Women, cholesterol and statins

This is a post from 2009 by Douglas Bremmer M.D.’s blog Before you take that pill. This subject has come to mind after a discussion with a woman I know who is being pressured by her M.D. to take a statin.

More Than Meets The Eye on Most Recent Analysis of Statins for Primary Prevention

A recent meta-analysis in bmj of the treatment of people with multiple risk factors for heart disease but without a history of heart attacks looked at 70,388 people. They reported a 12% reduction in overall mortality which was statistically significant.

OK, so far so good.

However there are a number of problems with the conclusions not to mention the multiple pharma conflicts of many of the authors that may have contributed to those distorted conclusions.

In the conclusion section, they incredibly report a 12% reduction in mortality with no mention of differences by sex or diabetes status. They go on to write ”no significant treatment heterogeneity was found between the sexes, in elderly and young people, and between people with and without diabetes.” However inspection of Table 3 shows that there were in fact no statistically significant reductions of any endpoint (mortality, heart attacks) in women or diabetics or people over age 65. Furthermore, there was no mention of number needed to treat (NNT), or the fact the number of people saved from a heart attack were not greater than those developed liver problems or severe muscle pain (which could lead to rhabdomylosis, possibly fatal). Or that the 12% relative reduction is equal to about a 1% absolute reduction.

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This misrepresentation of the results is bordering on fraudulent.

http://tiny.cc/x15u1

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