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Tuesday, April 5, 2016

"Statins Cause Cataracts, But So What?"

Are statin drugs for lowering cholesterol and inflammation truly valuable or truly risky? The latest study, which implies that another 20 million Americans need to be on the drugs, also finds that statins increase the risk of cataracts.

Entitled "Cholesterol Lowering in Intermediate-Risk Persons Without Cardiovascular Disease," the findings of the HOPE-3 clinical trial show that, unsurprisingly, taking Crestor lowers cholesterol levels. HOPE-3 enlisted over 10,000 volunteers who did not yet have heart disease to take either Crestor or a placebo for, on average, about 5-1/2 years. In the group that took Crestor, LDL levels were 26% lower.

Of greater clinical significance was whether taking Crestor reduced the risk of developing heart disease in people who did not already have it. HOPE-3 showed a significant decline in the rate of cardiovascular events in the group of patients taking the drug:

  • Among the patients on Crestor, 3.7% died of cardiovascular disease, or had a heart attack or stroke. Among the patients who did not take the statin, 4.8% died, had a heart attack, or had a stroke.
  • The study also measured less drastic outcomes, such as having to have a bypass or stent, receiving CPR, or developing congestive heart failure. In the Crestor group, 4.4% experienced one of these secondary outcomes, compared to 5.7% in the placebo group.
In other words, if you don't already have heart disease, you are about 1.3% less likely to get it if you take Crestor and you are about 1% less likely to die. However, the study also found that taking Crestor was associated with greater risk of cataracts, 3.8% versus 3.1%, and greater risk of a muscle symptoms, 5.8% versus 4.7%. 

Doctors associated with the study offer the opinions that:

  • Maybe these side effects are just a fluke. After all, if you study something long enough, you'll get false positives (the appearance of relationships that aren't real) and false negatives (failure to detect a relationship between two variables).
  • And if they aren't a fluke, wouldn't you rather be blind than dead?
But to put the matter in perspective, this study finds that Crestor helps at most 1 person in 100. It's not a cure-all. People still get heart disease even without statins, and more importantly, 95% of people avoid heart disease without it.

The attitude of cardiologists toward statins tends to be that we need more, more, more so our cholesterol levels can go lower, lower, lower. The truth is, our bodies make LDL for some very important reasons. It fuels white blood cells and helps the body fight infections. It provides a building block for hormones. It can react with free radicals and cause calcifications, but it also provides part of the basic plumbing of the human body. We all need LDL. I can't advise you not to take a prescription statin, but it's a good idea to work with your doctor to make sure your levels don't go too low. And there is a great deal more that you need to do to deal with the possibility of heart disease. Please see my book, Minimal Medication, available in the Amazon lending library for free.

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