The medical advice and facts need to be updated but who will take on the big pharmas who will rebuke any findings which provide very them wrong and that possibly most people who take Statins may not need them?
I’ve had something of a turnaround in my thinking about statins over the past 4-5 years, so I can see both sides of this conversation.
My current position is that there is every bit as much of an ‘industry’ making money from creating content that raises doubts over the effectiveness of statins, as there is about promoting them. There are those who make a career out of it (Harcombe, McKendrick, Malhotra, blah blah).
Imagine a world in which there existed an effective and cheap medication which prevented the number 1 killer of all humans everywhere. It worked (not 100%, but it significantly reduced the number of events at a population level). It was cheap. For the vast majority of peope, there were no adverse effects. And doctors
refused to let people have the medication. Endless hoops were set up that people had to jump through to prove they
really needed it. Chances are we’d be up in arms, making campaigns to fight for access.
Heart attacks kill people. And especially people with diabetes. Strokes can result in the need for lengthy rehabilitation programmes, heartache for families, lives that are forever altered. Looking after people who have experienced heart failure, stroke, or other CVD illness is an expensive business - both in terms of the human cost, societal impact, and also the financial cost.
There is no ‘plot’.
Statins have been studied, in great detail, over many many years. They are probably one of the most examined medications - both by industry-funded research, and also independent academic research. Overwhelmingly the results point in the same direction. And additional ‘let’s just check we have this right’ studies have clarified and confirmed the picture.
The reason they are offered so widely (which can feel like they are being ‘pushed at us and there’s some sort of weird agenda) is that they work, and they are cheap. That’s a pretty winning combination as far as evidence-based medicine goes. As a population level there is no question. You couldn’t even get a study past ethics approval any more to ask “do they work”, because there have been enough studies with more than enough people involved to render that a non-question.
In general people don’t want to take medication*. Even less so if they can’t actually see a benefit or effect that they want from it. How does one perceive a
reduction in risk? How can we know that something hasn’t happened because of a prescribed medication, or whether it just hasn’t happened? When taking a statin the ideal outcome is that
nothing happens. No wonder people find it hard to see the benefit of them.
The vast majority of people who take statins have no ill effects. Or if they do have some mild negative effects (like
@Robin) these disappear when taking a different statin.
There
are people, including people on the forum, who experienced a more significant negative reaction, but these are rare.
I’m prepared to accept that they may be slightly more common than some of the official RCT trial data may suggest (because from an ethics perspective, some trials have to include a run-in phase that removes anyone from the trial who can’t tolerate the medication). But there are large population, real-world, observational studies too.
One of the oddities about side effects and statins (perhaps because of the cloud of doubt that is so enthusiastically fostered around them by some high profile figures) is that trials often has as many ‘adverse events’ in the placebo arm as they do in the treatment arm. People genuinely experience negative effects because they are convinced that they will.
But that doesn’t cover everyone. And of course there will be people for whom statins are not appropriate. But to be honest, that is not very many people.
And actually the only way to know whether you will get on OK with them is to try them. And to try alternatives if you get any weirdness with the first one.
So I am more than happy to continue to take my statin, having been pretty suspicious of them for (or at least undecided) for years. But to reassure guests and lurkers. There is no plot. Statins are cheap, and they work. That’s all.
* A recent counter-example is Ozempic. People falling over themselves to get hold of a medication (that wasn’t even meant for that purpose) and wanting to use it “off label” because it promosed them the weight loss they wanted.
