This entry was posted on Saturday, November 19th, 2011

There continues to be a significant amount of controversy around the use of pharmaceutical agents for the treatment of elevated cholesterol and their long-term benefits versus their potential side effects. There is good evidence, and few people argue, that medications such as the Statin drugs are effective at lowering overall cholesterol levels. What is much less clear is whether or not these medications are beneficial or harmful when considering their overall effect on morbidity (poor health to do any cause) and mortality (death rate).

The important question is not whether or not medication, or any other form of treatment, lowers the cholesterol level but whether or not its long-term effect improves an individual’s overall health, quality-of-life and longevity or not.
Lipitor, a statin drug which became the first drug ever to produce more than $10 billion in annual sales, is commonly used in the treatment of high cholesterol. Pfizer, the drug company that produces Lipitor, has advertised that Lipitor reduces the risk of heart attack by 36%. In their ad the 36% is followed by an asterisk. The explanation following the asterisk at the bottom of the ad states that in a large clinical study 3% of the patients taking a sugar pill or placebo had a heart attack compared to 2% of the patients taking Lipitor. While the statement that Lipitor lowered the risk of heart attack by 36% in this study may be technically correct it can be misleading.

The numbers from this study are stating that for every 100 persons that participated in this over three-year study three people that were taking the placebos and two people that were taking Lipitor had heart attacks. So, in this study, what was the benefit of taking Lipitor? The benefit was that there was one fewer heart attack for every 100 persons involved in this study. 100 people had to take Lipitor for more than three years to spare one person a heart attack. The other 99 people received no measurable benefit.

Questions such as how many people in this study had negative effects associated with the administration of Lipitor should be asked when considering whether or not the administration of this drug improves overall health, quality-of-life or longevity. Statin drugs, like all drugs, can have negative effects as well as the positive effects they are designed to accomplish. An example of this may be found in a recent study cited in the June 2011 Journal of the American Medical Association which states that intensive dose statin therapy was associated with an increased risk of new onset diabetes compared with moderate dose statin therapy.

Another question which must be asked when looking at the treatment of high cholesterol with drugs is whether there are therapies that are more likely to improve overall health, quality-of-life or longevity. Some herbs which appear to produce significant reductions in total serum cholesterol include guggul, fenugreek, red yeast rice and artichoke. Are these herbs more, or less, beneficial overall compared to drug therapy when considering morbidity and mortality? I am not certain that this question can easily be answered conclusively. In my opinion, in many cases, it may make more sense overall to first try herbal therapies, along with good general health practices, which potentially will have fewer side effects and be more economically affordable.

Disclaimer: The information presented in this blog is for general discussion and educational purposes only. It is not intended to be used for the diagnoses or treatment of any disease or condition. It should not serve as a substitute for being evaluated by a certified health care provider. Any information or product discussed on this blog is not a substitute for the care of your physician or other health care provider.