When I read an article in last week’s Times entitled ‘Ten million in the U.K. take statins – I was reluctant to do so, until now’ by Dr. Mark Porter, I raised an eyebrow and decided to read on. The strapline to the headline read: “Why I have decided that the risks associated with the drugs are now worth taking to control my cholesterol” to which my immediate sceptical reaction was, “I wonder how much he is being paid to write this?”
There is much debate about statins and their benefits. The zealots in favour of statins claim that they save thousands of lives and thereby reduce a huge financial burden on the NHS from people suffering heart disease and stroke. In his Times article, Dr. Porter writes that “the National Institute for Health and Care Excellence (NICE) estimates the annual healthcare cost of cardiovascular diseases in England alone at well over £7 billion”. On the other side of the debate are people like Dr. Aseem Malhotra, who suggest that the risks outweigh the benefits; people should seek alternative approaches to reducing their risk of cardiovascular disease.
But I was intrigued to find out why Dr. Porter had changed his mind.
The fact is, Dr. Porter has either sat on the fence or more accurately jumped back and forth over that fence several times. Interestingly, he has a genetic pre-disposition to high cholesterol so he has more than a passing interest in anything that will lower his cholesterol. In a 2009 article, as a healthy 46 year old, he wrote that he had taken statins for a six month period with no ill effects and a dramatic reduction in his cholesterol. He had, in his own words “got off the fence and joined the majority of my colleagues in the pro-statin lobby”.
However, based on the current article, it would seem that something changed, as he clearly stopped taking the statins at some point between 2009 and now, even with his genetic predisposition to high cholesterol. Furthermore, it appears that he leapt back over the fence and gave a change in diet a go instead.
In 2016, he wrote an article in which he went on a low carbohydrate diet for six weeks. For those who are familiar with Low-Carb, High-Fat (LCHF) diets, this was nothing of the kind. He simply cut out a lot of the sugar in his diet by cutting out fruit juices, bread, cakes, biscuits and confectionary and reducing his intake of rice, pasta and potatoes. It was kind of low-carb but not in the way that any proponent of the LCHF diet would recognise. He even continued to have a sugar in his coffee! However, despite this, his cholesterol dropped by 20% and his triglycerides by 30%. His risk of heart attack or stroke, as calculated by the qrisk.org calculator, dropped by nearly 15%. As, he said, not quite as dramatic a decrease as you might get with a statin, but not far off.
Much of the debate about statins revolves around the fact that they are now being recommended to anybody with a 10% chance of stroke or heart disease. Generally speaking, if you are a man in your early 60s, even with a healthy BMI and no other risk factors, you fall into this bracket. For women, the risks are lower, but you start having a 10% risk factor in your late 60s with a healthy BMI and no other risk factors. So, basically, most people over the age of 65 are going to fall into this category of a 10% chance of having stroke or heart attack in the next 10 years, and would therefore be offered statins by their doctor.
In his 2009 article, Dr. Porter notes that, if statins are prescribed to people with a 20% risk threshold, “it is estimated that about 35 people will need to take a statin for five years to prevent one of them developing cardiovascular disease. Over the same period one in 40 taking the drugs will develop a statin-induced cataract, about one in 100 will have liver problems and one in 400 will develop kidney failure. Reducing the threshold to just 10% will mean more people will have to be treated to save a life, but the odds of a serious side-effect like kidney failure remain exactly the same, shifting the risk-benefit ratio towards risk”. Those don’t sound like great odds to me for the more serious side-effects, but it doesn’t even consider the multitude of more minor side-effects.
In a BMJ article in response to the media headlines suggesting that statins should be prescribed to all people over the age of 50, Margaret McCartney presented evidence that the risk of ‘minor’ side-effects is significant and shouldn’t be underestimated and such side-effects have a profound effect on patients’ wellbeing.
A consumer panel of over 10,000 current and former statin users found that muscular side-effects were reported in 60% of former and 25% of current statin users. A French study reported that 10% of patients taking statins had muscular symptoms, leading to 30% of those stopping treatment.
Since exercise is one of the best ways to reduce your risks of cardiovascular disease, it seems counterintuitive to take a drug that negatively impacts your ability to exercise.
I came across an interesting tweet by Charlie Spedding in which he quotes a 66 year old runner who, having experienced calf and Achilles injuries, finally stopped taking his statins and switched to a low carb diet instead. Seven months later he broke a Parkrun course record he’d set eight years previously! He would have hung up his trainers had it not been for reading Charlie’s excellent book and considered that the statins may have been the problem.
It is difficult to find a study in the scientific literature that really highlights these risks or properly balances them against the benefits. Most clinical trials are funded by the drug companies whose interests in promoting public health have to be weighed against their interests in promoting profits, so getting to the heart of the data is problematic. Independently written meta-analyses, which seem great, are riddled with similar bias from the original data. In addition, patients tend not to report side-effects; many presume that their musculoskeletal problems or their memory issues or brain fogginess are just further symptoms of old age. Even when these are presented to the doctor, any link between these new symptoms and the statins are often overlooked. The whole wellbeing of the patient is important and so patients should be fully informed of the risks of taking new medication and these risks need to be balanced against the potential benefits. This is difficult when the risks are not transparent. In addition, alternatives, such as changes in lifestyle should always be the first choice and should be supported by the doctor. As Dr. Porter found out, even a small change in lifestyle can dramatically decrease your risks.
I suggest that Dr. Porter keeps jumping over the fence to keep himself fit, and I suggest he also cuts out the sugar in his coffee!
Dr. Maggie Cooper is a pharmacist and research scientist.
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Methinks there’s an agenda to emphasise nurture over nature because reasons.
Diminish the significance of the parents, let the State raise the kids. A recurrent theme of the Scottish Government.
Indeed – and many others.
Obviously. It’s supposed to support the origin-of-xen¹ theory of the so-called progressive left which basically states that humans are not animals but something made of featureless clay which can be formed in whatever way someone desires to form it. Unsurprisingly, they’re again repurposing well-known Christian myths here.
¹ Politically correct way to refer to hairless and sexless hindleg-walking creatures killing the planet by burning stuff said to have brains capable of independent thought despite no evidence for this could be found so far.
“Reject your parents, they are of a world now dead.”
I’m an ignoramus – who said that?
“Not like their parents”
Mine are from a different fecking dimension !
What would you expect from the Times these days. They parted company from reality sometime ago.
$cience TM.
Sounds like a low quality study interpreted by low IQ ‘journalists’ looking for a headline. What a time to be alive!
Men are women.
Girls are boys.
Ineffective vaccines are effective.
Unsafe vaccines are safe.
Global warming = our heating bills are far higher than ever.
Children are more like their parents than we thought = children are less like their parents than we thought.
War is peace.
Freedom is slavery.
Ignorance is strength.
“Alice laughed. ‘There’s no use trying,’ she said. ‘One can’t believe impossible things.’
I daresay you haven’t had much practice,’ said the Queen. ‘When I was your age, I always did it for half-an-hour a day. Why, sometimes I’ve believed as many as six impossible things before breakfast.”
“When I use a word,” Humpty Dumpty said, in rather a scornful tone, “it means just what I choose it to mean – neither more nor less.”
“The question is,” said Alice, “whether you can make words mean so many different things.”
“The question is,” said Humpty Dumpty, “which is to be master——that’s all.”
“In the end the Party would announce that two and two made five, and you would have to believe it. It was inevitable that they should make that claim sooner or later: the logic of their position demanded it. Not merely the validity of experience, but the very existence of external reality was tacitly denied by their philosophy.”
Is this not precisely what the transgender hullabaloo is all about?
A man can be a woman.
A woman can be a man.