Statins increase life expectancy.

[KarenJ]

Statins increase life expectancy (http://news.yahoo.com/s/ap/20061010/ap_on_he_me/statin_study;_ylt=Aiz98R0FpZA8T7ZoPOxD7LtZ24cA;_ylu=X3oDMTA5aHJvMDdwBHNlYwN5bmNhdA--)

OK, We need someone who can get a copy of this. Must be flawed. :lol:

PS- I'm not a huge fan of statins, but two years isn't all that bad. Can I get my two years NOW, or do I have to wait until I'm 93?

Found the Abstract (hummm):

Statins have been shown to be effective in reducing cardiovascular events and overall mortality in primary and secondary prevention trials. This study was designed to examine the effect of statin use on overall death. Cross-sectional data were obtained from the Department of Veterans Affairs Veterans Integrated Service Network 16 database for approximately 1.5 million veterans followed up in 10 hospitals in the southern United States. Statins were prescribed more often to elderly subjects with a history of coronary artery disease, hypertension, diabetes mellitus, current smoking, and using cardiovascular drugs (β blockers, aspirin, angiotensin-converting enzyme inhibitors, and calcium channel blockers). The predictors of death were, as expected, cancer, diabetes mellitus, the use of cardiac drugs, and age. Importantly, using statins showed a highly significant negative association with death (odds ratio 0.54, 95% confidence interval 0.42 to 0.69, p <0.0001), even after adjustment for all other variables. Overall, the mean age at death among statin users was 2 years older than among nonstatin users, despite statin users being at a higher risk of death. In conclusion, the results of this study have shown that using statins is a potent life-saving strategy. The benefit observed in this study is unique because almost 1/2 the patients were ≥70 years of age when statin therapy was initiated.

[nawchem]

I read the physician information which gives the actual clinical data for statins it is very impressive for people with heart disease. I heard Dr. Oz, the cardiologist say on Oprah that the mistake in prescribing statins is that they believed the benefit to the heart was that it lowered cholesterol. There is no proven relationship between high cholesterol and heart disease. High blood pressure is damaging to the arteries and can be a predictor. The drugs can be beneficial once you have heart disease. (If you can stand the side effects).

It it has been shown that beta blockers can also affect the beta cells in the pancreas and lead to high insulin levels and diabetes in later life. So between the two statins might be the lesser evil once heart disease is diagnosed. Obviously the best defense is a good offense- avoid hyperinsulemia, hypothyroidism, diabetes, and unnecessary drugs, do exercise.

This is only my opinion- and I'm not trained in medicine.

[Whoa182]

OK, We need someone who can get a copy of this. Must be flawed.

There were actually preliminary reports suggesting this a while back. Two years is quite significant too! It looks like CVD most important factor is inflammation, and statins seem to be quite effective at lowering it.

So good news for those taking them :)

[treefrog]

I haven't read it, and I am not an expert either. But my take on this is, if you have CVD, then taking statins is probably a good idea. Statins have been shown to have beneficial effects, not related to lowering of cholesterol. They are not sure exactly what the statins are doing, but they think it may be related to reducing inflammation and inflammatory markers.

I do NOT think there is benefit to taking them to lower cholesterol. It has not been shown that lowering cholesterol leads to reduced overall mortality.

My 2 cents. ;)

[brobin]

Is the effect any more pronounced then any other anti-inflammatory (ie aspirin)?

[treefrog]

That, I don't know.

[treefrog]

By the way, here (http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T10-4KKFMH1-2&_user=38557&_handle=V-WA-A-W-BW-MsSAYVA-UUA-U-AAZBABZYAY-AAZUDADZAY-AEUYUCYAU-BW-U&_fmt=full&_coverDate=10%2F01%2F2006&_rdoc=15&_orig=browse&_srch=%23toc%234876%232006%23999019992%23633713!&_cdi=4876&view=c&_acct=C000004358&_version=1&_urlVersion=0&_userid=38557&md5=34da4098f0c5abd4fa3f76ab4bf7fa8e) is a link to the full text article. I hope anybody can access this.

[GeorgeMead]

Here is a direct link to the abstract for those curious. http://www.ajconline.org/article/PIIS0002914906011787/abstract

Unfortunately, you need a subscription, (for only about $1/day), to see the full text. Personally, I expect Dr. Mike Eades will be able to find some weakness in the study design and/or its conclusions. It is not unusual for the abstract to assert conclusions that are simply not supported by the data.

I would take issue with the first line assertion: “Statins have been shown to be effective in reducing cardiovascular events and overall mortality in primary and secondary prevention trials.” Statins have consistently been shown to be expensive and useless in primary prevention. From the abstract, this study seems to be focused on secondary prevention. Statins are known to be effective in this population. “almost 1/2 the patients were ≥70 years of age when statin therapy was initiated”. This gives the drug one advantage in that one of the most serious suspected side effects of prolonged use in healthy individuals, heart failure, could be masked.

http://www.webmd.com/content/article/101/106141.htm
life expectancies and the change in death rates since 2002:

White men: 75.4 years (death rate down 2.1%)
Black men: 69.2 years (death rate down 2.5%)
White women: 80.5 years (death rate down 1.2%)
Black women: 76.1 years (death rate down 2.4%)

So one factor in this study is that many of these subjects were very near the end of their life at the getgo.

[treefrog]

Here are a few informative lines from the text of the paper.

Bold=mine.

To evaluate the differential effect of statin use on the prevention of death among patients with varying levels of risk factors, we calculated a risk score (0 to 6) for each patient. One point was assigned for each of the following 6 selected risk factors: age (≥70 years), diabetes, previous myocardial infarction, hypertension, high LDL cholesterol (≥100 mg/dl), and current smoking. We performed a risk-stratified analysis using the Cochran-Mantel-Haenszel chi-square analysis with the Breslow-Day test to evaluate the homogeneity of odds ratios across strata.

baseline characteristics of the study population. Patients receiving statins were older and had a significantly higher incidence of coronary risk factors, such as smoking, hypertension, diabetes mellitus, history of CAD (myocardial infarction, angina pectoris, or coronary artery bypass surgery), obesity, and depression. The serum total and LDL cholesterol, and triglyceride levels were higher, and the HDL cholesterol levels were lower in the statin users (all p <0.0001). Prescriptions for β blockers, angiotensin-converting enzyme inhibitors, aspirin, and calcium channel blockers were 6 to 8 times higher for statin users than for the nonusers.

A significant positive association was found between statin prescription and age, male gender, a history of CAD, body mass index, diabetes, smoking, hypertension, elevated levels of serum total or LDL cholesterol, triglycerides, and the use of cardiac drugs (β blockers, angiotensin-converting enzyme inhibitors, aspirin, and calcium channel blockers) (Table 1). In contrast, a significant negative association was found between a history of cancer and HDL cholesterol with statin use.

Next, we examined the predictors of death (Table 2). Similar to the first model, the final version of this model exhibited acceptable goodness of fit (percentage of concordant pairs 74.9, c statistic 0.762, Hosmer and Lemeshow goodness-of-fit test p = 0.6411, residual chi-square 12.9, degree of freedom 10, p = 0.2288). A history of cancer was the strongest predictor, followed by diabetes and the use of cardiac drugs (angiotensin-converting enzyme inhibitors, β blockers, and calcium channel blockers). Patient age also showed a positive association, but the body mass index had a negative association. The use of aspirin did not have a protective relation with death in this study. Therefore, it did not make the final model. Also, the diagnosis of myocardial infarction was strongly associated with death; however, when combined with angina and bypass surgery into a CAD umbrella variable, the association was not significant; therefore, it was not included in the final model.

The use of statins had a highly significant negative association with death, even after adjustment for all other variables (odds ratio −0.54, 95% confidence interval 0.42 to 0.69, p <0.0001; Table 2). Overall, the mean age of death among statin users was 2 years older than that for nonstatin users (Figure 1), and the unadjusted death rate for statin users was 9% compared with 17% for nonusers (RR −0.53, p <0.0001).


After examination of the patient strata, it became obvious that statin use had no significant effect on death prevention for those with a risk score of 0 (odds ratio 0.9, 95% confidence interval 0.73 to 1.12, p = 0.3343). However, for those with a risk score of >1, statin use had significant protective effects against death. For those with a score of 1, it reduced the relative odds of death by 22%, a score of 2 reduced the odds by 40%, a score of 3 reduced the odds by 46%, a score of 4 reduced the odds by 48%, and a score of 5 or 6 reduced the odds by 49% (all p <0.0001; Figure 2).

[LC FP]

Cross-sectional data were obtained from

This was not a randomized study. Selection bias applies. Doctors, even at the VA, will treat people with statins that they think will be helped by the statins, and not use statins in those they think won't be helped. Plus they probably will do any number of other interventions on those they think can be helped. Apparently they guessed right.

A flip of the coin would have to be used to decide who to treat with statins and who not to treat if this study is to be given any creedence.

[tom sawyer]

I do think this is logical given that there is proof that statins do reduce the incidence of second heart attack. I always had issues with the notion that you could prevent second heart attack without increasing life expectancy. Granted the side effects might be unpleasant, to the point that you can't take the drugs.

I also agree completely that the best thing is to avoid the first heart attack. Especially wqhen the first one has a decent chance of killing you in the first place.

I also always thought that a heart attack meant that your entire arterial system was basically shot, but I read something the other day that suggested the vessels of your heart might be especially vulnerable. It'd be nice to think that.

[Nancy LC]

I think some of the statins also seem to do something with inflammation, and they don't really know why. If they could zero in on that, then we might have a very useful drug.

[catfishghj]

I would like to see a study comparing statins to fish oil.

[Angeline]

I'd like to see a study comparing statins with a low-carb/fish oil/supplement approach.

[tom sawyer]

With LC you don't put your body in inflammation mode to begin with, and you don't have the glycation problems since there is not a slug of glucose coursing through your veins every four hours.

An ounce of prevention is going to be worth a pound of cure in this case, is there any doubt of that? And would you risk taking statins just so you could go back to eating junk?

[LC FP]

I would like to see a study comparing statins to fish oil.
Lyon, a secondary prevention trial, wasn't fish oil versus statin, but it was the "Mediterranean diet" versus the SAD (so they say). It may have really been alpha-linolenic-(omega-3 short chain)- supplemented margarine versus the normal French diet. Anyway, the people who ate the margarine had a total mortality improvement of 72% over a couple years, including a lot less cardiac death and a lot less cancer death.

No study ever has had an improvement in total mortality anywhere near this good. I want some of that margarine!

Although the study was originally scheduled to last for five years, after only two years researchers were so astounded by the differences in the two groups that the study was abruptly ended for ethical reasons. It was found that those following the Mediterranean-style diet had a 70 percent lower death rate compared to those following the prudent low-fat diet. In a follow-up report the researchers also discovered that cancer rates among the Mediterranean group were 61 percent lower than those of the other group.

http://www.mediterrasian.com/scientific_research.htm

[K Walt]

And, glaringly, in that study there was NO difference in the serum cholesterol levels between the two groups.

The 'Mediterranean' diet group didn't lower their cholesterol levels at all, compared to the other group, but still had significantly better outcomes.

Ergo, cholesterol or LDL means diddly.

[ReginaW]

Ergo, cholesterol or LDL means diddly.

Exactly what this recent study said too - Narrative Review: Lack of Evidence for Recommended Low-Density Lipoprotein Treatment Targets (http://www.annals.org/cgi/content/full/145/7/520?maxtoshow=&HITS=&hits=&RESULTFORMAT=&amp;amp;author1=Hayward,+R&andorexactfulltext=and&searchid=1&FIRSTINDEX=0&fdate=7/1/2005&resourcetype=HWCIT) that I just wrote about in my blog!

[treefrog]

Thanks for posting the link to that article Regina. I just printed it out. I will be reading it this weekend, for sure. And of course checking out your blog.