Why do Cardiologists Give Statin Drugs to Women?
Why do cardiologists and mainstream docs continue to prescribe statins to women? It is very simple, they succumb to the drug company “spin” from the drug reps and the medical journals which are slanted in favor of statins. In addition, the mainstream doctors succumb to patient's demands and expectations for the drugs after seeing the celebrity TV ads.
Are You Still Not Convinced?
Mary Enig writes, "No study has shown a significant reduction in mortality in women treated with statins. The University of British Columbia Therapeutics Initiative came to the same conclusion, with the finding that statins offer no benefit to women for prevention of heart disease." (6) (7)
Are you still not convinced that women should NOT take Statin Drugs? Don’t take my word for it. Take the word of Judith Walsh MD who wrote this in JAMA, 4 years ago in an article entitled, Treatment of Hyperlipidemia in Women: "For women without cardiovascular disease, lipid lowering does not affect total or CHD (Cardiovascular Heart Disease) mortality. Lipid lowering may reduce CHD events, but current evidence is insufficient to determine this conclusively. For women with known cardiovascular disease, treatment of hyperlipidemia is effective in reducing CHD events, CHD mortality, nonfatal myocardial infarction, and revascularization, but it does not affect total mortality."(8)
Translation: Cholesterol lowering with statin drugs does not reduce total mortality in women, PERIOD. It doesn’t reduce mortality in women without heart disease, called primary prevention. It doesn’t reduce mortality in women with heart disease, called secondary prevention.
Still not convinced? then read this article by Malcolm McKendrick, a doctor in England, in the British Medical Journal, May 2007, entitled: "Should Women be Offered Cholesterol Lowering Drugs? NO ".(8A) "To date, none of the large trials of secondary prevention with statins has shown a reduction in overall mortality in women. Perhaps more critically, the primary prevention trials have shown neither an overall mortality benefit, nor even a reduction in cardiovascular end points in women. This raises the important question whether women should be prescribed statins at all. I believe that the answer is clearly no."(8A)
Note: Secondary prevention means women with known heart disease. Primary prevention means women without known heart disease.
Still not convinced ? Then read this June 2007 article by Electra Kaczorowski, of the National Women’s Health Network "There is currently no indication that women of any age or any risk level will benefit from taking statins to prevent CHD and other heart conditions – yet this is precisely how statins are being marketed to women. " (9)
Still not convinced ? Are statin drugs good for anybody? Read this review article by Joel Kauffman PhD, Dec 2003, in which the best statin trial results (the HPS simvastatin study) had an absolute reduction of all cause death rate of 0.38% per year. Yet this performance was inferior to the less expensive alternatives of buffered aspirin or Omega-3 oils.(10)
Quote: "The most favorable (statin) trial with seemingly impeccable reporting and minimal financial conflict of interest was the Heart Protection Study (HPS), on simvastatin for 5 years, in which secondary prevention in men (86% of patients) of any unwanted vascular event gave a RR = 0.76 (5.5% absolute, 1.1% per year), and an all-cause death rate drop of 0.38% per year. (Lancet 2002; 360:7-22) Since this performance is inferior to that of either Bufferin in men or omega-3 fatty acid supplements, both of which have lesser side-effects, and are far less expensive, the logic of prescribing simvastatin seems faulty."(10)
Still not convinced ? Then read this article by Harriett Rosenberg from Women and Health Protection from June 2007, Do Cholesteriol Lowering Drugs Benefit Women ? (11) Evidence for Caution: Women and statin use By Harriet Rosenberg Danielle Allard Women and Health Protection June 2007
Quote: "Our review of these fields identifies a troubling disjuncture between the widespread use of statin medication for women and the evidence base for that usage. What we found instead was evidence for caution."
Still not convinced ? Not only are statin drugs a failure for women, they also should never be prescribed to the elderly. Mortality in the elderly goes up as cholesterol goes down. Read this Letter to the Editor by Eddie Vos. (12)
Quote:"Regarding women, two 2004 analysis found no reduction in deaths from statin over placebo. In actual patient outcomes, the J-LIT study in 41,801 hypercholesterolemic Japanese (2/3rds women) found mortality in the 2 lowest on-statin cholesterol categories 2-3 times higher; its authors cautioned about ‘hyperresponders’ to statin. The 4S study ended with 3 more dead women on statin vs. placebo, and another ‘successful’ study, HPS, found no significant mortality benefit in women." See article for references.
Still not convinced ? Then read this article by Bill Sardi, Who Will Tell the People? It Isn't Cholesterol ! (13) " If physicians were truly honest with their patients, there probably would be very few people being treated for primary prevention with a statin drug."
Still not convinced? Then read this Jan 2007 Lancet article by Harvard trained MD, John Abramson, "Are lipid-lowering guidelines Evidence-Based ? ". (14)
Quote:" No studies have shown statin cholesterol-lowering drugs to be effective for women at any age, nor for men 69 years of age or older, who do not already have heart disease or diabetes. Better than 50 adults have to take a cholesterol-lowering drug for 1 patient to avoid a mortal heart attack, and that figure only applies to high-risk patients. There is a vanishing benefit to lowering cholesterol for healthy adults." [Lancet 2007; 369:168-169].
Dr. John Abramson joins with 30 more eminent MD's in this Sept 2004 letter to the NIH calling for a complete revision of the faulty cholesterol treatment guidelines.
Still not convinced? Then read this e-book by Shane Ellsion, "The Hidden Truth About Cholesterol-Lowering Drugs! ", by Shane Ellison, MS, Organic Chemistry. (15)
"Among healthy people, statin drugs do not prevent early death from heart disease, despite their cholesterol lowering effects. This is because there is no correlation or
relationship between low cholesterol and the progression of atherosclerosis – the number one cause of heart disease. Repeat that sentence. This became abundantly
clear with the statin drug trials."
"In the last 13 months, however, the failures of two important clinical trials have thrown that hypothesis into question. (that cholesterol lowering is beneficial).
First, Pfizer stopped development of its experimental cholesterol drug torcetrapib in December 2006, when a trial involving 15,000 patients showed that the medicine caused heart attacks and strokes. That trial — somewhat unusual in that it was conducted before Pfizer sought F.D.A. approval — also showed that torcetrapib lowered LDL cholesterol while raising HDL, or good cholesterol.
Torcetrapib’s failure, Dr. Taylor said, shows that lowering cholesterol alone does not prove a drug will benefit patients.
Then, on Monday, Merck and Schering-Plough announced that Vytorin, which combines Zetia with Zocor, had failed to reduce the growth of fatty arterial plaque in a trial of 720 patients. In fact, patients taking Vytorin actually had more plaque growth than those who took Zocor alone.
Despite those drawbacks, that trial, called Enhance, also showed that patients on Vytorin had lower LDL levels than those on Zocor alone. For the second time in just over a year, a clinical trial found that LDL reduction did not translate into measurable medical benefits." endquote from Alex Berenson New York Times (16)
”ENHANCE (Vytorin) results were a big surprise and a big disappointment. The data show no benefit for ezetimibe (Zetia) on top of simvastatin (Zocor). In fact, the data on both the rate of progression of atherosclerosis and cardiovascular events are trending in the wrong direction. This is a pretty clear failure. Physicians should now stop using ezetimibe or Vytorin except as a last resort. The drug doesn’t work”.
"The revelation that statin cholesterol drugs may be of little or no benefit, as revealed in a lengthy cover story in January 28 issue of Business Week (BW) magazine, begs the question: how did this misdirection go on for so long?
As the BW article pointed out, statin drugs "are the best-selling medicines in history, used by more than 13 million Americans and an additional 12 million patients around the world, producing $27.8 billion in sales in 2006."
How can anyone question the benefits of such a drug, asks BW, when they are "thought to be so essential that, according to the official government guidelines from the National Cholesterol Education Program (NCEP), 40 million Americans should be taking them. Some researchers have even suggested – half-jokingly – that the medications should be put in the water supply, like fluoride for teeth. And it's almost impossible to avoid reminders from the industry that the drugs are vital. A current TV and newspaper campaign for one statin drug, as endorsed by Dr. Robert Jarvik, artificial heart inventor, proclaims that this drug ‘reduces the risk of heart attack by 36%...in patients with multiple risk factors for heart disease’."
Statin drug ruse revealed:
But the cholesterol/statin drug ruse finally unraveled when, after two years of foot dragging delays to release data from a large study involving Zetia, a cholesterol-lowering drug that inhibits cholesterol absorption from foods, and Vytorin, which is a combination of Zetia plus Zocor, the latter a statin drug that inhibits formation of cholesterol in the liver, revealed no health benefits.
Even though this drug combo lowered circulating cholesterol numbers better than either drug alone, it did not reduce plaque formation in arteries and did not confer a projected reduction in mortality.
In fact, an earlier review published last year in the British journal Lancet by Drs. John Abramson of Harvard Medical School and James M. Wright MD of the University of British Columbia, could find no evidence for a reduction in cardiac mortality in a combined review of all published statin drug studies. [The Lancet 2007; 369:168–169]
Falsifying the numbers:
The Business Week report says statin drugs benefit only 1 in 100 users, but they claim to reduce the risk of a non-mortal heart attack by 36%. But that figure is a relative number, not a hard one. About 3% of patients taking an inactive placebo pill will experience a heart attack compared to 2% taking a statin drug, which produces the so-called 30-plus percent risk reduction. But in hard numbers, this is only a 1% reduced risk. This type of misleading advertising wouldn’t pass Federal Trade Commission guidelines. But public health agencies, serving as free publicity agents for the statin drug manufacturers, repeat the claim to give it a ring of credibility." end quote from Bill Sardi on Lew Rockwell.com.
Merck ran these these Cholesterol Lowering-Vytorin Televison Ads (see below) over the course of about a year spending 160 million dollars, allowing a windfall of 1-2 billion dollars on the sale of Vytorin. All the time they knew that the ENHANCE study showed that Vytorin didn't work. Take at look at the TV ads that fooled a nation into spending a fortune for drugs that don't work.
From the book: Solved: The Riddle of Heart Attacks by Broda O. Barnes, M.D., Ph.D. and Charlotte W. Barnes. Prevention of Heart Attacks: The Key to Progress in Medicine
In 1970, Dr. Broda Barnes had 1,569 patients on natural thyroid hormone who were observed for a total of 8,824 patient years. These patients were compared to similar patients in the Framingham Study. Based on the statistics derived in the Framingham Study, seventy-two of Dr. Barnes’s patients should have died from heart attacks; however, only four patients had done so. This represents a decreased heart attack death rate of 95 percent in patients who received natural thyroid hormone–a truly remarkable finding.
A List of All the Statin Drugs with Chemical Name and Trade Name:
Atorvastatin = Lipitor, Torvast
Cerivastatin = Lipobay, Baycol.
Fluvastatin = Lescol, Lescol XL
Lovastatin = Mevacor, Altocor
Pitavastatin = Livalo, Pitava
Pravastatin = Pravachol, Selektine
Rosuvastatin = Crestor
Simvastatin = Zocor, Lipex
Simvastatin+Ezetimibe = Vytorin
Lovastatin+Niacin extended-release = Advicor
Atorvastatin+Amlodipine Besylate = Caduet
How Do Statin Drugs Work?
Statin Drugs lower cholesterol by inhibiting the enzyme HMG-CoA reductase, which is the rate-limiting enzyme of the mevalonate pathway of cholesterol synthesis. Inhibition of HMG-CoA reductase also blocks production of Co-Enzyme Q10.
How were Statin Drugs Invented?
Statins are isolated poisons derived from the fungus known as red yeast rice (Monascus purpurus).
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The new cholesterol guidelines, Applying them in clinical practice Brian L. Pearlman, MD, FACP VOL 112 / NO 2 / AUGUST 2002 / POSTGRADUATE MEDICINE
The new cholesterol guidelines
USA Today, 2004, Cholesterol guidelines become a morality play the Associated Press
Mary Enig, Cholesterol and Heart Disease-- A Phony Issue
Questioning the benefits of statins Eddie Vos and Colin P. Rose , CMAJ • November 8, 2005; 173 (10). doi:10.1503/cmaj.1050120.
Dangers of Statin Drugs: What You Haven’t Been Told About Popular Cholesterol-Lowering Medicines By Sally Fallon and Mary G. Enig, PhD
Therapeutics Initiative, Do Statins have a Role in Primary Prevention? There were 10,990 women in the primary prevention trials (28% of the total). Only coronary events were reported for women, but when these were pooled they were not reduced by statin therapy, RR 0.98 [0.85-1.12]. Thus the coronary benefit in primary prevention trials appears to be limited to men, RR 0.74 [0.68-0.81], ARR 2.0%, NNT 50 for 3 to 5 years.
Drug Treatment of Hyperlipidemia in Women Judith M. E. Walsh, MD, MPH; Michael Pignone, MD, MPH JAMA. 2004;291:2243-2252.
BMJ 2007;334:983 (12 May), doi:10.1136/bmj.39202.397488.AD Should women be offered cholesterol lowering drugs to prevent cardiovascular disease? No Malcolm Kendrick, general practitioner
Women's Health Activist May/ June 2007: Exploring Statins: What Does the Evidence Say? By Electra Kaczorowski, National Women’s Health Network
Statin Drugs: A Critical Review of the Risk/Benefit Clinical Research, Joel M. Kauffman, Ph.D. Professor of Chemistry Emeritus USP Philadelphia, PA, USA 9 Dec 2003
Evidence for Caution: Women and statin use By Harriet Rosenberg Danielle Allard Women and Health Protection June 2007
LETTER TO THE EDITOR: Statins for women, elderly: Malpractice? Nutrition, Metabolism & Cardiovascular Diseases (2007) 17, e19ee20 Eddie Vos 127 Courser Rd, Sutton (Qc),
Who Will Tell the People? It Isn't Cholesterol! by Bill Sardi
Lancet: Vol 369 January 20, 2007 Are lipid-lowering guidelines evidence-based? J Abramson and JM Wright
The Hidden Truth About Cholesterol-Lowering Drugs, by Shane Ellison, MS, Organic Chemistry
New Questions on Treating Cholesterol, By ALEX BERENSON, New York Times January 17, 2008
Government Health Agencies Complicit in Cholesterol Ruse by Bill Sardi on Lew Rockwell.com
Pharma Marketing Blog by Shaun McIver, of Streamlogics, Inc discussion of Zetia Enhance trial.
January 14, 2008, 9:11 am Zetia Doesn’t Enhance Zocor Posted by Shirley S. Wang Wall Street Journal
Vytorin video AD on You Tube 30 sec, Humorous clothes which look like the food.
These adds have been pulled from natiuonal television.
Letter from John Dingel Mich to CEO of Pfizer asking for records on Jarvik and Lipitor, celebrity endorsement of Lipitor Ads.
Wall Street Journal January 16, 2008, 3:44 pm Congress Investigates Vytorin Ads Posted by Anna Wilde Mathews
January 7, 2008, Wall Street Journal, Congress to Pfizer: Why is Robert Jarvik the Lipitor Man? Posted by Shirley S. Wang
Lipitor Ad with Robert Jarvik 60 seconds. This ad has been pulled and no longer shown on national television.
New Questions on Treating Cholesterol By ALEX BERENSON Published: January 17, 2008
LDL Cholesterol, Bad Cholesterol or Bad Science by Anthony Colpo, Journal of American Physicians and Surgeons Volume 10 Number 3 Fall 2005
Recurrent Acute Pancreatitis Possibly Induced by Atorvastatin and
Rosuvastatin. Is Statin Induced Pancreatitis a Class Effect? JOP. J Pancreas (Online) 2004; 5(6):502-504.
Statin Adverse Effects: Implications for the Elderly by Beatrice A. Golomb, M.D., Ph.D. Geriatric Times May/June 2004 Vol. V Issue 3. "No survival benefit with statin drugs is seen in elderly patients at high risk for cardiovascular disease (Shepherd et al., 2002). For patients older than 85, benefits may be more attenuated and risks more amplified (Weverling-Rijnsburger et al., 1997). In fact, in this older group, higher cholesterol has been linked observationally to improved survival.
Preventive health care in elderly people needs rethinking, BMJ 2007;335:285-287 (11 August), "Preventive use of statins shows no overall benefit in elderly people as cardiovascular mortality and morbidity are replaced by cancer".
Pravastatin in elderly individuals at risk of (PROSPER): a randomised controlled trial. THE LANCET • Published online November 19, 2002 •
SpaceDoc, Duane Graveline MD Autho of Statin Drugs Side Effects
THINCS THe International Society of Cholesterol Sceptics
Misleading Recent Papers on Statin Drugsin Peer-Reviewed Medical Journals Joel M. Kauffman, Ph.D. Journal of American Physicians and Surgeons Volume 12 Number 1 Spring 2007
Science in the 21st Century: Knowledge Monopolies and Research Cartels
HENRY H. BAUER Professor Emeritus of Chemistry & Science Studies Dean Emeritus of Arts & Sciences Virginia Polytechnic Institute & State University / Journal of Scientific Exploration, Vol. 18, No. 4, pp. 643–660, 2004
Radiologic Appearance of the Jarvik Artificial Heart Implant Its Thoracic Complications AJR 151:667-671, October 1988 Laurie L. Fajardo
The End of Life: Euthanasia and Morality (Oxford University Press, 1986).]
SUICIDE AND EUTHANASIA Barney Clark’s key to turn off artificial heart.
Statins for primary prevention: at what coronary risk is safety assured?
Peter R Jackson Br J Clin Pharmacol. 2001 October; 52(4): 439–446. For people with no known heart disease (primary prevention), "statin use could be associated with an increase in mortality of 1% in 10 years."
Statins act like Vitamin D !! Lancet. 2006 Jul 1;368(9529):83-6. Grimes DS. "There are many reasons why the dietary-heart-cholesterol hypothesis should be questioned, and why statins might be acting in some other way to reduce the risk of coronary heart disease. Here, I propose that rather than being cholesterol-lowering drugs per se, statins act as vitamin D analogues, and explain why. This proposition is based on published observations that the unexpected and unexplained clinical benefits produced by statins have also been shown to be properties of vitamin D. It seems likely that statins activate vitamin D receptors."
Pfizer pulls TV ads with heart expert Jarvik . By Lisa Richwine Mon Feb 25,WASHINGTON (Reuters) - Pfizer Inc said on Monday it was pulling television advertisements for its Lipitor cholesterol drug featuring Dr. Robert Jarvik, inventor of the Jarvik artificial heart, because they created "misimpressions."
The ads involving Jarvik had come under scrutiny from a U.S. House of Representative committee as part of an investigation into celebrity endorsements of prescription medicines.Democratic lawmakers had voiced concern that Jarvik's qualifications were misrepresented in widely seen TV commercials touting the blockbuster drug. They said Jarvik seemed to be dispensing medical advice even though he is not a practicing physician.
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Disclaimer: The reader is advised to discuss the comments on these pages with his/her personal physicians and to only act upon the advice of his/her personal physician. Also note that concerning an answer which appears as an electronically posted question, I am NOT creating a physician -- patient relationship. Although identities will remain confidential as much as possible, as I can not control the media, I can not take responsibility for any breaches of confidentiality that may occur.