I don't understand this, other than for money reasons.
All 18 clinical dietary intervention trials show the low saturated dfat diet to do nothing to lower CHD mortality, CHD incidence or total mortality.
LLRC-CPPT, Framingham Heart Study, MONICA, all show no support to the farcical Lipid Hypothesis of coronary artery disease.
The fact that Ancel Keys hand picked 7 nations knowing the outcome and also deliberately omitted data that did not fit his false theory
The fact that WITHIN nations no relationship between saturated fat and CHD mortality was found
http://www.ravnskov.nu/myth4.htm
Here is a review of the primary literature with references to 6 of clinical dietary intervention trials to date
http://www.eurheartj.oxfordjournals.org/...
Again so WHAT are the reasons other than a mythology or personal belief rather than science based evidence? Okay....aside from yesterday's fiasco.....
CAD is not necessarily CAUSED by diet, however, the resounding extrapolations of studies (more recent than 11 years ago) have determined that it IS a contributing factor. That is a fact.
Short of being a vegan, those who tend to eat a diet that is higher in fat, cholesterol, and have equally poor lifestyle habits (smoking, alcohol abuse, etc.) DO have a higher risk of CAD, and thus an event. Please look at how the Framingham Risk Score is put to use in clinical medicine.
Such as there are risk factors related to lifestyle, there are also genetic risk factors. Those who have a predisposition NOT to metabolize fats and cholesterol in an efficient manner. Equally, those who have co-morbidity health issues (Diabetes) are FAR more likely to have an event with LDL cholesterol levels that are above the cut-off.
Cholesterol lowering medicines have had a profound impact on the overall health of the patients who take them. Look at studies that are double-blind placebo controlled, and you will see that there is definitely an advantage. Likewise, many of these medications have reduced mortality for those who have already suffered a heart attack, and reduced the chances of having another.
I've been in healthcare for over 15 years. Reading countless outcome based studies that demonstrate that the effectiveness of cholesterol lowering medications DO, IN FACT, have a positive impact on the lives of my patients -- moreso than snippits of conjecture that weigh little on the reality of clinical guidelines and practice.
Sorry, but my license to practice is more important than suddenly supporting the "theory" of a few people who want to go against the standard of care. As long as my patients are living safer and healthier lives because their risk factors are lowered with the use of medications....I think I'll continue to practice the way I've studied to do so.
Best regards.
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Oh my GOD! Another Colpo drone.
Here's enough with plenty of links. Colpo is a JOKE.
http://slowburn.typepad.com/my_weblog/20...
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RazwellR
I'm not sure what is more pathetic....Either your inability to read studies that demonstrate outcomes based evidence toward the advantages and decreased mortality by the use of cholesterol lowering medications, or your horrifically biased and purely uneducated attempt to side with THEORISTS in the field who want to demonstrate an OPINION that is completely outside the standards of care set by the health care community.
Colpo is a nut-job. He's been called on his twisted remarks and rediculous rhetoric more times than he can be given any credit. The scientific community thinks he's a laughing joke.
You cite 3 different "doctors."
How about checking into the THOUSANDS of doctors who use statins to reduce mortality (A FACT), rather than buying into the ridiculous and immensely unsupportable claims of a paltry few.
I highly doubt you have an education that is beyond high school. Try getting a Master's Degree in something so you understand how to cite EVIDENCE BASED LITERATURE before you spew this diatribe.
You need help.
Oh, and what about NIASPAN? Great stuff!! And....did you know....IT'S A VITAMIN!!!?!?!?!?!?!?! Yeah!! B3 baby!!!
Good luck in your plight.
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"IF yo u had read you would see statins DO reduce CHD mortality BUT NOT TOTAL MORTALITY"
You said it yourself -- statins DO reduce CHD related mortality....
But not TOTAL mortality?!?! What in the heck is that? Are you suggesting that people will LIVE FOREVER?!?!?!
Youtube is not what anyone would call "research based literature." This is where teens hang out and put up silly videos. Not something I would use to promote a "point" I'm trying to make -- no matter how unsupportable its claim may be.
So that you're better learned about this...here are a few studies that demonstrate effectiveness and reduced risk with statin use. This is peer reviewed work. Not just conjecture and opinion.
http://www.medscape.com/viewarticle/4451...
http://www.newswise.com/articles/view/51...
http://www.theheart.org/viewArticle.do?s...
http://qjmed.oxfordjournals.org/cgi/cont...
And the list can go on and on and on.
When you cite articles, please try to find something that is (A) less than 5 years old, (B) peer reviewed, and (C) has some sort of credible evidence base outcome. What you have cited is OPINION, and NOT a result of a study that demonstrates a double-blind placebo control. Your "articles" show nothing more than conjecture and bias that is solely intended to dissuade people from FACT versus FICTION.
You are an incredibly misinformed and poorly educated soul that needs to understand more about human pathophysiology and pharmacology than anyone I dare say I've encountered here.
God help you.
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aceofspd wrote: "Just want to ask the doc, is it worth 100 people taking this expensive drug for 3.5 years, to save ONE event?"
Expensive? Most copays will cover statins within 10-30 dollars. "Expensive" is more subjective than anything. And yes, with the reduction of and MI (specifically), it is DEFINITELY worth it. Try consoling the wife or husband of a loved one that refused to take these medications and suffered a fatal even as a result. It's very difficult. Now, where 3.5 years come from....I have no clue.
Regarding your overwhelming list of side effects of these medications, please be advised they are POTENTIAL and not ACTUAL for EVERY person taking the medication. Please don't act like everyone taking statins is guaranteed to suffer from these ailments. On that same note, any credible practitioner whose patient is suffering from these potential adverse side effects SHOULD most certainly, remove the medication and try another. (I should point out though, I'm NOT a big fan of Lipitor at all -- I simply don't use it unless a patient has already been established on it and is doing well).
You also wrote: "How about these irreversible problems that can be triggered by statins, amyotrophic lateral sclerosis, Parkinsonism, frontal lobe dementia and Alzheimers' disease and other neurodegenerative conditions."
Pure speculation, and poorly researched. You should know this, if you've read the literature and understand these disease processes. Because there are many neurological diseases that are the result of multi-infarct lesions in the brain, please understand there has ALWAYS been a relationship of these diseases with regard to those with HIGH and UNTREATED HYPERCHOLESTEROLEMIA. Isn't it just convenient that many have suddenly drawn some sort of ideology that it's the medications, but not the YEARS of markedly elevated cholesterol levels that may be at the bottom of all this.
Yeah, right. Next.....
The issue with Zetia is self explanatory. Yet, another drug I do not use. Don't think that just because a drug is on the market that I necessarily prescribe it, nor do many others. Zetia only proved one thing -- it could LOWER the LDL levels by an average of 22%. What it DIDN'T do, is demonstrate any reduction of risk for MI, stroke, etc. At the same time....Zetia has not HURT anyone either. So don't be so quick to rush to the idea that my patients are going to accuse me of DOING something adverse to their health. Be careful in what you accuse others of...especially if you have NO idea of what I do and how I do things.
You also wrote: "I have decided to spend the rest of my working years as a pharmacist getting the word out. I diagnose 2 to 3 patients a day with life altering side effects."
Is this to suggest that you are (A) already a pharmacist, or (B) have decided to BECOME a pharmacist? I can assure you, that your job will be on thin ice if you decide that you are in the position of "diagnosing," patients. Pharmacists are NOT LICENSED to do so. You may also want to rethink your position on just how negatively you attack statins with the patients of health care providers. I can assure you, that if I heard that you convinced one of MY patients to get off their statins (based on your beliefs), and whether or not they had an event because of that action, I would have your license in a heartbeat. Guaranteed.
I have read more about the drugs I prescribe than you can imagine. Despite what the drug companies will shove into their product information guidelines, that's only half the story. Yes, I agree, you don't always need elevated LFTs to suddenly have symptoms. I, unlike the canned-prescriber nitwit you want to portray me as, DO listen to the complaints of my patients and ALWAYS discuss potential side effects.
Be careful about what influence your opinions may have on the people who read it. There are a few who will liken it to fact, and rather than discussing it with their provider, will take things into their own hands and stop their medications; putting them at risk. I can assure you this happens, and more often than you could even imagine. I realize that nobody WANTS to be on a medications, but when these medications help to reduce the chances of death or harm, then there is a reason for it. I've had the unfortunate experience of having patients either severely harmed for making such a decision on their own, or died as a result despite the best intentions.
Don't assume that all provi Jane A falls in to the ad hominem logical fallacy.
Razwell R does not cite the primary literature.
Lisa L's IM is LISAHASAPUSSY
Michael M wonders what Jessica Alba's buttcrack smells like.
Razzi R does not read the full text, only repeats what Colpo writes. Razwell, considering the reliance of the cult of Colpo on misquoting studies and misinterpreting them, it's the cult's beliefs that are mythological & personal.
I guess it's because I'm used to dealing with residency trained PharmDs that I was surprised to read the pharmacist's answer. The ENHANCE study showed that Zetia had no effect on morbidity & mortality. It was not designed or powered to "decide" the role of cholesterol & CAD. There are innumerable double blinded, placebo controlled studies that have shown a benefit to lipid lowering with statins.
Statins have been around for years, since the early days of Mevacor. If they were as deadly as claimed, there would have been millions of deaths. I've been on high dose statins & niacin for many years. I'm still waiting for the horrible side effects and for my liver enzymes to change.
As for "I diagnose 2 to 3 patients a day with life altering side effects.", I've yet to meet a pharmacist that's trained to diagnose. There's a vast difference between recognizing and diagnosing.
BTW, the use of multiple IDs (Jane A/ Razwell/ Razzi R) is against YA guidelines. Just want to ask the doc, is it worth 100 people taking this expensive drug for 3.5 years, to save ONE event? This is right from a Lipitor advertisement. Do you know that the side effects include memory loss, depression, fatigue, tendon pain, permanent muscle damage, neuromyopathies, 26% increase in death from cancer, mitochondrial sequences mutation, dolichol inhibition, episodes of transient global amnesia, loss of mitochondrial function. How about these irreversible problems that can be triggered by statins, amyotrophic lateral sclerosis, Parkinsonism, frontal lobe dementia and Alzheimers' disease and other neurodegenerative conditions. I wonder how you explain the ENHANCE study. Zetia lowered LDL 17% when added to Zocor. The measure of plaque actually increased. This just means that Zocor should be used by itself? I think this disproves any link between LDL and arteriosclerosis. And what is with not publishing the results for almost two years? How could they spend millions on advertising for a drug that does not work?
No, I think you should worry about how mad your patients are going to be when they figure out what YOU have done to them.
I have decided to spend the rest of my working years as a pharmacist getting the word out. I diagnose 2 to 3 patients a day with life altering side effects.
CKM, why do you spin the results of ENHANCE, the same way the drug companies do?
If you would read about the side effects from some other source than the drug companies, you might find that you do suffer from more than one side effect. Liver enzymes do not have to be elevated to suffer from horrific muscle side effects, not mentioning the cognitive effects. Completely ignored by the drug companies and the doctors they educate.
Play semantics if you want but I have helped many patients to explain why they feel 20 years older than they are.
Please email me or turn on your email. Others on this board, along with myself, just want to get the word out. If you will just have an open mind, we might be able to help you or many of your loved ones.
I will put my 30 years of experience and personal side effect experience against the extra year of schooling your pharmDs have. And please lighten up on Roz or Jane or Lisa as that person is just trying to help people. He should lighten up a bit and be less confrontational, as should I.
This is a passionate issue for me, statins almost ruined my life, please do not dismiss it lightly. |
