Article on statins for primary prevention

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http://www.sacbee.com/296/v-print/story/146331.html

"Most of the 36 million people who take cholesterol pills do not have
heart disease. Their doctors prescribe pills as a form of preventive
medicine -- hoping that lower cholesterol might prevent heart disease in
the future.

In some cases, there is no data to support these assumptions at all. In
other cases, the data suggest only a very small benefit. Given the small
benefit, some reasonable people might decide to not take the pills when
they consider the expense and the daily reminder that their bodies are
abnormal."

Susan

"Susan" <nevermind@nomail.com> wrote in message
news:5b167jF2r992rU1@mid.individual.net...
> x-no-archive: yes
>
> In some cases, there is no data to support these assumptions at all. In
> other cases, the data suggest only a very small benefit. Given the small
> benefit, some reasonable people might decide to not take the pills when
> they consider the expense and the daily reminder that their bodies are
> abnormal."
>

You mean the daily reminder that I have to watch everything I eat, do
multiple bg tests, check my feet, etc -- all that isn't a daily reminder
that my body is "abnormal"? Let's not forget the exercise -- sometimes I
just don't wanna! I try not to go two days in a row without *something*,
even if it's just a stroll around the block.

Diabetes management is *far*, *by far* the more emphatic "daily reminder"
compared to the little thyroid pill I have to take (no option -- compare to
insulin for a T1 dm). That pill I take when I'm barely awake; the other
stuff requires *thought* and *action* throughout the day.

Of course, if someone doesn't want even a daily pill (of whatever sort) as a
reminder of abnormality, s/he is unlikely to do well managing diabetes
either.
bj

x-no-archive: yes

bj wrote:

> You mean the daily reminder that I have to watch everything I eat, do
> multiple bg tests, check my feet, etc -- all that isn't a daily reminder
> that my body is "abnormal"? Let's not forget the exercise -- sometimes I
> just don't wanna! I try not to go two days in a row without *something*,
> even if it's just a stroll around the block.
>
> Diabetes management is *far*, *by far* the more emphatic "daily reminder"
> compared to the little thyroid pill I have to take (no option -- compare to
> insulin for a T1 dm). That pill I take when I'm barely awake; the other
> stuff requires *thought* and *action* throughout the day.
>
> Of course, if someone doesn't want even a daily pill (of whatever sort) as a
> reminder of abnormality, s/he is unlikely to do well managing diabetes
> either.

Was that really the most salient take home message you got from the
entire article?

The point was that there's little to no benefit at all for many of those
being prescribed statins routinely.

Susan

Susan <nevermind@nomail.com> wrote in part:

>x-no-archive: yes
>
>http://www.sacbee.com/296/v-print/story/146331.html
>
>"Most of the 36 million people who take cholesterol pills do not have
>heart disease. Their doctors prescribe pills as a form of preventive
>medicine -- hoping that lower cholesterol might prevent heart disease in
>the future.
>
>In some cases, there is no data to support these assumptions at all. In
>other cases, the data suggest only a very small benefit. Given the small
>benefit, some reasonable people might decide to not take the pills when
>they consider the expense and the daily reminder that their bodies are
>abnormal."
>
>Susan

I dunno. Statins aren't "cholesterol pills." And exactly what "heart
disease" is isn't entirely clear. A large class of those who go on to have
clear heart disease seem to have an inflammatory disorder that involves the
kidneys, arteries, and other organs. Statins seem to make that illness
progress more slowly.

We do need better ways of knowing who will benefit and who will not and who
will have side effects and who won't. But right now, we've got what we've
got.

The author seems to focus on the high cost of a drug "to lower cholesterol."
Simvastatin, even in the US, is much cheaper than the $3000 for 5 years that
is cited. Plant sterols and stanols are a lot less if the writer is really
talking about cholesterol reduction pills.
--
Jim Chinnis Warrenton, Virginia, USA