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No. The safeguards do not solve the problems. Meta-analyses are easy to bias. Experts are vulnerable to group think. Statin research has been extremely deceptive, but that got right past the "safeguards" you rely on.
For example the trick of reporting relative (as opposed to absolute) risk reduction. If a drug decreases the risk of a disease from 4% to 2% that can be reported as 2% absolute risk reduction, or as a 50% relative risk reduction.
Which do you think the drug industry supported research reports? But side effects are reported as absolute.
Just one example, but a good one. And MDs just keep falling for this kind of trick.
There is a board of experts not just one expert. Your fear of the bias, fraud, contradictory, etc flaws associated with research has always been there. It is minimized by having experts take a vote after reading and interpretation the research. Medicine is a very broad profession and it relies on expert opinion from the specialists. The specialists role is to instruct the general doctor population. That is the system we have.
Just to contrast what exists in the alternative realm with Lyme literate doctors, anyone can claim to be a Lyme literate doctor. There is no board certification required to call yourself a LLD. There is no examination. No certification of competency. There is no medical society associated with LLD. LLD do not do research and don't publish research in scientific journals. There are no published practice guidelines by LLD on how to treat Lyme disease. Nothing, absolutely nothing is learned by them or from them. Each is an individual doing whatever they want and having an open mind in doing so. They read anything they want and can act on it.
The role of medicine is to reduce disease so the relative risk reduction is very significant. The absolute risk reduction applies to economics.
When placing absolute risk reduction above all else then one ignores most diseases. At any one point in time how many people have cancer? Every year 240,000 women are diagnosed with breast cancer. The US population is what? 330 million. That is .07% of the population. Why do anything with such insignificant numbers. If you have a successful treatment like curing one half then you are curing 0.03%.
Most disease are rare events with some more than others. In order to judge a treatment or prevention measure one looks to see treatment outcomes or prevention outcomes in terms of disease. One doesn't look at people who don't have disease or never will come down with disease which is what we are talking about when you introduce absolute numbers.
For example the trick of reporting relative (as opposed to absolute) risk reduction. If a drug decreases the risk of a disease from 4% to 2% that can be reported as 2% absolute risk reduction, or as a 50% relative risk reduction.
There is a right way and a wrong way to use absolute vs relative risk reduction.
For example, for highly communicable diseases, you would always want to use relative risk reduction. For largely stable diseases, you would absolute risk reduction.
A good example:
If we throw someone out of a helicopter we know that parachutes will save them 99% of the time. This is a relative risk reduction.
Now, if we give parachutes to only people who plan to jump out of airplanes, RRR = ARR. However, if we choose to give parachutes to the general population, ARR will be nearly 0%.
I'll allow you to think about this example and why that means we would to use RRR for vaccines for highly communicable diseases and ARR for say someone with high cholesterol and prescription of statins.
When placing absolute risk reduction above all else then one ignores most diseases. At any one point in time how many people have cancer? Every year 240,000 women are diagnosed with breast cancer. The US population is what? 330 million. That is .07% of the population. Why do anything with such insignificant numbers. If you have a successful treatment like curing one half then you are curing 0.03%.
Most disease are rare events with some more than others. In order to judge a treatment or prevention measure one looks to see treatment outcomes or prevention outcomes in terms of disease. One doesn't look at people who don't have disease or never will come down with disease which is what we are talking about when you introduce absolute numbers.
There is no drug given to prevent cancer!! But statins are given to people just because of their age! So millions are taking statins who will have no benefit, only side effects. You raise a person's blood glucose and make their metabolic syndrome/ pre-diabetes worse, for a tiny possible benefit!
So relative vs absolute risk really does matter with preventative treatments like statins.
On "Drugs.com" you can put in any medication and get reviews from real people.
You're not going to get the reviews from people who have taken the drug recommended by their doctor and had good results without noticeable side effects; only the rare people who have had side effects plus a whole bunch of people who either experience "anti-placebo" effects or who are using "post hoc ergo propter hoc" analysis to blame an issue on the drug they took/
Coughing IS a side effect of statin use. You're correct. But it's also a symptom of CHF. In fact why we use the word "congestive" in Congestive Heart Failure. It should be pointed out that prescribing statins to patients with HF is a controversial practice, something a physician needs to carefully weigh with their clinical experience and patient history.
It's also a common side effect of ACE blood pressure drugs, and of seasonal allergies.
There is no drug given to prevent cancer!! But statins are given to people just because of their age!
No, statins are given when blood cholesterol, specifically LDL (the fluffy stuff that clogs arteries) remains high despite diet, exercise and weight management. They lower LDL and they're proven to reduce plaque formation.
For people 30 years of age with highish LDL, the risk of a cardiac even is low. For those over 60, the risk is considerably higher. That's the age component.
No doctor is recommending statins for 65 year olds with 130 total cholesterol and 30 LDL. Simply isn't happening.
There is no drug given to prevent cancer!! But statins are given to people just because of their age! So millions are taking statins who will have no benefit, only side effects. You raise a person's blood glucose and make their metabolic syndrome/ pre-diabetes worse, for a tiny possible benefit!
So relative vs absolute risk really does matter with preventative treatments like statins.
Just to be clear your perspective is from one from the general population who won't come down with any coronary or vascular event and not from the perspective of somebody who had a TIA.
One should not interchange the two.
The question then becomes how do you know you will never have heart disease or a stroke to say that you are not a candidate for statin drug? I presume your answer is that one should not care because it only has a tiny possible benefit. The tiny part again refers to the overall numbers absolute risk. It doesn't refer to the relative risk of those having an event. The benefit is seen in those who have experienced an event. TIA is having an event. The person was taking statins and who's to say it did not prevent a full on stroke.
Now if you have a family history of heart disease with an abnormal lipid panel and are refusing to take statins then good luck to you if you are going by the tiny absolute risk.
Just to be clear your perspective is from one from the general population who won't come down with any coronary or vascular event and not from the perspective of somebody who had a TIA.
One should not interchange the two.
The question then becomes how do you know you will never have heart disease or a stroke to say that you are not a candidate for statin drug? I presume your answer is that one should not care because it only has a tiny possible benefit. The tiny part again refers to the overall numbers absolute risk. It doesn't refer to the relative risk of those having an event. The benefit is seen in those who have experienced an event. TIA is having an event. The person was taking statins and who's to say it did not prevent a full on stroke.
Now if you have a family history of heart disease with an abnormal lipid panel and are refusing to take statins then good luck to you if you are going by the tiny absolute risk.
Family history and abnormal lipid panel would not be an indication to go on statins. See the post I made earlier in the thread.
Quote:
Originally Posted by WaikikiWaves
I will weigh in here.
If, and only if, you have CHD, clinical trials have shown that for 1000 patients treated over 5 years, statins will prevent 9 strokes. This is in comparison to 17 strokes prevented through antiplatelet agents (aspirin being the most common).
If you don't have CHD, statins have not been shown to reduce your risk of stroke, even if you had a stroke in the past.
This is data from 9 trials with over 70,000 patients.
If you do not fit these groups, please ask your doc what meta-analysis of clinical trials supports you being put on statins given your risk factors. If he cannot answer that question off the top of his head, you need to get a second opinion. Do a search for a doctor who is an expert in this field.
If you do fit the criteria, you can ask him why statins over aspirin. And then you can decide if the small reduction in odds of developing another stroke are worth the side effects of statin use.
No, statins are given when blood cholesterol, specifically LDL (the fluffy stuff that clogs arteries) remains high despite diet, exercise and weight management. They lower LDL and they're proven to reduce plaque formation.
For people 30 years of age with highish LDL, the risk of a cardiac even is low. For those over 60, the risk is considerably higher. That's the age component.
No doctor is recommending statins for 65 year olds with 130 total cholesterol and 30 LDL. Simply isn't happening.
Everything you say is medical industry dogma. You are not questioning any of it or thinking about it.
Cholesterol naturally rises with age, probably because it is protective. Also because of the modern lifestyle which tends to cause (here I will say it YET AGAIN) metabolic syndrome, which leads to insulin resistance and chronic inflammation.
You NEVER say anything like that, and you NEVER respond when I say it. Not ever.
And NO, MDs are not waiting until a patient has changed to a lifestyle that can reverse metabolic syndrome. They don't even know what that might be. They recommend low fat low cholesterol diets, and a very small amount of exercise.
Statin drugs are probably needed for the small minority that have extremely high cholesterol for genetic reasons. That small minority skews the average, and makes it seem like most others benefit.
For most people with high cholesterol, that is NOT the cause of heart disease or stroke. It is the RESULT of metabolic syndrome!
But it seems you never even heard of metabolic syndrome. Yes, it began as an "alternative" medical theory, many years ago. But now it is acknowledged and mainstream. But you never even heard of it. You ignore everything I say about it.
Statin drugs are mistaken in several ways. And, as I said, their effectiveness is greatly exaggerated by reporting only relative risk reduction. And their safety is greatly over-estimated.
And your panels of experts aren't the great infallible oracles you imagine they are. Groups of experts are vulnerable to group think and peer pressure, especially when huge profits are involved.
Everything you say is medical industry dogma. You are not questioning any of it or thinking about it.
Statin drugs are mistaken in several ways. And, as I said, their effectiveness is greatly exaggerated by reporting only relative risk reduction. And their safety is greatly over-estimated.....
OK, so you'd maintain that there is no cardiac risk reduction for a 60 year old with family history and mildly elevated LDL and total cholesterol. In other words, you'd say the American College of Cardiology guidelines are wrong. OK.
SHOW US THE DATA.
Not a bunch of Youtube videos made by people flogging their alternative theories.
DATA.
We'll be waiting.
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