The docs are so exercised about cholesterol (and statin drugs in
particular) since the only sources of information for most of them are
the drug company reps that visit them incessantly and the heavily biased
drug trials in our corrupt medical journals. Even if they read the
journals all most ever read is the abstract. Almost all drug research
in the US and Europe is today funded totally by the drug companies who
always manage to get the results they desire. Richard Smith, former
editor of the British Medical Journal tells how it is done here.
<http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.0020138>
A summary here:
-------------------------------------------------------
Examples of Methods for Pharmaceutical Companies to Get the Results They
Want from Clinical Trials
Conduct a trial of your drug against a treatment known to be
inferior.
Trial your drugs against too low a dose of a competitor drug.
Conduct a trial of your drug against too high a dose of a
competitor drug (making your drug seem less toxic).
Conduct trials that are too small to show differences from
competitor drugs.
Use multiple endpoints in the trial and select for publication
those that give favourable results.
Do multicentre trials and select for publication results from
centres that are favourable.
Conduct subgroup analyses and select for publication those that
are favourable.
Present results that are most likely to impress—for example,
reduction in relative rather than absolute risk.
---------------------------------------------------------
Smith left the BMJ because of the corrupting influence the drug
companies were having on his publication. He also commented that the
American journals were much worse.
Cholesterol and statin drug research is particularly hard for the docs
to understand even if they read the full journal articles. Cholesterol
research it totally based on epidemiological evidence. There is no
medicine involved as there is no credible biological explanation for why
cholesterol causes heart disease. The epidemiological evidence is, of
course, purely statistical using simply awful methods such as
unjustified use of single tail vs. two-tail tests of significance. Even
then the correlations are extremely weak. To be fair, statin drugs do
reduce the incidence of heart attack and stroke. However, they work
equally well whether you have high or low cholesterol. The most likely
reason that they work at all is that they also have an anti-inflammatory
effect. But the effect is no more effective than an aspirin or fish oil
in the diet and those have little or no adverse effects.
I've tried to educate my own doc (whose office is always filled with
drug reps) but his eyes just glass over when we get to the statistics.
Not part of his education and he just quietly says "very interesting".
Using the studies from U of Hawaii and others having to do with
cholesterol and the elderly I did manage to convince my 89 year old
father's doc not to put him on cholesterol lowering drugs. There are
still some researchers that are independent of drug money but they are
few and far between.
If you're really interested in this subject your eyes will be opened by
reading at this site: <http://www.thincs.org/> The primary mover here
is a Swedish physician, Uffe Ravnskov, well published in the Lancet and
elsewhere. I got into this years ago by accidentally picking up his
book "The Cholesterol Myths". In it he speaks of the problem of drug
company influence and of docs only reading the abstracts of papers. He
states that often these papers make claims in the abstracts that are not
actually supported by the data in the paper. I thought this was
preposterous. This is "peer reviewed" science. I was ready to throw
his book in the trash. But before doing that I decided to check for
myself. I located two small (3 pages) papers on PubMed
<http://www.ncbi.nlm.nih.gov/pubmed/> that were small enough and
sufficiently statistical (vs medical) that I could understand them
without much difficulty. Apart from my selection criteria the selection
was random. To my utter horror I discovered that both of these small
papers made claims not actually supported by the data. But these claims
were not different from the more general cholesterol hysteria and would
not be picked up or even suspected without careful examination of the
actual data in the papers.
Unfortunately, "peer reviewed" in some circles has come to mean "buddy
approved".
Chuck Norcutt
Moose wrote:
> On 6/19/2010 5:45 AM, Chuck Norcutt wrote:
>> 'tis a matter of opinion. High cholesterol (by research at U of
>> Hawaii and u of California at San Diego) has been shown to be
>> protective in the elderly. Above the age of 65-70 the higher your
>> cholesterol the longer you live.
>
> Never heard that.
>
>> In fact, there is no association whatsoever between cholesterol and
>> heart disease in men over the age of 50 and in women of any age.
>> None. Never has been.
>>
>
> So why are the docs so exercised about it?
>
> I've completely ignored my cholesterol for well over ten years now,
> and don't plan to start monitoring it to see if I can get it up any
> more than I did to keep it down.
>
> When I was in a heart study, they did measure it, but I paid little
> attention.
>
> Moose
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