Statistics for statins appear nefarious

Dear Dr. Roach: Would you comment on some information I discovered about statin drugs, which I think reveals some nefarious numbers on behalf of the drug companies?

So far I have found two reports that say the actual number of people who have heart attacks after being placed on Lipitor was reduced from 3.1% to 2%. This was a study of thousands of people over 10 years and was done by the drug company, not an independent lab. The drug company selling the statin drug claims that a reduction from 3% to 2% is a 33% drop.

I beg to differ on that. If my chances of having a heart attack drop from 3% to 2%, I say that is a 1% drop. So I quit taking the drug because of the long-term side effects. I also changed my diet to eliminate sugars and highly refined carbs, and I am eating a lot of dark green veggies.

I had a heart attack and triple bypass 11 years ago. My current cardiologist wants to up my statin drug from 40mg to 80mg.

Anon.

Answer: What you are calling nefarious, the drug company calls marketing, and both ways of looking at it are true, as long as you understand what is being said.

The original study that looked at the effect of a statin drug in people with heart disease showed that after 5.4 years, the risk of dying was 8% in the group randomly assigned to statin, and 12% in the group randomly assigned to placebo. The paper called that a 45% relative risk reduction, but I would call it a 4% absolute risk reduction.

I would never recommend a statin to a person with a 3% 10-year absolute risk. Most authorities recommend a statin once their 10-year risk is above 7.5%.

People at high risk of heart attack and stroke benefit from statin therapy, but the amount they benefit depends on how much risk they have. Those with a prior history of heart attack or bypass graft are likely to have much more benefit than harm from a statin. People without a history of heart disease have less absolute benefit, and so a careful evaluation, including assessment of lifestyle issues, is critical. I have had many people who no longer met criteria for a statin once they made some healthy changes to their lives.