The number of potential statin users has been doubled and is approaching 100 million people in the US alone. What is going on? Skeptics might see this as another initiative by big pharma to enrich itself by further polluting our blood streams with their products. An article by John D. Abramson and Rita F. Redberg in the New York Times suggests that profit may be the motive.
"This announcement is not a result of a sudden epidemic of heart disease, nor is it based on new data showing the benefits of lower cholesterol. Instead, it is a consequence of simply expanding the definition of who should take the drugs — a decision that will benefit the pharmaceutical industry more than anyone else."
The authors then go on to suggest that those who formulated this recommendation might be paid lackeys of the pharmaceutical industry.
This view fits well an "evil pharma" scenario. However, the guidelines on statin usage that have been issued also included a rather surprising recommendation. An article by Gina Kolata in the New York Times, New Cholesterol Advice Startles Even Some Doctors, provides some background.
"According to the new advice, doctors should not put most people on cholesterol-lowering medications like statins based on cholesterol levels alone. And, despite decades of being urged to do so, patients need not monitor their cholesterol once they start taking medication. The guidelines do not even set target levels for LDL, the so-called bad cholesterol."
What the guidelines seem to be saying is that you should take statins if you are at risk for cardiovascular disease, but risk should be based on overall health indicators such as obesity rather than on cholesterol levels. Meanwhile tens of millions of people are now taking statins solely based on cholesterol levels. This would indicate that the emphasis on cholesterol has been inappropriate.
"Dr. Lisa Schwartz, a professor of medicine at Dartmouth, said that medical systems constantly prodded doctors to report patients’ LDL levels and used the numbers to judge doctors’ performance. Referring cardiologists often insist that LDL levels be measured and then lowered."
"’Everyone adopted the targets,’ Dr. Schwartz said. ‘It drove a huge amount of testing and focusing around the LDL number. Many doctors thought it was crazy. We were prescribing higher doses of drugs for older patients, which was probably dangerous’."
Everyone seems to agree that statins are beneficial for those have or are at high risk for cardiovascular disease. Everyone—or nearly everyone— seems to have assumed that cholesterol was the culprit that needed to be controlled. However, statins provide benefits other than controlling cholesterol.
If the main interest of drug companies is selling statins to as many users as possible, and lowering cholesterol is the marketing angle for sales, how can the new guidelines be viewed as serving the wishes of the pharmaceutical industry? This source provides further insight.
That is encouraging. One might even go so far as to claim that the panel responsible for the new recommendations took a courageous step in correcting a misconception related to cholesterol that has long been a part of medical tradition.
While the range of people that might be prescribed statins has grown, the focus on other indicators of cardiovascular risk rather than on cholesterol highlights the option that just living a healthier lifestyle is as good, if not better, than medication. It is not clear what this change will mean for statin sales in the long run.
We need to ask ourselves a serious question. There has never been any conclusive evidence that lowering cholesterol in an otherwise healthy person protects them from heart attacks and strokes. So how did it become "common knowledge" that cholesterol lowering medications, statins, should be prescribed? This source provides a clue:
Who has the resources—and the motivation—to purchase the allegiance of medical professionals, flood academic journals and the media with self-serving articles, and create a market where none needs exist?
"Evil pharma" lives—and we should not forget that it has lived for a very long time.
And we should remember that doctors don’t always know what they are talking about. Do your own research.