Monday, December 21, 2015

This should kill off the Statin religion (but it won't, of course)

There have been many anecdotal reports of statins adversely affecting mental functioning, to the point where the upsurge of Alzheimer's in recent decades could be nothing more than an effect of widespread statin use.

Scientists, however, rightly pooh-pooh anecdotal reports unless they are backed up by survey or other evidence.  So a recent study (below) is of great interest.  And its findings are striking. Where epidemiological reports in the medical literature characteristically make a big deal out of tiny odds ratios -- with ratios just above one being typical -- the odds ratio for the effect of statins is 4.4!  A very strong result by epidemiological standards.  So statins definitely can and do wreck your memory. The critics of statins are resoundingly vindicated.

The authors below don't want to believe their results, of course, so clutch for comfort their finding that ALL lipid lowering drugs -- not just statins -- wreck your memory. Quite how that is a comfort quite eludes me, however.  I would have thought that the finding shows that we NEED our lipids in our brains and that ANY attempt to lower them is destructive.  And statin critics have often made that point. There is of course a LOT of cholesterol in  our brains. It belongs there.

So we might ask what good is something that protects your heart but wrecks your brain?  But the reality is even worse than that.  A recent very comprehensive study found that statins did not even protect your heart. You were just as likely to die of heart failure with or without them.  Here are the statistics:

Statins reduced the numbers of patients experiencing non-fatal HF hospitalization (1344/66 238 vs. 1498/66 330; RR 0.90, 95% confidence interval, CI 0.84–0.97) and the composite HF outcome (1234/57 734 vs. 1344/57 836; RR 0.92, 95% CI 0.85–0.99) but not HF death (213/57 734 vs. 220/57 836; RR 0.97, 95% CI 0.80–1.17).

And since statins have an acknowledged muscle-weakening effect and the heart is one big muscle, the use of statins to treat the heart was always deeply paradoxical!  Words rarely fail me but that went close.

Clearly, the prescribing of statins to the general public should cease forthwith.

Statin Therapy and Risk of Acute Memory Impairment

Brian L. Strom et al.


Importance:  Reports on the association between statins and memory impairment are inconsistent.

Objective:  To assess whether statin users show acute decline in memory compared with nonusers and with users of nonstatin lipid-lowering drugs (LLDs).

Design, Setting, and Participants:  Using The Health Improvement Network database during January 13, 1987, through December 16, 2013, a retrospective cohort study compared 482 543 statin users with 2 control groups: 482 543 matched nonusers of any LLDs and all 26 484 users of nonstatin LLDs. A case-crossover study of 68 028 patients with incident acute memory loss evaluated exposure to statins during the period immediately before the outcome vs 3 earlier periods. Analysis was conducted from July 7, 2013, through January 15, 2015.

Results:  When compared with matched nonusers of any LLDs (using odds ratio [95% CI]), a strong association was present between first exposure to statins and incident acute memory loss diagnosed within 30 days immediately following exposure (fully adjusted, 4.40; 3.01-6.41). This association was not reproduced in the comparison of statins vs nonstatin LLDs (fully adjusted, 1.03; 0.63-1.66) but was also present when comparing nonstatin LLDs with matched nonuser controls (adjusted, 3.60; 1.34-9.70). The case-crossover analysis showed little association.

Conclusions and Relevance:  Both statin and nonstatin LLDs were strongly associated with acute memory loss in the first 30 days following exposure in users compared with nonusers but not when compared with each other. Thus, either all LLDs cause acute memory loss regardless of drug class or the association is the result of detection bias rather than a causal association.


Posted by John J. Ray (M.A.; Ph.D.).

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