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Written By: Werner L Knoepp

Statin Drugs - Oversold, Overhyped: Some Benefit from Statin Drugs, Most Don't

The January 17, 2008 issue of Business Week carries a well researched article titled: Do Cholesterol Drugs Do Any Good? The article goes on to answer this question with a resounding No! The short story about statin drugs is that they can in fact be life saving in men who have already had a heart attack. But statin drugs are worthless for everyone else! This is just one of countless incidences of good drugs being pushed too far in Big Pharma's marketing efforts.

The pharmaceutical industry has studied this question extensively. And they have been unable to show any reduction of deaths or serious health events among any people who are regularly taking statins. Reading the Business Week article brings to light the fact that when statins are given to men who actually have serious heart disease, then the statin drugs, through a complex enzyme reduction process, dial back serious and damaging arterial inflammation. In men, specifically. The process is not replicated in women.

Another interesting fact brought out by the Business Week article is that cholesterol does not cause heart disease. And any problem with cholesterol should not be a reason for taking statin drugs. This of course has done nothing at all to deter Big Pharma's unabashed marketing efforts. The marketing of these predominantly useless and often harmful and dangerous drugs goes on relentlessly.

In July of 2008, the American Academy of Pediatrics (AAP), heavy beneficiaries of Big Pharma's largesse, issued recommendations that statins should be prescribed for children as young as 8 years! This in the face of indisputable evidence that statins provide absolutely no benefit to anyone who has not already suffered a heart attack!

When Pfizer was confronted with this question, they did not challenge the facts. Instead, they simply parotted their consistent claim that "statins reduce the risk of coronary events" without supporting this with any empirical evidence.

If any of these pharmaceutical manufacturers could show with any degree of certainty that statins are completely safe and inexpensive, then their use would be a no brainer. But 10% to 15% of statin users, aside from not receiving any benefits, suffer serious side effects, including severe muscle pain, cognitive impairment, and sexual dysfynction.

The entire statin story is actually just another case among many others. A story of good drugs being pushed too far in the interests of profits. Drug companies are after all, a business. Drug companies are supposed to boost sales, just like any other business. Corporations are expected to return profits to shareholders. The problem the drug companies are faced with though is that many of their drugs, like statins, are effective in only small subgroups of patients. And with statin drugs specifically, these patients are men - and only men - who have already had a heart attack. Women are entirely out of the equation. Women receive no benefit from taking statin drugs no matter what their medical history.

Since this is hardly a blockbuster market, we can now see the need for marketing these drugs to increasingly wider groups of people who stand to benefit less and less from them. So that's where marketing these drugs to children comes in. It fits right in with the entire cradle to grave marketing philosophy Big Pharma has been promoting all along.

Drugmakers make sure that the researchers and doctors who promote the benefits of their medications are well compensated. Dr Rodney Hayward, professor of internal medicine at the University of Michigan Medical School puts it bluntly: "It's almost impossible to find anyone who believes strongly in statins, who does not get a lot of money from the industry."

Cholesterol has become a buzzword in our society and the pharmaceuticals have rushed in full force to give us relief. Cholesterol is a marker. A number. And people like the idea that such a number can be monitored and altered. This makes the statin drugs an easy sale. It's simply the perception of benefit. People get fixated on the number and begin to believe that controlling it will be the answer to all their health problems. Doctors go along with it. Many do so in good faith, all do so because denying their patient a cholesterol screening will cause the patient to go stomping out of the office muttering "quack."

So here's the reality. Cholesterol is just one of many risk factors associated with coronary disease and by itself cannot be taken as any kind of definitive marker. It has been pretty well established that higher LDL levels of cholesterol often help set the stage for heart disease by contributing to the buildup of arterial plaque. But it takes a lot more than high cholesterol to cause heart disease. Dr Ronald M Krauss, director of atherosclerosis research at the Oakland Research Institute asserts that patients with heart disease rarely have significantly higher cholesterol levels than people without heart disease.

Among many doctors, the debate over cholesterol and statin use had become fierce. A growing number of physicians are taking the position that LDL levels can be safely ignored altogether, while their dissenters rage at this idea and never hesitate to flatly state that anyone proposing such heresy should be summarily jailed.

However, both sides of the debate are on common ground when it comes to a general approach to avoiding heart disease in the first place, and it has nothing at all to do with statin drugs. The general approach to reducing or eliminating heart disease that both sides agree on is better diet and increased physical activity.

For those people who might actually benefit from treatment with statins, such drugs might be better prescribed if a patient's risk for heart disease is closely evaluated first. The simple fact that a person has "high cholesterol" is not enough of a reason to prescribe these dangerous statin drugs. Doctors are becoming increasingly convinced that the risk of heart disease does not relate to cholesterol levels at all, and many are calling for a more rational use of these drugs.

Will that ever happen? Not until the country changes the way our health care system is run. And changes it radically. Today it's based on what makes money. Making sick people well has no place in this picture.

George Kosmides DC, CCN, CMUA

93 banyan Dr. Hilo, Hawaii 96720