Re: Positive Trial for Statins / Barry Groves book

[Guest guest]

--- <jeremytfox@...> wrote:

> The trial was ended early because of favorable results; treatment

> lasted an average of 2 years, with some up to 4 years.

, 2 to 4 years doesn't seem like a very long period for

evaluation. I'd be more impressed if it was 10 or 20 years.

Also, there are bound to be dietary changes, like minimizing sugar and

PUFA that would likely provide much better benefit than taking an

expensive drug that probably has long-term side effects. Of course,

this option won't make money for the drug company. Definitely a trick

and treat situation.

> In other news, I read most of the new book, Trick or Treat, by

> Barry Groves. It advocates a high-fat diet. It seemed pretty

> comprehensive and heavily influenced by the WAPF advice.

Barry is an honorary member of the board at WAPF

> On heart disease, he covered more types of disease / adverse

> outcomes than list member Masterjohn, but seems less

> knowledgeable about atherosclerosis in particular.

I haven't read any of Barry's books, but I like his web site. I've

been following his trick and treat blog:

http://barrygroves.blogspot.com/

[Guest guest]

> The bottom line for me would be that 190 of the statin users died,

compared to 235 of the

> non-stain users.

correlation, not causation

> Figure 2

> showed the heart disease benefit accrued

And they were counting " heart disease benefit " how? by disease

diagnosis? or lab markers?

> Perhaps the dangers of statins are

> outweighed by the benefits for

> those who will not adopt a diet

For those who will not adopt a diet that leads to health, throwing

drugs at the symptoms might change the symptoms but can't fix the

original problem- the diet.

As Groves said somewhere in his blog: Statinators may show benefits

by inductive reasoning, and may expand the use of statins to include

populations, but we DON'T HAVE TO TAKE THEM.

[Guest guest]

>

> > The bottom line for me would be that 190 of the statin users died,

> compared to 235 of the

> > non-stain users.

>

> correlation, not causation

Uh, this was a randomized trial where the only difference was that the treatment

group was

given statins and the control group was given a placebo.

[Guest guest]

and ,

> Also, there are bound to be dietary changes, like minimizing sugar and

> PUFA that would likely provide much better benefit than taking an

> expensive drug that probably has long-term side effects. Of course,

> this option won't make money for the drug company. Definitely a trick

> and treat situation.

There is little doubt that statins reduce inflammation, which can help

prevent atherosclerosis. It appears that the benefits of statins are

mainly due to this characteristic, rather than to their

cholesterol-lowering effects. This new study confirms this, and it

will surely increase pressure on doctors to prescribe statins to more

patients. It's atrocious that studies funded by drug companies who

stand to benefit from positive results are still allowed, but it's

going to be a while before that changes because of the tremendous

power they have.

As notes (and as has explained well elsewhere), PUFA and

(probably?) excessive carbohydrates lead to increased oxidative stress

and inflammation. Even in people with high CRP results, a healthier

option would be to address their diet rather than face the side

effects of statin drugs.

Tom

[Guest guest]

> a healthier

> option would be to address their diet rather than face the side

> effects of statin drugs.

> Tom

Interesting take on the Jupiter statin study at Hyperlipid:

Cholesterol, heart attacks, and Jupiter

http://high-fat-nutrition.blogspot.com/2008/11/cholesterol-heart-

attacks-and-jupiter.html

" Here are the missing numbers:

Heart attack deaths on statin: 9

Heart attack deaths on placebo: 6

Hmmm, 50% increase of being dead from a heart attack on Crestor, with

an LDL half the level of the people on the placebo.......... Good job

the study was not powered to detect this!

....

What the news clips claimed was:

" The study [JUPITER] of 17,800 men and women with normal cholesterol

levels found a new statin drug cut deaths from heart attacks and

strokes "

Note the words " deaths " , " heart attacks " and " strokes " . There were 3

stroke deaths in the statin group, 6 in the placebo group. Exactly

enough to reverse the heart attack effect. Phew!

[Guest guest]

Mike Eades has a pretty interesting commentary on the JUPITER trial on

his blog.

<http://www.proteinpower.com/drmike/cardiovascular-disease/1853/>

I highly recommend reading the whole post, but here are a couple

choice bits.

> Let’s look at the sort of fishy aspects of this study. First, the

> patient population is most unusual. How many subjects are there out

> there who have both normal LDL-cholesterol levels (defined as 130 mg/

> dl or below) AND elevated C-reactive protein levels. Not very

> many. Especially if you eliminate anyone with any history of

> inflammatory disorders, which the researchers did. Most people who

> have an inflammation arising from the metabolic syndrome, obesity or

> other common inflammatory disorders will have both elevated lipids

> AND elevated C-reactive protein levels. They are typically found

> together. The authors of this study had to use 1315 sites in 26

> different countries to get the 17,802 subjects involved. Simple

> division tells us that there were an average of about 13 subjects

> per center. Not many. To paraphrase F. Fitzgerald who said

> “the rich are different from you and me.” Well, these subjects are

> different from you and me. And what may work for them may not

> necessarily work for you and me.

>

> Second, when you look at Table 1 showing the baseline

> characteristics of the participants, you can see that in virtually

> all respects the two groups of subjects look identical, which is as

> it should be in a randomized study. But closer evaluation indicates

> that there not identical in a couple of parameters. In the category

> Family history of premature CHD (coronary heart disease) we see that

> there are 51 more subjects with a family history of premature CHD in

> the placebo group than in the Crestor group. Since a family history

> of premature CHD is probably the strongest risk factor for

> developing premature CHD, do you think a few more of the subjects in

> the placebo group may have developed it? And maybe died as a result?

>

> Third, looking at this same table and checking the very next

> category, Metabolic syndrome, we find that 71 more patients in the

> placebo group with metabolic syndrome than we do in the Crestor

> group. Since the metabolic syndrome is another strong risk factor

> for development of CHD, do you think some of that difference in

> deaths could have come from this disparity in the groups? As I say,

> not conclusive, but fishy.

>

> One of the negative findings in this study was that the group on

> Crestor developed diabetes during the trial at a significantly

> higher rate than did those on placebo. I suspect that the outside

> group checked the progress of the study, found that the subjects on

> Crestor were at the time of the evaluation showing better results

> than those on placebo, so the decision was made to stop the study

> while it was looking good. Had it gone on for the full term, the

> deaths could have evened out, way more people could have developed

> diabetes, or who knows what might have occurred had the study

> continued. So, the powers that be decided to quit while ahead.

>

> But, let’s assume I’m taking this study at its absolute worst.

> Let’s look at it in the best light possible. If we do, we find that

> a small group of unusual patients - those with low LDL-cholesterol

> AND high C-reactive protein - may slightly decrease their risk for

> all-cause mortality by taking a drug that costs them almost $1,300

> per year and slightly increases their risk for developing diabetes.

> That’s the best spin possible given the data from this study.

> Compare that to the spin the media is giving it.

[Guest guest]

I haven't read this paper yet, but the New York Times article I read

on the way to the airport Monday morning said that the trial ended

after 2 years and only some of the patients were subject to the

follow-up currently published. Were patients randomized to follow-up

vs. non-follow-up?

Chris

[Guest guest]

I got the impression different patients started at different times, but all

ended at the same

time. So patients were in the trial between 2 and 4 years.

>

> I haven't read this paper yet, but the New York Times article I read

> on the way to the airport Monday morning said that the trial ended

> after 2 years and only some of the patients were subject to the

> follow-up currently published. Were patients randomized to follow-up

> vs. non-follow-up?

>

> Chris

>

[Guest guest]

,

> I got the impression different patients started at different times, but all

> ended at the same

> time. So patients were in the trial between 2 and 4 years.

Yes, that's the case, but the article in the NYT made it seem

otherwise to me. Now that I've read the NEJM article that is pretty

clear.

Chris