re: Dr Wants to Prescribe Statins..I Disagree

I love a good, honest discourse

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There is no study like this that I am aware of. However, there was a study that looked at high-risk patients who were separated between placebo and statin groups. The statin groups died less of heart attack and stroke, but had more deaths overall. So, you were more likely to die from taking statins than if you didn't.

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In a quick view of the study (and I'm going to fail to address the sentimentality of your post appropriately, but it's appreciated, and I appreciate your arguments, too!), I'm not finding the concern that you have with it. From the study:

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Effect of statins on all-cause mortality
Overall, approximately 244 000 person-years of follow-up were accrued in the 11 trials, which provided information on a total of 2793 deaths, with 1447 deaths occurring among 32 606 participants assigned to placebo arm and 1346 deaths among 32 623 participants assigned to statin-treated arm, reflecting about 100 fewer deaths in the statin-treated group. In a random-effects model meta-analysis of these 11 trials, the risk ratio for all-cause mortality associated with the use of statins was 0.91 (95% CI, 0.83-1.01). The corresponding risk ratio using a fixed-effect model was 0.93 (0.86-1.00) (Figure 3A). There was no strong evidence of heterogeneity in the effect estimate across the studies (I2 = 23%; 95% CI, 0%-61% [P = .23]). Similar results were obtained in analyses that excluded CARDS15 and ASPEN22 (which had recruited individuals with diabetes only), with a risk ratio of 0.92 (95% CI, 0.84-1.02) in a random-effects model and 0.94 (95% CI, 0.86-1.01) using a fixed-effect model (Figure 3B). There was no strong evidence of publication bias when assessed using a funnel plot and the Egger’s test (P = .50) (eFigure).

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By my count, that's 101 fewer deaths in the statin arm. Whole numbers are kind of worthless though.
With lower risk ratio, but we are not confident that the risk ratio is significant as opposed to just being random chance (the CI or confidence interval crosses "1." ".91" is reported, basically meaning you are 1-.91 or 9% less likely to die on a statin. Allowing for all the possible errors, we say that with 95% confidence (complicated equation. 95% is often what's reported) that the risk ratio is 0.83 (1-0.83=17% less likely to die) all the way up to 1.01 (1.01-1 = 1% MORE likely). So, it would take a pretty big stretch to say that that we think they increase mortality, though it is fair to say that there's a very small chance that they may slightly increase all-cause mortality.

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Mortality rates
The Table reports the rates of all-cause mortality across studies which ranged from 3.6 to 26.0 per 1000 person-years (weighted mean, 11.4 per 1000 person-years) in the placebo/control arm and from 2.4 to 27.2 per 1000 person-years (weighted mean, 10.7 per 1000 person-years) in the statin-treated group. We assessed the relationship between baseline characteristics and mortality rates observed in these studies. As anticipated, the strongest correlation was observed with mean baseline age, which accounted for an estimated 66% of the variation in mortality rates across studies (R2 = 0.66; P < .001; Figure 2). Inclusion of mean baseline LDL-C levels in the regression model did not make a statistically significant change (P = .50).

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Working backwards up the paper here, there's more deaths per person-year in the placebo vs statin group, but that's a very small number and unlikely to be really impactful. I don't say that to suggest statins are absolutely decreasing all-cause mortality, but I do bring it up to show that I'm not certain where the idea that they are increasing it comes from.


Would you mind terribly linking where in that text you find an increase all-cause mortality in the statin group? I'm not seeing it. I'm seriously not trying to troll, and I think that comes through

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Your numbers appear to be that of someone on a low-carb diet, they have low triglycerides, high HDL, and moderately high LDL.

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That's exactly what I'm on...low carb, high fat diet. That's why I'm not so sure statins are necessary for my high cholesterol as I have low triglycerides and high HDL. Plus I've been losing weight on this diet, which I've read can also raise cholesterol.

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Just finished the Mercola video with Stephanie Seneff

I can see how this could be convincing for someone with a limited science background, but that woman is looney tunes. Just a couple of claims that really have no evidence:

1. You can lower your LDL enough to offset heart disease by getting sun exposure

2. Statins cause ALS, parkinsons, calcification of arteries, heart failure, Alzheimer’s, diabetes, “muscle weakness”, aging, and I’m probably forgetting a few. She deduced all of this from word searches of patient reported side effects.

She makes broad assumptions based on solid biochemical foundations. For example, “if you don’t have cholesterol the cell membrane can’t transfer potassium so muscle cells can’t contract” ... that’s correct but then she follows with “this is why statins cause heart failure”

The first premise is true but then she follows it with totally unqualified nonsense. People on statins have cholesterol, it’s 100% false to say they don’t.

What she does is very tricky, but she appears to be a quack. Don’t be fooled.

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I'm not fooled. You call this woman a loon, a quack? Really? I'm not gonna go thru the video again, but you misrepresent what she says. Some of the stuff is clearly her opinion or a hypothesis of hers. And I'm pretty sure she doesn't say statins cause all of those things, but rather these are symptoms that people report while taking statins. Statins fricks with the pathway in the liver that controls a lot of important stuff. You'd have to be a fool to take such a drug that provides little to no actual benefit compared to the many risks. Statins do nothing to correct the underlying problem (which seems to never be defined, other than high cholesterol). We need cholesterol. The body makes cholesterol. The doctor says "Take this statin" while doing nothing to solve the actual problem. It's stupid and it's fricking lazy.

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Not even close to needing a statin. If it gets over 250, then I'd consider it.

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Dale Murphy

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Careful, OP. Murph got his medical degree from some random third-world country. I wouldn't trust him...

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calculate your ASCVD risk

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1.4%

I'm on a statin with these numbers (but I'm diabetic so I automatically jump a risk category).

Total: 163
LDL: 84
HDL: 71
Triglycerides: 38
Glucose: Pick a random number between 65-140

Not ultra-religious about taking it.

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you misrepresent what she says. Some of the stuff is clearly her opinion or a hypothesis of hers.

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I’m stating exactly what she said. And you are right it is her opinion. An opinion that doesn’t have scientific evidence to support it. it’s just funny that people will believe wholeheartedly someone on YouTube’s opinion, but not rigorous peer reviewed scientific studies. And I’m not saying they can never be wrong, but just imagine how much shite is wrong with this woman’s opinion if it was actually studied clinically and peer reviewed.

This is classic “backup quarterback” syndrome

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little to no actual benefit compared to the many risks.

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Studies don’t support this

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We need cholesterol. The body makes cholesterol.

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Do people who are on statins have ZERO cholesterol? Most of the time they have normal levels. This is the problem with her theories. She is presenting information that MAY be true if your body had no available cholesterol. That is absolutely false in a patient on statins.

And finally, I’m not saying statins are good or bad. I’m just saying that woman didn’t present any evidence supporting either side

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But still if you extrapolate that data, for every 1500 patients you treat with a statin, only one will live longer?

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For secondary prevention (patients who have had an event already), it's 1 per 83 treated (life saved, essentially)


this is specifically for low-risk patients. Basically for every 200 patients treated, you prevent a heart attack but you don't have an effect on prolonging life. I'll point out that I think they are over calling significant "muscle injury" in the number needed to harm on that second one.
That said, no one is arguing that low-risk patients need a statin (the OP appears to be pretty low risk from what I can gather, for what it's worth). I think that number you guessed was a little high.

1. extremely low fat diet
2. True, had that tested, and have that issue.

bottom line is now...Repatha cut my cholesterol down to 140 and my LDL down to 45.

So now, after 5 bypasses and 7 stents, I am good.

My doc put me on statins 15 years ago.

Wait...what were we talking about?