Forums » Open clinical » Cardiology » So should everyone be on a statin?
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So should everyone be on a statin?
posted at 17/5/2012 11:58 AM BST
on bmj.com
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Posts: 93
First: 18/3/2011 Last: 4/3/2013 |
A study in the Lancet may not settle the debate but says there is benefit for people who are not at high risk of heart disease or stroke from taking statins. NICE currently recomends statins for people with CVD or those with a 20% risk of developing CVD within 10 years.It's a big meta analysis |
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Re: So should everyone be on a statin?
posted at 17/5/2012 12:45 PM BST
on bmj.com
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Posts: 3031
First: 27/3/2012 Last: 11/5/2013 |
I must say NO! The argument here being, as I have already posted in a seperate forum, to repeat once again: I remember the only well-established outcome of various research activities on usefulness & effectiveness of lipid lowering agents , like ‘Clofibrate’, ‘Gemfibrozil’ & others in the past being ‘Significantly higher incidence of deaths from sudden cardiovascular events was observed consistently in patients put on therapeutic doses of the lipid lowering agents’ the primary mechanism being weakening of the capillary endothelial basement membrane leading to end organ microvascular as well as macrovascular bleedings & ultimately failure! Thence, their use was banned for a long period. The basic pathological lesion seen in all diabetic patients is ‘Microangiopathy’ which is responsible for the major complications of diabetes like retinopathy, nephropathy, peripheral neuropathy & cardiovascular complications. Although the new generation lipid lowering agents, the ‘Statins’ are more effective in lowering LDL & increasing the HDL, their lipid lowering efficacy is directly proportional to increased damage to the capillary endothelial basement membrane! To explain this more simply, the action of the lipid lowering agents is akin to ‘Soap action ‘. They act by reducing the surface tension, the ‘Surfactants’. But more important fact being this action is not ‘Target specific’. So more they become potent the more dangerous are they in inducing micro/macro-vascular damage.! Is it the right time now to reassess the usefulness & risk benefit aspect of irrational use of the lipid lowering agents? Also there seems to have commercial interests involved. |
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Re: So should everyone be on a statin?
posted at 17/5/2012 2:11 PM BST
on bmj.com
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Posts: 1257
First: 13/4/2010 Last: 17/5/2013 |
Bottom line is you would still need to treat a hundred for only one to benefit. When you put it in terms of "take this tablet - there's a 99% chance it won't really do you any good" it kind of makes it less inviting doesn't it? |
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Re: So should everyone be on a statin?
posted at 17/5/2012 2:37 PM BST
on bmj.com
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Posts: 153
First: 29/11/2010 Last: 20/4/2013 |
Well not in primary prevention with people without high risk factors.For me life style change comes first,untill we get more solid evidence and data regarding this.The following video link will be helpful. |
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Re: So should everyone be on a statin?
posted at 17/5/2012 5:27 PM BST
on bmj.com
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Posts: 1280
First: 9/12/2011 Last: 14/5/2013 |
Absolutely Not! Why would one even consider this? Should everyone also be on an Antibiotic, or Heart Pill, or Insulin> ? Or Blood pressure meds? This is pure madness. The mere thought of it provokes many types of Malpractice... DuaneF |
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Re: So should everyone be on a statin?
posted at 18/5/2012 1:28 PM BST
on bmj.com
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Posts: 321
First: 12/11/2010 Last: 8/5/2013 |
It is interesting that this proposal should come out just after the price of Atorvastatin dropped by 93% as it came off patent. It sounds like a marketing to ploy to replace income to me. |
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Re: So should everyone be on a statin?
posted at 18/5/2012 4:04 PM BST
on bmj.com
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Posts: 453
First: 29/4/2011 Last: 14/5/2013 |
I find the skepticism from the BMJ bloggers about the value of statins in persons with cardiovascular disease and in prevention in high risk individuals puzzling. In the US it would never occur to us not to use them for their demonstrated benefits in such patients. I am not talking about low risk people, but I refer the readers to a recent Cochrane review as I posted in my diabetes discussion reviewing their preventative value in high risk persons: http://www.update-software.com/BCP/WileyPDF/EN/CD004816.pdf |
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Re: So should everyone be on a statin?
posted at 18/5/2012 4:18 PM BST
on bmj.com
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Posts: 1280
First: 9/12/2011 Last: 14/5/2013 |
Diabetes MD, I think it is not skepticism, but rather the idea of putting everyone on them. The post says should everyone be on them? and No everyone should not, nor should everyone be on cardiac drugs, or Antibiotics, or anything else... DuaneF |
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Re: So should everyone be on a statin?
posted at 18/5/2012 5:27 PM BST
on bmj.com
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Posts: 1784
First: 7/3/2009 Last: 18/5/2013 |
This is not scepticism. It is he reality. Our current knowledge shows that medications are not of the same efficacy in different subpopulations. And there is no "magical pill". As for statins, there are also side effects to be considered. |
Forums » Open clinical » Cardiology » So should everyone be on a statin?
