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3 Scary Misconceptions About One of the Most Widely Prescribed Drugs for Heart Attack Prevention

Statins are a classic example of a misused medicine.
 
 
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With statin medications, used to prevent heart attacks, among the most widely prescribed drugs in the U.S., most people make certain assumptions:

  1. There is solid science for their use.
  2. There is no doubt that their targeted mechanism of action prevents a heart attack.
  3. No less costly approaches exist.

None of these is entirely true.

When it comes to any widespread medical treatment, most people want to trust that the health recommendations they receive are for their benefit. People don’t want to have to evaluate the credibility of their doctor’s medical advice, no less the premises of the healthcare system. While many treatments are effective, it’s not wise to overlook that the economic motive sometimes intrudes in the health equation. This occurs because the interlocking sectors of the current healthcare system blur important ethical boundaries, and in some cases erase them.

The intrusion of economics into health science is most noticeable in the gaps between health claims and actual outcomes. When seemingly “evidence-based” research is shaped by market considerations, healthcare treatments may fall short in delivering favorable aggregate health results.  In this article, I’ll explore the gap through the disputed science, and protectionism accorded one of the most widely prescribed medications in the conventional medical arsenal: Statin drugs.

Conspiracy of False Hope

Currently, 24 million Americans take statin medications that lower cholesterol as so-called “secondary prevention,” which research has demonstrated to be effective. Secondary prevention means deterring subsequent heart attacks and strokes in those who have already experienced a heart attack.

In contrast, “primary prevention” is the prevention of cardiac incidents in people who have yet to experience any cardiac problems.  Though initially approved by the FDA only for the purpose of secondary prevention, statins are now in even wider use for primary prevention, despite the fact that the medical evidence of their efficacy for this specific use is sketchy. Encouraged by pharmaceutical companies, doctors often prescribe drugs beyond their proven scope of efficacy, with the result that millions can be on drugs that may or may not work, and may have harmful side effects (which can include muscle weakness, kidney damage, blood sugar levels, memory loss, and cataracts).

Statins are one of the most well-known examples of this standard practice of extended use of a drug beyond its area of solid efficacy. How does this happen?

"There's a conspiracy of false hope," explained Harvard Medical School's John Abramson, a critic of widening statin use. "The public wants an easy way to prevent heart disease, doctors want to reduce their patients' risk of heart disease and drug companies want to maximize the number of people taking their pills to boost their sales and profits."

Phrases like “simple, fast, and easy,” are droned repetitively in all forms of health advice from the self-help to the medical realms. They speak to a population too pressured, preoccupied or concerned with economic goals to spend much time taking care of themselves (or each other for that matter). People are entrained by all forms of medical advertising to go for the quick fix.

The Science for Statin Use

Prescribing statins to prevent heart disease seems like a bone fide quick fix. Except that there is a debate as to whether science has demonstrated their efficacy for “primary prevention.”

That claim rests upon the findings in a sole study.

Today, the results of the so-called JUPITER study ("Justification for the Use of Statins in Primary Prevention," published in 2008) serve as the principle basis for the statin prescriptions doctors write for millions of people who have never had heart attacks and who take them as per their doctor’s advice to prevent heart attacks.

 
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