I spent some time investigating the claims on the is site. They ranged
from mildly deceiving to out right mischaracterizations and untruths.
I'm talking about erros on the level of 2+2=5.
Also while it may appear that the site is unbiased, it's actually a
front for a vitamin supplement company (
http://www.iherb.com).
If a pharmaceutical company made these claims they would be subject to
severe Federal sanctions, but a supplement can get away with these
stunts.
In no way am I a fan of statins, nor would I take them myself, but
that does not mean that it's OK to demonize statins (or anything else)
with bad science. There is no doubt that Statins can and have saved
lives, but the numbers are not that impressive to me as a single
person.The best studies show that you need to treat about 50 people to
prevent 1 death in 5 years. For me personally that's not very
impressive. From the point of view of medicine and the population at
large it's quite significant. Treat 10 million people and save 200,000
lives in 5 years.
Negative side effects do exist and it's clear that the numbers are
certainly higher that reported in the literature, but I see no reason
to believe they are near the levels nor severity reported by fringe/
blogs/pseudo sources.
In any case here are the specifics point by point. I'm going to be
brief cause this stuff can get quite involved. I've tried to provide
good solid counter references.
Claim 1:
"There is no clear correlation between blood cholesterol levels and
the risk or even the advancement of heart disease. "
In 70's the largest, most rigorist study to date was commissioned to
looked into this very questions. 316,000 folks were monitored for 12
years to see who got heart attacks.
The results were striking as regards serum cholesterol. The lower the
cholesterol levels the lower the rate of heart attacks. This effect
was continuous through the all cholesterol ranges. This study was done
before statins were available.
See:
http://www.gpnotebook.co.uk/simplepage.cfm?ID=718274624
From the study:
"for each five-year age group, the relationship between serum
cholesterol and CHD death rate was continuous, graded, and strong.
the pattern of a continuous, graded, strong relationship between serum
cholesterol and six-year age-adjusted CHD death rate prevailed for
nonhypertensive nonsmokers, nonhypertensive smokers, hypertensive
nonsmokers, and hypertensive smokers. These data of high precision
show that the relationship between serum cholesterol and CHD is not a
threshold one, with increased risk confined to the two highest
quintiles, but rather is a continuously graded one that powerfully
affects risk for the great majority of middle-aged American men"
see ref:1
Claim 2:
The web site claims the homocysteine is a cause of blood vessel damage
and can be lowered by certain nutrients and vitamins implying better
heart health.
BUT - What they don't tell you is that numerous large scale studies
have been done. B vitamins did indeed lower homocysteine levels, but
the heart attack rate did not decrease. In other words the notion that
lowering homocysteine levels to reduce heart attacks has been
investigate and disproved. You wouldn’t know this from reading the
article. Remember this is a disguised supplement company out to sell
supplements.
See ref:2
Claim 3:
"Lowering Cholesterol has nothing to do with the benefits of Statin
Use. Statin drugs "work" by lowering inflammation, not by lowering
cholesterol."
That broad statement does not stand up to current understandings and
data.
First of all the inflammation metric they are referring to is C-
reactive protein. It's recently been established (2008) this is a
marker not a cause of heart disease. For scientist that study this
stuff this was a big deal and a game changer in the understanding of
the role of C-reactive protein and heart disease.
When ldl initiates the disease process inflammation is increased
because it part of an inappropriate immune/inflammatory process.
The ldl disease process and inflammatory process are not necessarily
separate.
Even more importantly when C-reative protein is decreased ldl is also
decreased. In the Jupiter study ldl was reduced by 50% along with the
C-reactive protein reduced by 37%. It's not clear at all that these 2
processes are distinct.
see ref: 3
Claim 4:
This deception is very alluring and appears in different forms in many
activities. It runs something like this " If "something" (food,
supplement, activity, habit) is good for you, then any less of this
"something" is going to be bad for you. In this case, cholesterol is
necessary component of life. Its involved in hundreds or thousands of
functions. In fact it's so fundamental that it probably doesn't make
sense to even try to number its functions. For instance one function
of cholesterol is involved in hormone production.
The argument is that if we lower our cholesterol level our hormone
production will decrease with undesired results. That's a very
reasonable concern and one that medical research took seriously. A
number of well controlled trials have been undertaken to investigate
just this fact, with consistent negative findings. Unfortunately,
these studies are not mentioned on the web site. Instead the results
of two negative findings by studies without the degree of rigor/
control as the other studies are reported. Wouldn't a fair
presentation present all the information?
Ref: 4
Not done, but I think you get the picture. A very one sided, biased
presentation from this web site. It's very easy to provide a link with
what looks to be a convincing argument, no so easy to produce the
other, in my view, fuller picture.
Randy
Refs:
1.
http://www.gpnotebook.co.uk/simplepage.cfm?ID=718274624
2.
299:2027-2036, 2008
Ebbing M and others. Mortality and cardiovascular events in patients
treated with homocysteine-lowering B vitamins after coronary
angiography: a randomized controlled trial. JAMA 300:795-804, 2008.
SEARCH Collaborative Group. Effects of homocysteine-lowering with
folic acid plus vitamin B12 vs placebo on mortality and major
morbidity in myocardialinfarction survivors: A randomized trial. JAMA
303:2486-2494, 2010.
House AA and others. Effect of B-vitamin on progression of diabetic
nephropathy: A controlled trial. JAMA 303:603-1309, 2010.
Lonn E. Homocysteine-lowering B vitamin therapy in cardiovascular
prevention—Wrong again? JAMA 299:2086-2087, 2008.
3.
http://www.webmd.com/heart-disease/news/20081029/crp-not-cause-of-heart-disease
http://www.nejm.org/doi/full/10.1056/NEJMoa0807646
4.
Grundy SM, Cleeman JI, Merz CN, et al. Implications of recent clinical
trials for the National Cholesterol Education Program Adult Treatment
Panel III guidelines. Circulation. 2004;110:227-239. Abstract
Johnson C, Waters DD, DeMicco DA, et al. Comparison of effectiveness
of atorvastatin 10 mg versus 80 mg in reducing major cardiovascular
events and repeat revascularization in patients with previous
percutaneous coronary intervention (post hoc analysis of the Treating
to New Targets [TNT] Study). Am J Cardiol. 2008;102:1312-1317.
Abstract
Travia D, Tosi F, Negri C, Faccini G, Moghetti P, Muggeo M. Sustained
therapy with 3-hydroxy-3-methylglutaryl-coenzyme-A reductase
inhibitors does not impair steroidogenesis by adrenals and gonads. J
Clin Endocrinol Metab. 1995;80:836-840. Abstract
Isaacsohn JL, Bakker-Arkema RG, Fayyad R, Whitcomb R, Black DM.
Atorvastatin, a new HMG-CoA reductase inhibitor, does not affect
glucocorticoid hormones in patients with hypercholesterolemia. J
Cardiovasc Pharmacol Therapeut.1997;2:243-249.
Dobs AS, Schrott H, Davidson MH, et al. Effects of high-dose
simvastatin on adrenal and gonadal steroidogenesis in men with
hypercholesterolemia. Metabolism. 2000;49:1234-1238. Abstract
Bairey Merz CN, Olson MB, Johnson BD, et al. Cholesterol-lowering
medication, cholesterol level, and reproductive hormones in women: the
Women's Ischemia Syndrome Evaluation (WISE). Am J Med. 2002;
113:723-727. Abstract
Santini SA, Carrozza C, Lulli P, Zuppi C, CarloTonolo G, Musumeci S.
Atorvastatin treatment does not affect gonadal and adrenal hormones in
type 2 diabetes patients with mild to moderate hypercholesterolemia.
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Atheroscler Thromb. 2003;10:160-164. Abstract
Dogru MT, Basar MM, Simsek A, et al. Effects of statin treatment on
serum sex steroids levels and autonomic and erectile function.
Urology. 2008;71:703-707. Abstract
Stanworth RD, Kapoor D, Channer KS, Jones TH. Statin therapy is
associated with lower total but not bioavailable or free testosterone
in men with type 2 diabetes. Diabetes Care. 2009;32:541-546. Abstract
Kocum TH, Ozcan TI, Gen R, et al. Does atorvastatin affect androgen
levels in men in the era of very-low LDL targeting therapy? Exp Clin
Endocrinol Diabetes. 2009;117:60-63.
2. Lonn E. Homocysteine-lowering B vitamin therapy in cardiovascular
prevention—Wrong again? JAMA 299:2086-2087, 2008.
3.Effects of homocysteine-lowering with folic acid plus vitamin B12 vs
placebo on mortality and major morbidity in myocardialinfarction
survivors: A randomized trial. JAMA 303:2486-2494, 2010.
4.Albert CM and others. Effect of folic acid and B vitamins on risk of
cardiovascular events and total mortality among women at high risk for
cardiovascular disease: a randomized trial. JAMA 299:2027-2036, 2008
5.Malinow MR and others. Homocyst(e)ine, diet, and cardiovascular
diseases: A statement for healthcare professionals from the nutrition
committee, American Heart Association. Circulation 99:178-182, 1999.
6. Tanne D and others. Prospective study of serum homocysteine and
risk of ischemic stroke among patients with preexisting coronary heart
disease. Stroke 34:632-636, 2003.