article: The Truth About Statins

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http://www.cbsnews.com/stories/2008/01/17/eveningnews/main3725545.shtml

The Truth About Statins

New York, Jan. 17, 2008

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(CBS) A new class of prescription drugs burst on to the scene over the last 15

years called statins designed to lower cholesterol. They're now taken by more

than 18 million americans. And statins are a $21 billion industry. But do all

the people taking them really need to be? CBS News teamed up with BusinessWeek

magazine to investigate

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As an architect, Mullican specializes in unique designs for beachfront

homes. So when his doctor told him to take lipitor to treat his high

cholesterol, he had a better idea.

" I didn't want to do a prescription medicine so I was going to try to figure out

a way around it, " Mullican said. " I took the prescription home with me but I

never filled it. "

Instead, he chose to lower cholesterol the hard way - through diet and exercise,

CBS News medical correspondent Dr. Jon LaPook reports.

Our national obsession with cholesterol numbers has led to us to depend on

statins as the easy way to fight heart disease - and why not?

It's hard to ignore ads. One advertisement is for Lipitor, the most popular

statin on the market. But if you look into where this number - the 36 percent

reduction in heart attacks comes from - you'll find out that benefit may not be

as dramatic as you think.

The study in the ad split people into two groups. For over three years, one

group took Lipitor, the other took a placebo. For every 100 people in the

placebo group, there were three heart attacks; in the Lipitor group there were

two. That means that 100 people had to take Lipitor for more than three years to

spare just one person from a heart attack.

Statins do one thing extremely well. They lower cholesterol - especially bad

cholesterol - and the science tells us there's one group of people who

definitely should be taking it.

" In people with known heart disease, this has become a standard of care, that

you really need to be on a statin, " said Cannon.

But what about the millions of people with elevated cholesterol who are taking

statins but have no heart disease or other risk factors? Here's where the

controversy heats up.

" We have no evidence that taking a cholesterol-lowering medication like a statin

will present them from getting heart disease, " said Nabel, director of

the National Heart, Lung, and Blood Institute. Dr. Nabel oversaw government

guidelines that say don't consider statins in patients with low risk factors

unless their bad cholesterol is over 160. That hasn't stopped the statin craze.

Even though guidelines say don't use statins in patients with low risk factors

unless their bad cholesterol goes over 160, in the real world, many doctors

prescribe statins anyway.

" We have been perhaps driven too quickly into this sort of assumption and this

model, that it's all about the cholesterol number and if we can just lower that

number, everything is better, " Dr. Brody said.

But statins have side effects and cost money. What's more, they may give a false

sense of security. Statin users may be tempted to neglect other risk factors,

like high blood pressure, lack of exercise, and poor diet.

" Doesn't a guy like me want to believe that I can have a greasy cheese burger

with fries, extra fries, and then if I swallow this pill everything will be

great, " Brody said.

Mullican's approach paid off. He lost 30 pounds and lowered his

cholesterol, without a pill.

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