Statins do not help you live longer. They do more harm than good

by Dr Malcolm Kendrick

Dr Kendrick has been warning about the almost total lack of effectiveness of statin drugs to prevent heart disease for over a decade, during which time the number of prescriptions written for these drugs in England alone has more than doubled from from 25 million to over 50 million. So much for his ability to affect public policy. However, last month it seemed that the official view had finally caught up with him. [Editor]

Yesterday, I was sent a copy of a ‘Patient page’ from the Journal of the American Medical Association (JAMA).  The page was from the April 3rd 2013 edition, pp 1419. It is stamped ‘JAMA – copy for your patients’. JAMA is one of the highest impact medical journals in the world. This patient page states that:

‘One question involves disagreement about whether the statin side effects are merely uncomfortable or actually pose significant health risks. The other question is whether reducing bad cholesterol will actually help you live longer than you otherwise would. Some of this disagreement involves how physicians interpret the results of studies. However, a 2010 analysis combined the results of 11 studies and found that taking statins did not lower the death rate for people who did not have heart disease. If your physician recommends taking a statin, talk to him or her about the risks and benefits for your individual situation.’

For many years, I have been ridiculed by colleagues for saying that if you do not already have established heart disease, statins do not increase your life expectancy. By which I mean that they don’t’ actually work. ‘Don’t be ridiculous,’  they exclaim. I usually reply that the evidence is pretty clear and always has been. But I know that they don’t believe me.

However now one of the most influential medical journals in the world had turned round and confirmed it. JAMA has stated in black and white that if you do not have established heart disease, e.g. angina or a previous heart attack, you will not live any longer if you take a statin. I should add, at this point, that around 95% of people who take statins do not have established heart disease.

Surely statins improve quality of life

But statin supporters have another arguement up their sleeve. ‘Ahbut it is not just death we are talking about here…. statins prevent non-fatal heart attacks and non-fatal strokes and suchlike. These are terrible things that damage the quality of your life. Medicine is not only about getting people to live longer, it is also about quality of life. Preventing a non-fatal stroke is extremely important, and statins do this.’ In other words, statins don’t make you live longer, but they do provide other, very significant benefits, by preventing Serious Adverse Events (SEAs).

This is a good arguement. At least it would be if it were true. However, we have no idea about whether it is or not. For the simple reasons that the data on SEAs is almost entirely hidden from view. Data on SEAs are considered so commercially sensitive that, in most jurisdictions, pharmaceutical companies won’t release them (and don’t have to release them), even if you ask nicely.

But first I need to clear up a bit of confusion over two the meaning of two related terms “adverse events” and side effects which are often talked about as if they are the same but which can mean very different things.

Firstly, there are drug-related adverse effects. These are often called ‘side-effects’. But side-effects can be good, or bad. For example Viagra was developed as an angina drug but it was found to create enhanced erections, as a side-effect. [You can decide if this is a beneficial side-effect or not]. Viagra also causes headaches. This is also a side-effect, but it would be more accurate to call it a drug-related adverse effect.

Drug-related adverse effects = negative/unpleasant ‘side-effects’ of a drug

A Serious Adverse Event (SEA) may sound similar to a drug-related adverse effect, but it means something completely different. An SEA is a significantly bad thing that a drug might prevent e.g. non-fatal heart attack. Or, it could be something that the drug causes e.g. rhabodmyolysis (muscle breakdown), followed by kidney failure. Which is something that is known to be caused by statins.

The side effects that are normally kept hidden

SEAs can therefore be good, or bad. Depending on whether they are caused by, or prevented by, the drug. This means that there is absolutely no point in presenting figures on SEAs prevented by statins, without knowing if they caused an equal number of SEAs at the same time.

Completely unsurprisingly, whilst we are bombarded with statistics about how many SEAs are prevented by statins, we have very little idea about how many SEAs are caused by statins. Because in most countries, these data are not released. It’s commercially sensitive dontcha know. [Damned right it’s commercially sensitive. If the public saw this data they would stop taking half their meds overnight.]

There have, however, been glimpses of SEAs with statins – when the data escaped from the clutches of the pharmaceutical companies. When the Cochrane collaboration first looked at primary prevention studies (involving people who hadn’t had a heart attack but had a raised risk of one), two of the five major studies did report ‘negative’ SEAs (although they did not say what the SEAs were, and still won’t.) In these two trials called AFCPAS and PROSPER, the SEAs were:

Statin arm:      44.2%
Placebo arm:  43.9%

This is an alarming finding for anyone convinced of the safety of statins. This is how the journal describes the result: ‘In the 2 trials where serious adverse events are reported, the 1.8% absolute reduction in myocardial infarction and stroke should be reflected by a similar absolute reduction in total serious adverse events; myocardial infarction and stroke are, by definition, serious adverse events. However this is not the case: serious adverse events are similar in the statin group, 44.2%, and the control group, 43.9%. This is consistent with the possibility that unrecognized serious adverse events are increased by statin therapy and that the magnitude of the increase is similar to the magnitude of the reduction in cardiovascular serious adverse events in these populations.’  (read more…)

In  other words what you would expect if  there was a reduction in the number of of heart attacks and strokes in the group getting the statin, is that there should be an equal reduction in the number of serious adverse events over all. But the number of SEAs was almost the same in the placebo group meaning that as well as reducing some SEAs the statins were also causing some new ones.

So what do we now know? We know that if you do not have established heart disease, and you take a statin, you will:

  • not live any longer
  • not avoid major Serious Adverse Events

Which means that there is no possible improvement from taking a statin in either the quality, or the quantity, of life. On the other hand there is a good chance that you will suffer from significant adverse effects e.g. muscle pain, joint pain, impotence, stomach upset, rashes etc. etc. On balance therefore we can state that, if you do not have established heart disease, statins provide no benefits on any important outcome. All they can do is to give you adverse effects. ‘Oh boy, that sounds like a great deal doc. Can’t wait, can’t wait, can I get them now?’

This is a slightly edited version of a post by Dr Malcolm Kendrick on his blog on 27 September 2013.
Dr Malcolm Kendrick

Dr Malcolm Kendrick

Dr Malcolm Kendrick – a GP in Lancashire – is the UK’s most determined and informed critic of statins – The Great Cholesterol Con - as well as other medical obsessions such as health checks and mammograms. He campaigns for a more balanced approach to health at drmalcolmkendrick.org

12 Comments

  • Thanks Malcolm – keep going – great stuff – best Oliver Gillie BSc PhD

  • Ignore this article. This author doesn’t know what he is writing about. People who promote unscientific nonsense like this should be held liable for the deaths that they cause by publishing this garbage. Statins reduce the risk of a heart attack, the risk of a second heart attack, and they have been proven to extend your life span. These are all proven and without doubt in the real scientific community. They do not cause memory loss. This too has been disproven in resent studies. Statins DO increase longevity in those without heart disease, and a s already stated, reduce the risk of a first heart attack. If you do not take a statin your doctor recommends than you are an idiot. If you believe this quack author you must be a moron.

    • Editorial

      I’ve approved this post because it is a good example for others of the kind of comment that we are not interested in having on this site. Not because we disagree with it but because it is intolerant, abusive and seems to have a very poor grip on the evidence. It is true to say that the official view is still that statins for prevention are an effective way of reducing the risk of developing cardiovascular disorders and significantly extend life.

      However there are a number of informed clinicians who are also experienced researchers – the author of the original piece Dr Malcolm Kendrick is one of them – who strongly disagree and have evidence from trials and metanalyses to back them up. There is also the difference between what makes sense on a personal and population level. It might be reasonable government policy to give cheap generic statins to millions to reduces the the number of cardiovascular events by several thousands. That doesn’t mean that taking statins makes sense for the individual. This is without taking into account the risk of side-effects which, it can be shown, has been consistently underplayed by the authorities and poorly reported by the drug companies.

      If you wish to comment further on this site please do so in an informed and civilised manner or your contributions will be removed.

      • I agree! I’m very interested in actually finding some proof, some reason, some guidance that maybe, just maybe we are all wrong and the pharma and “experts” are right – afterall, they should be, our nations health is in their hands. However, I cant find anything – not a thing that makes sense. Whenever you get their advocates commenting, they dont give any reasons for their belief, they just insult like spoilt children “believe me or I’ll call you a moron”.

        Anyway, my head and my own personal anecdotal evidence tells me HFLC is the way, it makes sense and feels right – it has certainly made me feel, look and behave better than when I followed low fat diets! So other than leading “sheep” who dont bother to investigate (including many doctors), how can they justify high carb, low fat???

    • I would imagine someone with strongly held views like this wouldn’t waste their time commenting on articles written by ‘quacks’. I suspect this person is paid by vested interested to trawl websites and blogs to discredit anyone who refutes the pharmaceutical industry’s claim that statins are a wonder drug. No doubt it will copied and pasted around the place.

    • Ed, I suspect that your use of insulitng language will probably ensure that no-one pays any great heed to your post. It may interest you to know (or maybe not), that I am a peer-reviewer for the BMJ, I am regularly asked to give lectures to doctors on statins/CHD and like, and journal regularly contact me to write on CHD. I was elected to Who’s Who for my work in CHD research. I worked with the Europan Society of Cardiology to set up their educational website, and I set up the first website for the National Institute for Clinical Excellence. I do not write this to blow my own trumpted, but to make it clear that I do know what I am talking about.

      I am all for robust scientific debate But this does not include the words idiot, quack and moron. Nor should you readily accuse others of killing people. If you wish to enter a debate on the evidnece, feel free to do so. If your only interest is in ad-hominem attacks and insults then perhaps you should remain silent. Forever.

  • Hi Jerome and Malcolm. I wonder if you’ve seen this pertinent book review by Zoe Harcombe, posted just yesterday: http://www.zoeharcombe.com/2013/10/how-statin-drugs-really-lower-cholesterol-and-kill-you-one-cell-at-a-time/.

  • I am not entirely clear if this website is for medical doctors only – because although I have a PhD in chemistry, it didn’t relate to anything physiological – so please remove my comment if it isn’t appropriate.

    I had been taking simvastatin for 3 years when I suddenly started getting intense cramps in my polio leg. I thought I was getting Post Polio Syndrome, but fortunately I experimented with stopping the statin and restarting again several times. On each occasion the pain decreased while I was not taking the drug, and increased about a week after resuming. I have not taken simvastatin since February this year. The unpleasant symptoms have all slowly disappeared.

    This suggests several things:

    1) I was told that any side effects from simvaststin would happen in the first few weeks of treatment. This may mean that a lot of side effects that emerge later, are not being recognised.

    2) Only my polio leg was affected, so it would suggest that a damaged limb may be more vulnerable to statin – which might also result in statin effects not being recognised – possible there are people living with the effects unaware that statins are responsible!

    3) Shortly before my troubles began, the appearance of the tablets changed – from red brick to white. Although the dose remained at 40 mg, I wonder if the grain size might have been reduced, causing it to me more easily absorbed.

    • Editorial

      Thanks for your post. Will pass it on to a couple of the doctors who know about statins to see if they can give you a response

  • Thanks for this wonderful article Dr. Kendrick on a subject that is of extreme importance to modern medicine.

    I was just wondering about the statistics you mention. In clinical trials, end points and serious adverse events (SAE´s) are usually counted separately. So, if myocardial infarctions and strokes are counted as end points, they are usually not counted as SAE´S as well.

    So, can we be sure that the incidence of SAE´s mentioned in the paper (44.2% and 43.9% respectively) also include SAE´S the are defined as end points ?

  • Low carb high fat and moderate protein has worked for me. I have lost 140 pound in weight.
    I no longer take my glucophage meds simply because I am no longer type 2 diabetic due to low carb and completely cutting out all wheat products from my diet.
    I no longer take my Lipitor 40 because I honestly feel the evidence clearly shows that its benefits’ if any are far outweighed by its damaging affects, and this is coming from me who had a heart attack at the age of 44 in 2010. For me my metalonate pathway not blocked by statin medication greatly increases more my chances of a better quality of life.

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