What the Media Isn’t Telling You About Statin Drug Trials | Chris Kresser

What the Media Isn’t Telling You About Statin Drug Trials


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Press releases and media reports about statin drugs often dramatically overstate their effectiveness, while understating their risk.

The information we have on the risk and effectiveness of statins is not complete. iofoto/iStock/Thinkstock

I just read a fantastic article by Dr. Malcolm Kendrick about how deceptive and misleading media reporting on statin drug trials can be.

Dr. Kendrick uses the Heart Protection Study (HPS) as an example. From the press release for the study:

“In this trial, 10 thousand people were on a statin. If now, an extra 10 million high-risk people worldwide go onto statin treatment, this would save about 50,000 lives each year—that’s a thousand a week.”

That sounds pretty compelling, doesn’t it? It’s hard to argue against saving 50,000 lives a year.

But that’s not what the study showed at all. In fact, the following would be a more accurate report on the results of this study, couched in the context of what we know from other statin drug trials:

  • Out of 100 high-risk people taking a statin for five years, 98.2 will not see any benefit to their heart health at all—but they will be exposed to significant side effects and complications, including muscle damage and diabetes.
  • The 1.8 people that do benefit will live an average of 6 months (and a maximum of one year) longer than those that didn’t take the statin. 
  • These results only apply to the people at highest risk for a future heart attack: middle-aged men who’ve already had a heart attack (aka “secondary prevention”). There is no compelling evidence that statins extend lifespan at all in men without pre-existing heart disease, or women with or without heart disease. 

It’s misleading to claim that the HPS study showed that statins “save lives.” According to the HPS data, even in the highest risk populations, the best that statins can do is extend lifespan for a few months for <2 out of 100 people who take them

For the 2 people that did get the benefit, are the possible side effects (some of which can be debilitating, like muscle fatigue, cognitive decline, and diabetes) worth the additional 6 months of life? 

And since there’s no way of knowing in advance whether you’ll be one of the 2 people that benefit, or more likely, one of the 98 that don’t, is the very small chance that you’ll gain an extra 6 months of life by taking a statin for five years worth the considerably higher risk of experiencing significant side effects that could impair the quality of your life during that period?

When you think of it this way, statins start to seem somewhat less like the “wonder drugs” they’ve been made out to be, no?

For a more on the effectiveness of statins, see this article I wrote a while back. I also encourage you to read the full article by Dr. Kendrick. 

Let me know what you think in the comments section.


Join the conversation

  1. Wow….I am overwhelmed and so happy I stumbled into this conversation. Thank you all for your imput. I’m stopping my statin today!!!!

  2. Are you doctor Chris? Talking people out of evidence-based medicine is not only ethical wrong, which should put you at extreme liability, but morally wrong as well. If you talk someone out of their medications causing an increase in mortality and morbidity, it not only effects them but their loved-ones as well. Please be responsible with what you publish.

    • The article is partially correct. It is the adulteration of Omega-6 in these oils that makes them dangerous (the processing). Omega-6 itself is essential to all our body functions. Just ratcheting up Omega-3 consumption does not correct for poor quality Omega-6 in the diet. I can’t stress this enough.

      • Sorry Dr Jeff but we are going to have to agree to disagree. While the processing is indeed dangerous it is also the consumption of omega-6 in such excess. The balance of omega-6 to omega-3 in our diets and bodies is way out of balance and these oils are the main cause.

        • Actually, if you know your biochemistry, you will see that is not true. We need lots of proper Omega-6 and and little bit of Omega-3, it’s just that the Omega-6 that exists in our diet is of such poor quality. I’ve seen the results personally and in my patients, remarkable turnarounds just by giving proper 18 carbon Omega-6 and -3 from vegetable sources. Omega-6 gets converted to PGE1, the most potent anti-inflammatory in our body. The Omega-3 pathways are all quite minor in comparison. The Arachidonic Acid pathway is way overblown and is minor in comparison to the PGE1 pathway.

          • Well I am not a biochemist, that is true. I did do a lot of research for my article and experienced first hand what happened when I quit eating walnuts, which are high in omega-6. All of my joint pain went away and I had been struggling with that for months.

            • Walnuts are high in Omega-6 but are very high in Omega-9, if the walnuts were dried or roasted, the Omega-6 content would be adulterated, also you may have had an underlying food sensitivity to it to cause inflammation. Also I’m unsure of the stereochemistry of walnuts, to be useful, the Omega-6 would have to be in the 1 or 3 position of the triglyceride chain, some of these (like Borage oil) are in the 2 position, making it mostly unusable by the human body. The biochemistry is all important when it comes to understanding food, most of what is published today about Omega’s is just plain wrong.

  3. Very interesting reading. However I need to ask what does the acronym “NDT” stand for? It was mentioned in a post related to hypothyroidism on December 28, 2014, by Leslie. This individual was on Synthroid for a short while and wanted a Rx for NDT.

    I searched for acronym definition, but came up with a boatload and nothing jumped out at me.

    Thanks in advance,

    Bo Dirigo

    • NDT (Natural Desiccated Thyroid)
      Comes from the thyroid gland of pigs. The glands are dried and ground into a powder that is combined with binders and fillers and is pressed into pill form.

      Contains both of the main thyroid hormones, T4 and T3

      May contain other hormones (T1, T2, calcitonin)

      The natural thyroid brands manufactured in the United States include:

      Armour Thyroid (made by Forest Labs)

      NP Thyroid (made by Acella Labs)

      Nature-throid and WP Thyroid (made by RCL Labs)

      And in Canada, Thyroid (made by Erfa Canada Inc.)

      Compounding pharmacies can also used the raw ingredient (USP Thyroid Powder) to fill an RX to a doctor’s specifications.

      • JayeP –

        Thanks for a very enlightening answer. I currently take 150 mcg levothyroxine sodium and am not sure it is really helping. Have been taking it for years and have not had any notable side effects, if any. But also haven’t had any burst of energy, weight loss or clarity of mind over the same time frame. LOL

        I have to do some more homework here. Again, thanks.

        Bo Dirigo

        • Bo- Maybe it is good for you to switch to NDT products. It’s because NDT products has both the main T4 and T3 hormones. T3 is the active one and is ready for use by the cells. T4 is the inactive one which the body will converted to T3. If the body lacks the nutrients necessary to convert T4 or have problem converting it, then you may be hypo, thus the lack of energy or slow metabolism.

          I’m using NDT called Thyro-Gold. It’s a whole gland thyroid powder from cows. Here’s the link if you’re interested:http://www.naturalthyroidsolutions.com/Home_Page.html. Hope this helps.

  4. Niacin has a better track record, than the majority of cholesterol drugs, yet is prescribed a tiny fraction of the cases. In a large long term trial they found it reduced overall death 10% giving the average person 2.5 years. Doctors are largely just drug pushers. I believe the largest problem is the extra 2 years required of doctors here that isnt required in the majority of developed countries. Medicine has become a monopoly and a bad monopoly at that(as monopolies are want to do).

    • Yup. And the FDA is a monopoly, given special privileges by government (tax-funding, and a legislated customer base). In numerous other industries that sell potentially lethal products, there are multiple regulation and safety testing agencies that compete in an open market. They compete on test accuracy, speed, cost, and transparency. These are industries like scuba gear and toasters. One example of a safety test and certification company is United Laboratories.

  5. So many otherwise healthy people are spending money to make themselves less healthy for the profits of pharmaceutical companies and doctors. I am a 65 year old woman who has jumped off this insane merry-go-round after over 15 years of Lipitor and am left with chronic peripheral neuropathy and Tinnitus. Thankfully, most of the other adverse side effects have diminished (brain fog, morning headache, fatigue, etc.) and I jumped before developing diabetes but not in time for cataracts.
    My doctor ignored my complaints and tried to get me on Crestor after being told I am off Lipitor and taking CoQ10. I rather drop dead tomorrow from a heart attack or stroke, even if a statin provided protection than live another day with all of the conditions I developed because of deficiencies from statin use and eating low fat. I have lost all faith in the medical community even though I have a medical background. Why can’t these doctors take some time off from golf and do some research and help instead of harm their patients.

    • I concur – I prefer dying from a heart attack/stroke than allow a statin to give me a lot more illnesses that would harm my heart anyway. I’m so glad I bumped into this website. At Medicare eligibility I was forced to switch doctors and had to replace Cresstor with Lipitor then 3 months later I was diagnosed as pre-diabetic, I began to experience very tired painful legs and my CREATININE showed I was at stage 3 CKD. After reading Kresser’s article I immediately dumped Lipitor and refused to go back to Cresstor. Now, 20 days after stopping Lipitor my legs are back to normal, I re-tested and my CREATININE is no longer at stage 3 CKD. My cholesterol was not high to begin with – the cardiologist had seen less than 5% of my heart not receiving enough oxygen and prescribed Cresstor as a pre-caution. Now I’m paying extra attention with my diet to keep my cholesterol within range.

      • Stories like these drive me crazy, most doctors have either forgotten their basic biochemistry or never learned it in the first place. Statins can’t possibly work, and they have a huge side effect profile. Their NNT is 100 and their NNH is only 8. It is unethical to prescribe such a drug.

  6. Statins should be removed from the market, they have no role in human physiology and are very disruptive. The large pharma studies have uniformly been a failure yet due to alarming statistical manipulation (using risk ratios instead of absolute risk) it greatly exaggerates the results, exposing us all to untold risk. Vegetable sourced whole foods are the answer or vegan sourced, cold pressed, unprocessed essential Omega-6 does help. Remember there is NO Omega-3 in your skin or arteries.

    • Can you please cite references for your claim that there is no Omega-3 in the skin or arteries? Also, do you mean to be implying with the “artery” thing that there is none in the walls of the arteries themselves, or that there is none in the substance the arteries transports (the blood)?
      Can you also explain the relevance of your amusing assertion about omega-3 in the skin to a conversation about cardiac health? One of the ways that omega-3 is believed to benefit cardiac health is by reducing inflammation produced (in part) due to and excess of omega-6 fats. Vegan or otherwise.
      And (as always) if your point is that DHA/EPA omega-3 is bad because you have to eat animals in order to get it, please explain why a nutrient (DHA/EPA) that has been part of the human diet for a million years is harmful, and a diet that has never been successfully practiced by a large number of people for a long period of time (veganism) is somehow likely to be better than ones that have (non-vegan). Thank you.

      • 15. Spector AA. Plasma free fatty acid and lipoproteins as sources of polyunsaturated fatty acid for
        the brain. J Mol Neurosci 2001;16:159-65; discussion 215-221.
        16. Chapkin RS, Ziboh VA, Marcelo CL, Voorhees JJ. Metabolism of essential fatty acids by human
        epidermal enzyme preparations: evidence of chain elongation. J Lipid Res 1986;27945-954.
        17. Andersson A, Sj_din A, Hedman A, Olsson R, Vessby B. Fatty acid profile of skeletal muscle
        phospholipids in trained and untrained young men. Am J Physiol Endocrinol Metab Bunting S,
        Moncada S, Vane JR. The prostacyclin—thromboxane A2 Balance: Pathophysiological and therapeutic
        implications. BMJ 1983;39:271-276.
        18. Markides, M., et al., “Fatty acid composition of brain, retina, and erythrocytes in breast- and
        formula-fed infants,” The American Journal of Clinical Nutrition, 1994;60:189-94 and Agneta
        Anderson, et. al., American Journal of Endocrinological Metabolism, 279: E744-E751.
        19. Bunting S, Moncada S, Vane JR. The prostacyclin—thromboxane A2 Balance:
        and therapeutic implications. BMJ 1983;39:271-276.
        20. Spector A. Plasma free fatty acid and lipoproteins as sources of polyunsaturated fatty acid for
        the brain. J Mol Neurosci 2001;16:159-165.
        22. Watkins, PA, Hamilton JA, Leaf A, et al. Brain uptake and utilization of fatty acids: Applications
        to peroxisomal biogenesis diseases. J Mol Neurosci 2001;16:87-92.
        We know that the intima (inner arterial wall) consists of a single
        layer of endothelial cells containing significant essential 18 carbon omega-6 (LA),
        but no omega-3 (ALA), according to article 22 above, and there is no omega-3 in the skin as per article 16 above. It makes sense because they perform similar functions, they act as liquid barriers, whether it is keeping body fluid or plasma from leaking. Therefore, Omega-3 cannot have effects on cardiovascular health. The rest of the references give you ratios in the brain, muscles etc.
        And DHA/EPA have not been part of our diet for millions of years, we make all we need. I believe that we evolved on that land and nature wouldn’t have made a stupid mistake such as making us fish oil “depleted”. I’m a omnivore, so I eat meat, this is all about the science. Never would we have access to deep sea fish except in recent history. Fish have high levels of EPA/DHA in order to have functional cell membranes at low temperatures, we don’t need that.
        Oh and veganism has been practiced by certain Hindu sects for centuries and there still seems to be a lot of them around and gorillas are vegan and seem to survive quite well on it, even though they are very similar to us genetically.

  7. What is really amazing that simple dietary changes can accomplish the same as statins and are usually MUCH more effective. Plant Based Whole Food Lifestyle is proven as or MORE effective for treating hypertension and has NO side effects besides being healthier, more energetic and improving overall blood stats!

    Why people take these is beyond me!

    Skip Stein
    Whole Foods 4 Healthy Living

    • My father got rhabdomyolosis from statin drugs and went off them as soon as a PA figured it out. He was never warned about side effects from his primary physician. So he changed his diet and of course his LDL levels went down without medication. He passed away recently but he was very angry about statin drugs and felt like he had been robbed off the strength of the muscles in his legs.

  8. I am surprised that in 2014 a person still believing on the cholesterol hoax and unaware of the statin’s side effects. There are quite a few books, studies and research indicating that statins DO NOT prevent heart attacks or strokes. In addition, all these OLD side effects are included in every medication that it’s prescribed. Two movie documentaries: STATIN NATION and STATIN NATION II have been shown all over Europe however there have been NO promotion or showings in the U.S. The initial statin’s guidelines began thirteen years and were initiated by the marketing department of a well-known pharmaceutical and exposed by Dr. Jesse Polanski, the former marketing director of Lipitor (2001-2003). In closing, ALL doctors in the U.S. are MANDATED to prescribe statins. They are just following NEW controversial guidelines recently established [ONLY] in the U.S.

  9. As I was watching TV, I was happy to see that there is a lawsuit filed against the maker of Lipitor, by people who took the drug and now have gone on to develop type 2 diabetes. As much as I hate for those people to have that condition, I hope that they get ALOT of $ out of their lawsuit. I have been speaking out about the dangers of statin drugs for years.

  10. Hellow: I had a ordeal on lipitor. Had been on this nasty drug for about four and a half years. These were my side effects. #1 Lower right side back pain that brought me to my knee’s, kidney area. #2 Bottom of feet near the toes,very painful.Thought I needed arch support’s, wrong. #3 Neck pain and or stiffness. #4 I had pain in the bottom part of baby fingers. #5 Itchiness on arms.#6 Sharp pain on upper inside of my thigh.#7 Back side of kneecap.#8 Skin flakiness on eye lid.This pill was attacking my joints and mussel’s. I had gone to doctor and told him it is impossible to have all these aliments in one year.He told me to get off of the lipitor and I told him I already did.I am happy to say have no more ailments. I would say just eat omega 3 to get your cholesterol under control. Listen to Chris. Thank you I hope my post help’s.

  11. Being terribly uneducated about the mis-information, i made the mistake of taking a statin drug for six months. when memory issues popped up i stopped and will never take it again. i am now better informed through reading and listening to people like Chris, Amy Myers and others. i wish i could share it with friends who do take statins but they are too married to OLD western medicine.

  12. My husband has not had a heart attack, but has a *very* strong family history of heart attacks/stents. And, his particle count is too high. He is on the highest dose of Crestor that he can take without his knees hurting, and that is *only 2.5 mg*. He is also on 1000 mg of niacin. Chris, would small doses be advisable for someone with bad blood markers and a strong family history?

    • Niacin??? You may want to read a study result that is over three years old.. NIH Pulls Plug on AIM-HIGH Trial with Niacin
      May 27, 2011 Lisa Nainggolan
      Bethesda, MD (updated with commentary) – A trial of high-dose extended-release niacin (Niaspan, Abbott) given in addition to statin therapy in patients with a history of cardiovascular disease, high triglycerides (TG), and low levels of HDL cholesterol has been halted prematurely, 18 months ahead of schedule, because niacin offered NO ADDITIONAL BENEFITS in this patient population [1].

      • I can’t access that page. His doctor has him on regular niacin, not extended release. Any new studies out on that?

        • Maybe best to forget the niacin. Concentrate on soluble fiber foods and plant sterol supplements. More important is making sure you take K-2 supplements with your Vitamin D 3. If you are on warfarin, you can take nattokinase without the Vitamine K.

          • He does take vitamin K. He hasn’t been on the niacin long, so I guess we will wait until we see the next results. I had wondered if the niacin was a healthy choice or not. We are changing doctors, so I guess we will have another opinion, too.

  13. I would suggest if noone else has, to pick up Dr David Perlmutter grain brain. He gives an even greater explanation into the terrible effect of statins and how ridiculous and flawed this anti cholesterol push is.

  14. This comment confuses me a little bit. Can you clarify?
    “These results only apply to the people at highest risk for a future heart attack: middle-aged men who’ve already had a heart attack (aka “secondary prevention”). There is no compelling evidence that statins extend lifespan at all in men without pre-existing heart disease, or women with or without heart disease.”

    What confuses me is the definition. My husband never had a heart attack, but he did have 4 stents placed due to pretty severe angina, so does have heart disease. They said there was no damage to the heart muscle, though. So does he fit the description of high risk? When I mentioned to his cardiologist my concerns about the significant side effects, his reply to my husband was, “Well, do you want to die of heart disease, or do you want to die of cancer?” No real discussion to speak of! Thanks for any information you can pass along!

    • seems to me that even if your husband falls into the category of those that would benefit from statin drugs, the important point is that it only helps 2 out of 100. that’s two people. 2%. and helps those two people live another 6 months. why even think about statin drugs when there are better ways that would benefit his overall health as well?

        • My good friend is the diabetes educator at our area hospital. She has high cholesterol (even though she’s slender and has careful diet and exercise habits. I don’t know her cholesterol statistics but I was telling her about my high ldl (130) (down from 168 a few months before). She does not follow a Paleo diet but does Yoga and Cycling/Walking/etc. Her son has had Type 1 diabetes since he was about 5. So she has great personal interest in cholesterol controversy. She is fairly conservative about health issues, but when I told her they want to put me on statins she said, “Just tell your doctor, ‘No'”. Her recommendation was for the insoluble fiber, plant sterols, yoga, and exercise and lowering stress however you can. Her wonderful father-in-law was blasted with X-rays (this was probably in the 1930’s) by his father who was a Columbia U. trained radiologist. So they have no trouble saying “no” to medical folks. I don’t know if you’ve tried high intensity interval training. I keep planning to try HIIT (I do HIIT kettle bell workouts to see if that will make a difference with the cholesterol. In the New Year I plan to try to find a functional medical person to see if my high ldl is related to gut health or thyroid health. Good luck to you. Besides the HIIT exercise, stress reduction techniques and modest changes to my Paleo type diet, I am thinking the K-2 may prove to be most important.

          • Oh, by the way, the reason for blasting my friend’s father-in-law’s face with X-rays? Adolescent acne. His poor father had to live with the consequences of seeing his son suffer terrible X-ray burn his whole life.

          • I was recently diagnosis with Hypothyroidism by my new doctor who is a PA. My cardiologist said I wasn’t Hypo with a 3.08 TSH even though I suffered with many symptoms. My ldl was over 200 and she wanted to put me on a statin. I said absolutely not and that I would try to lower it on my own so she gave me 3 months to do so, she also gave me a low dose of Synthroid even though I asked for NDT for the Hypo (because I had told her about my symptoms and that I also was having trouble losing weight even while working out with a trainer 3 times a week and calorie intake of 1200-1500.) I had also read several articles that said being Hypo raises your ldl which she thought was nonsense. 6 weeks in on the Synthroid and no relief of any symptoms so I decided I need to see another doctor. I found a great one who did more thorough testing and found out that t4 only meds (Synthroid) would not work for me because I don’t convert t4 to t3 so he put me on NDT and after 3 months I’ve lost 10 pounds and lowered my ldl over 100 points!

            • God for you – I would have done the same. A few years ago I realize that doctors are NOT all the same. Some do not know as much as another, some do not keep up with the latest medical information and some don’t care.

            • Congratulations for being so proactive! My doctor laughed at me when I told him I was adding a couple of supplements to my self-treatment plan to cure my fibro. He said supplements don’t work but go ahead. One year later, my fibro is gone, completely gone and I did it with no help from a medical doctor. Clean food, cleanses, a few supplements, exercise and its gone. People kept telling me there was NO CURE for fibromyalgia!

            • Leslie, cutting calories to 1200-1500 per day will ultimately screw up your hormones. When following a paleo lifestyle you no longer have to count calories at all. It will, over time, heal your gut and weight loss is pretty easy.

          • ” has careful diet .. habits”
            Does that mean “heart-healthy grains” and “heart-healthy vegetable oil”?

  15. My father was put on these drugs years ago and within 6 months he had Rhabdomyolysis. His physician never warned him about possible side effects. A physicians assistant who was a friend of mine diagnosed him when he was visiting me. He was so angry and even 8 years later he said the muscles in his legs were never as strong.
    Is it possible that statins could cause permanent damage.
    My LDL levels are only 109 . Is this something to be concerned about as my physician who did my tests said it was pathologically low.

  16. My understanding from a medical friend is that statins, or cholesterol drugs, purpose is to dry up the cholesterol or fats in the body. Since the brain is made up mostly of fats, statin drugs dry up the brain, and dry up everything else that is dependant on fats to operate.

  17. Dear Dr Kresser. I would like to recomend the paper published in BMJ 2013;346 :12610 (Published 23 May 2013.
    Risk of incident diabetes among patients treated with statins:population based study.

    thak you very much
    Dr. alberto Medina

  18. My husband’s nurse practitioner told me I was sending my husband to an early grave because I would not allow him to take cholesterol lowering drugs. If we see her again, I’ll bring these articles for her to read.

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