All Giddy about Cholesterol
Two other studies at the AHA meeting also furthered the cause of the cholesterol advocates, although these utilized statins alone. A study of Scottish men with high cholesterol who took Pravastatin for 5 years had a drop in heart attack (20/1000) and death (7/1000) later in their lives. Said one article: “This is the first study to show conclusively that pharmacological intervention to reduce cholesterol levels in otherwise healthy men with hypercholesterolemia can lead to reduction in mortality.” The words “first study” and “conclusively” should hardly be in the same sentence, since other studies have been far less sanguine about treating healthy people with statins, so this is hardly conclusive proof that statins should be taken by everyone. Still, that is what the press would lead us to believe; statins perhaps need to be used by everyone! A third study looked a small subgroup of elderly (defined as age 65-70)who took simvastatin and found a large relative risk drop (over 30%) in death and heart attack endpoints. Again, this unpublished work without any data on absolute risk reduction sounds like other similar statin studies that show a very modest reduction of endpoints in the elderly in absolute terms, but that did not stop some academics from stating that we should not be withholding life saving treatment from the elderly by denying them statins. I have seen what statins can do to the elderly, and the population in this study was hardly old, so it may be best not to leap to such definitive conclusions. Still, as all three studies indicate, although the role of cholesterol lowering and statin use remains controversial and patient-specific, the cardiology community will have us all believe that frequent labs tests, drug use, and dramatic LDL lowering is a gospel to which all of us must adhere. Well, until the next study comes out, in which case they will inevitably have to backslide again.