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If moving “high risk” patients to lower cholesterol levels does not decrease mortality, why bother with statins?
by someguydave 7y ago
If moving “high risk” patients to lower cholesterol levels does not decrease mortality, why bother with statins?
- afiori 7y agobecause they had high cholesterol for decades and the damage is already done. Decreasing cholesterol helps them, but they are not as healthy as someone with naturally such low cholesterol.
- someguydave 7y agoBut naturally low cholesterol was not associated with decreased mortality in Koreans?
- carbocation 7y agoThis study doesn't tell us if these participants had naturally low cholesterol or artificially low cholesterol (i.e., from medications). So no such conclusion can be determined.
- someguydave 7y agoAgreed, yet that conclusion (that low cholesterol is somehow harmful) cannot be excluded either. I agree that it would be interesting to see how the results of the Korean study would change if statin-takers were excluded.
- ArturSoler 7y agoIt could be that it reduces mortality, but it's still above average.
- carbocation 7y agoI agree with this conclusion. Not all mortality risk operates through cholesterol-dependent mechanisms. And even for those that do, decades of exposure to high cholesterol can’t be totally reversed by medications.
- someguydave 7y agoThat’s reasonable. Does that mean that another endpoint aside from cholesterol should be the target of control?
- carbocation 7y agoUltimately you want a readout of CAD risk, and we know that only a portion of CAD risk is attributable to LDL. We're always on the lookout for better biomarkers, but right now there isn't a comprehensive CAD biomarker (aside, perhaps, from coronary calcium - but we can't go around exposing everyone to radiation every year just to observe disease progression).
- village-idiot 7y agoLast time I’d read into it, statins didn’t move mortality numbers for most members of the population. Edit: they do decrease your risk of a heart attack a bit, but the increased incidence of cancer and diabetes actually eliminates the benefit for most users. The only people who showed any measurable reduction in mortality were non-elderly patients with a history of cardiovascular disease. https://www.marksdailyapple.com/the-evidence-continues-to-mount-against-statins/ https://www.marksdailyapple.com/the-evidence-continues-to-mo...
- carbocation 7y agoThis is a mix of outdated and simply wrong information.
- village-idiot 7y agoI’m unconvinced by your unsupported assertion.