X-Message-Number: 17241
From: 
Date: Fri, 10 Aug 2001 09:04:07 -0400
Subject: Re: CryoNet #17235

Message #17235
From: "Jan Coetzee" 
Subject: Statins kill
Date: Thu, 9 Aug 2001 21:41:02 -0400


>Note I was put on statins 5 years ago and had to quit after a few >weeks 
because of this terrible side effect. I was not on Baycol. >Take statins at your
own risk.



COMMENT: The generalization here is not appropriate. Have ANY medical stuff done
at your own risk, including having your appendix out. The surgery can kill you.
The relevant question is whether having the surgery is more dangerous than NOT 
having it (which can also kill).


The statin class of drugs may by the single best long-term tested 
high-number-of-patient-tested drugs known to man. It dwarfs what we know about 
any vitamin or food supplement from any controlled study. The news is good: in 
at least 4 studies statins not only cut heart disease, but total mortality risk 
as well, without any known increase in cancer.


Alas, these studies are expensive to do. The later and most recent "me-too" 
cheapo statins like Lescol and Baycol have been approved without them, but only 
on the strength of short term side effects and cholesterol lowering ability. If 
you worry about statins, stick to the best tested ones (which are of course most
expensive since you will be paying for those old long-term studies): These are 
mevacor, simvastatin/Zocor, and Pravachol/pravastatin. 


Stay away from fibrate drugs like Lopid/gemfibrazole or Tricor. These have NOT 
ever been shown to decrease even cardiac mortality, let alone total mortality. 
They also carry a distinct increased cancer risk, particularly bowel cancer. In 
2 fibrate studies mortality from all causes goes up (!).  It's amazing these 
thing are still legal.


Niacin and diet means of lowering cholesterol appear safe also. Not as easy, but
okay. There's little to suggest that they are safer than statins, though. Don't
assume it.


There's probably a causal association with high bowel (cecal) cancers and LOW 
cholesterol, particularly in obese men.  This is true even without drugs. We 
think it's causal because it persists as long as 10 years into studies, and 
occult cancers don't lower choleterol that long without making themselves known.
Since cecal cancers are far up the bowel and can only be found on colonoscopy, 
make very sure you have this procedure if you are smug about your heart disease 
risk.

Steve Harris, M.D.

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