statin

There is good evidence that a lot of drugs are overprescribed - see the latest statin controversy.

Ridker is an advocate of expanded statin use in primary prevention, a major advance of the new ACC/AHA guidelines.

The statin screening especially hit home for me as I've been threatened with being put on statins myself.

The primary one is that the NNT is tied to a very specific outcome; for example: How many patients do I need to treat with a statin to lower cholesterol?

One in five people statin intolerant due to muscle disorders.

I've heard anecdotal mention of memory problems with statin use, but have never been convinced I've seen it in any of my patients.

There's a tremendous body of evidence showing improved cardiovascular outcomes -- ie, reduced heart attacks and strokes; even, in some studies, improved survival -- with statin use.

The former molecule was basically an unusably toxic drug candidate that never would have been approved by the FDA, whereas the latter was the first safe and effective statin to go to market.

> Statin drugs have fewer side-effects than OTC painkillers.

And even then, the answer I actually get is: How many patients do I need to treat with a statin to prevent a heart attack or stroke in a one year period?

For example, it's been shown that women who have never had a heart attack have increased mortality with statin use, yet it's common for South Asians to get on statins in their 30s, at the slightest news of elevated total cholesterol.

That's a lower number than the number I need to treat go get the outcome I actually care about: How many patients do I need to treat with a statin to prevent one heart attack or stroke?

For example, Tim Noakes says "never prescribe a statin to a loved one".

"But, in a major embarrassment to the health groups, the calculator appears to greatly overestimate risk, so much so that it could mistakenly suggest that millions more people are candidates for statin drugs." What?

There's a lot more money in coming up with some new statin that lots of people will take for 20 years than a life-saving antibiotic that will be taken for 10 days by a smaller number of patients - especially when hospitals practice "antimicrobial stewardship," meaning that they don't prescribe newer, better antibiotics unless they think the old ones won't do.

Statin drugs are nearly entirely generic now, with a 3-month supply being $12, made by competing manufacturers.

Statin's crimes weren't fully revealed until two generations later, and Mao is still mostly unknowable.

Statin drugs have fewer side-effects than OTC painkillers.