Sunday, November 24, 2013

Statins and cardiovascular conflicts of interest /

A compendium of comments on the new statin guidelines from Gary Schwitzer at Health News Review:
I’d like to see a public survey of comprehension of the recent splash of news about new guidelines for heart disease prevention and statin drug use.  Heads must be spinning.Here are some of the pieces that I found noteworthy:
“The chairman and one of two additional co-chairs of the working panel that wrote the controversial cholesterol guidelines on reducing cardiovascular risk, released last week, had ties to the drug industry at the time they were asked to lead the panel. And, in all, eight of the 15 panelists had industry ties.”
“The process by which these latest guidelines were developed gives rise to further skepticism. The group that wrote the recommendations was not sufficiently free of conflicts of interest; several of the experts on the panel have recent or current financial ties to drug makers. In addition, both the American Heart Association and the American College of Cardiology, while nonprofit entities, are heavily supported by drug companies.The American people deserve to have important medical guidelines developed by doctors and scientists on whom they can confidently rely to make judgments free from influence, conscious or unconscious, by the industries that stand to gain or lose.We believe that the new guidelines are not adequately supported by objective data, and that statins should not be recommended for this vastly expanded class of healthy Americans. Instead of converting millions of people into statin customers, we should be focusing on the real factors that undeniably reduce the risk of heart disease: healthy diets, exercise and avoiding smoking. Patients should be skeptical about the guidelines, and have a meaningful dialogue with their doctors about statins, including what the evidence does and does not show, before deciding what is best for them.”
“even if these guidelines were not written by people in the pay of the drug industry, they could just as well have been. And somehow, while important new evidence against the routine use of statins, and suggesting that we really don’t know much about the true mechanism by which these drugs work in the cases where they do, crept into the guidelines for the first time, the bottom line is largely unaffected by such enlightened thoughts. We’re back to putting statins in the water supply.”

UPDATE:  The NY Times informs us that if we are in the 20% having muscle pain from statins, it may be caused by a drug reaction. Perhaps another drug is slowing down metabolism of the statin.
Okay: but if you are having muscle pain, what other side effects might you be having that you didn't notice?  Liver inflammation? Cognitive decline? Do you really want to stay on the statin under these conditions?  Do you really want to get off other drugs?

No comments: