflammation destabilize the plaque."

https://www.sciencedaily.com/release...0428142300.htm

"'We've found that, given a certain type of nutrition, cholesterol crystals are deposited in the arterial walls after a relatively short time,' says Dr DŁwell. 'These crystals are then taken up by the immune system's scavenger cells.' This becomes the starting signal for a catastrophic chain reaction. The unhealthy food results in the accumulation of cholesterol crystals that activate an 'inflammasome' complex within the scavenger cells. One of the functions of this multi-protein complex is to induce the release of inflammatory mediators. The mediators then attract more and more immune cells to the site where the problem is occurring. The growing invasion ultimately destabilizes the vessel walls -- with potentially life-threatening consequences."

https://www.tandfonline.com/doi/pdf/10.2217/clp.09.79

The cholesterol comes first, then the inflammation.
 
Old 08-06-2018, 05:24 PM
 
Location: Georgia, USA
21,499 posts, read 26,102,510 times
Reputation: 26471
Quote:
Originally Posted by Good4Nothin View Post
It isn't just me. There are experts who criticize the deceptive practices of drug company funded research. One obvious example, which I have posted, is reporting relative risk reduction, instead of absolute risk reduction. This practice makes a one percent reduction is risk look like a fifty percent reduction.

And side effects are often reported in absolute terms, in order to minimize them.

There may be an explicit intent to deceive or obfuscate, some of the time. That is not unheard of in marketing. In fact, marketing is all about making things appear good.

And research reports are inherently confusing, and very easy to obfuscate. Most MDs do not study research statistics, and they are busy, so they trust the expert interpretations.

Statin drugs are a huge money-maker, and the drug companies probably want to keep this going for a while. Do they sincerely believe in their products? Maybe some do.
A one percent reduction in risk is not the same as a one percentage point reduction. If you are going to talk about it, perhaps you should get the terminology right.

The risks and benefits have to be couched in terms that the individual patient can understand. Many doctors do prefer to use absolute risks. Where do you get the idea that they don't? The only person who can decide whether than one percentage point reduction in risk is a benefit that justifies taking the med is the patient, after consulting his doctor. He also needs to understand that risk calculations apply to groups, not individuals. The fact is that many people are at very high risk for adverse cardiovascular outcomes, and a 50% reduction in relative risk for them translates into much more than a 1% reduction in absolute risk.

Where is your source that "most MDs do not study research statistics"? That they are unable to interpret study results for themselves?

Quote:
Originally Posted by Good4Nothin View Post
Well they probably should but I don't see that as a central problem. If the drugs worked for most white males, they would probably also work for women and minorities.

The real problem is they DO NOT generally work for white males!

They seem to work for patients whose cholesterol is extremely high for genetic reasons. And maybe for patients with known heart disease.

Hardly any benefit at all for everyone else. Yet something like half of all Americans over age 60 are taking them!
No, you cannot assume that women will react the same as men or that African Americans will react the same as whites. That is why women and African Americans must be studied - and are.

Quote:
Originally Posted by Good4Nothin View Post
No, SuzyQ, it has been disagreed with. People have different opinions. You believe anything that is pro-drug.
Yep, it has been disagreed with and the disagreement supported with evidence.

Quote:
Originally Posted by Williepaws View Post
Do some research. Just because a drug works for a white middle aged man, doesnt mean its going to work the same way with the same side effects for an elderly woman, or an african american etc.
True, which is why all demographic groups need to be studied.

Quote:
Originally Posted by Good4Nothin View Post
No it might not work exactly the same. But we are the same species, and it will probably work similarly.

Maybe it is a problem, but it is a very small problem compared with all the other problems with drug research.

For one thing, the drugs have not been shown to work to prevent heart disease in people who don't have it. Yet, millions of these people have been given the drugs.

I think it's better to focus on the really serious problems, and there are plenty. For example, drug company research says that statin side effects are imaginary. Somehow they made it look that way, and this was broadcast all over the internet. So when patients complain of severe pain and weakness, their doctors won't believe them.

And this is EVEN THOUGH the mechanism for statins damaging muscle cells is known.
We do not all have the same genetics, and there are ethnic and gender differences in the response to many drugs. That is why all demographics need to be included in studies.

The drugs do work; you have been presented tons of evidence to support that. Have you been through all of the references here yet? The article evaluates the rationale behind each recommendation for diagnosis and treatment.

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

What research has found is that there is a nocebo effect going on with statins and muscle weakness and pain. The complaint of weakness and pain is real, not imaginary, it is just not caused by the statin. The mechanism for muscle damage is known, and such damage can be tested for. Patients who complain of pain and weakness often have no objective evidence of muscle damage. The same person may experience pain and weakness when he knows he is getting the statin but not when he does not know he is getting it.

https://www.sciencedirect.com/scienc...33287416302112
 
Old 08-06-2018, 05:25 PM
 
5,644 posts, read 3,196,510 times
Reputation: 6628
Quote:
Originally Posted by suzy_q2010 View Post
In the past women were sometimes excluded because of the risk that they would get pregnant. There is info on women:

https://www.sciencedirect.com/scienc...35109711049898

And minorities:

https://www.medscape.com/viewarticle/714598_9

Note that the risk calculator includes sex and differentiates African Americans

ACC/AHA ASCVD Risk Calculator
What is the average sized woman? 5'4, 140 lbs? I am 5'1, 98 lbs. So I need to be medicated the same as that average sized woman, let alone a 6', 200 lb. man?????

I can remember the first time my husband was in the hospital, there was a sign on his room door. ONLY use a PEDIATRIC Cather!!!! He is 6'1". One "size" fits all adults????
 
Old 08-06-2018, 06:45 PM
 
Location: Georgia, USA
21,499 posts, read 26,102,510 times
Reputation: 26471
Quote:
Originally Posted by Jo48 View Post
What is the average sized woman? 5'4, 140 lbs? I am 5'1, 98 lbs. So I need to be medicated the same as that average sized woman, let alone a 6', 200 lb. man?????

I can remember the first time my husband was in the hospital, there was a sign on his room door. ONLY use a PEDIATRIC Cather!!!! He is 6'1". One "size" fits all adults????
I have no idea what this post has to do with the thread, but most adult medications are not dosed on body weight. Once a certain weight is reached, it is indeed one size fits all, because that works.

That catheter may have been for comfort. That is the reason a pediatric scope is used for my colonoscopies.
 
Old 08-06-2018, 07:50 PM
 
3,347 posts, read 925,925 times
Reputation: 2571
Quote:
Originally Posted by kitty61 View Post
You are painting your theory with a wide brush.
Don't forget how penicillin has saved millions of lives. Our ancestors used plant-based remedies and there are medicines today that are derived from these same plants. Willow bark - aspirin. Humans have discovered how to synthesize the essence.
Maybe you think I was saying no one should ever use drugs. I did not say that.
 
Old 08-06-2018, 07:54 PM
 
3,347 posts, read 925,925 times
Reputation: 2571
Quote:
Originally Posted by bluedevilz View Post
You keep making this erroneous claim apparently believing if you say it enough times people will actually believe it to be true.

I also think it is better to "focus on the really serious problems" such as the fact that cardiovascular disease is the number one killer of americans so focusing on THAT would seem to make more sense than the minority of patients that experience side effects from the medication...

Bottom line, the overwhelming majority of research on cholesterol supports the "cholesterol theory" of CVD and the use of statins in the appropriate patients absolutely aids in primary prevention of CVD

"In adults at increased CVD risk but without prior CVD events, statin therapy was associated with reduced risk of all-cause and cardiovascular mortality and CVD events, with greater absolute benefits in patients at greater baseline risk."
https://jamanetwork.com/journals/jam...rticle/2584057
And how many patients had to take the drug for how many years for one patient to benefit? I don't know where they buried that information.
 
Old 08-06-2018, 08:02 PM
 
3,347 posts, read 925,925 times
Reputation: 2571
Quote:
Originally Posted by suzy_q2010 View Post
The risks and benefits have to be couched in terms that the individual patient can understand. Many doctors do prefer to use absolute risks. Where do you get the idea that they don't?
You will argue about ANYTHING. Drug research results have usually been reported as relative risk reduction, because a 50% reduction is more impressive than 1%! And this sure looks like intentional deception to me.
 
Old 08-06-2018, 08:05 PM
 
3,347 posts, read 925,925 times
Reputation: 2571
Quote:
Originally Posted by suzy_q2010 View Post

The drugs do work; you have been presented tons of evidence to support that. Have you been through all of the references here yet? The article evaluates the rationale behind each recommendation for diagnosis and treatment.
And YOU have been presented with tons of evidence that many millions of patients are taking these drugs who will get a tiny benefit, or none at all.
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