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Statins For Children - This Is Madness by Dr. Malcolm Kendrick, author of The Great Cholesterol Con
Thursday, May 06, 2010 10:34 am Email this article
When someone sent me a copy of an article in the [ December 2, 2003 ] Washington Post, stating that more and more doctors now think that children as young as four should be put on statins, my fingers started to itch.
(This article was written by Malcolm Kendrick, MD, author of the wonderful, eye-opening, paradigm-shifting book The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It .) Washington Post Headline
The offending headline from the Washington Post
Here’s the offending headline:
‘Despite Controversy, Pressure Grows to Treat High Cholesterol in Children After Studies Link Elevated Levels to Adult Heart Disease.’
By Elizabeth Agnvall
Special to The Washington Post
Tuesday, December 2, 2003
Primary Prevention vs Secondary Prevention Trials
Primary Prevention is in people who have risk factors; Secondary prevention is in people who have had symptoms or a heart attack
The first thing that I have to point out here is that, in primary prevention trials, statins have never been found to reduce the risk of death. I don’t care if they have been found to reduce the rate of heart disease.
Does it really matter if someone is saved from dying of heart disease, only to die of something else?
By primary prevention trials, I mean trials in people who, whilst they may have risk factors for heart disease, have not been found to have any clinical signs, or symptoms related to heart disease.
Secondary prevention trials are different.
These are done on people who have already suffered a heart attack, or have angina, or some other clinical manifestation of CHD.
And it is true that in ‘secondary prevention’ trials, statins have been found to reduce the rate of dying of heart attacks, and also to reduce overall death rates. By a small, but significant, amount.
Statins in Children
In children, all you can hope to do is shift the risk of dying from cardiovascular disease to something else… 60 years in the future
However, that is not relevant to this discussion. Because, by definition, all children are in the primary prevention category.
And this means that there is not one scrap of evidence to suggest that statins will do them any good.
The best you might manage is to shift their cause of death from heart disease to something else - usually cancer - about sixty years in the future.
How do I know this?
Because the clinical trials tell me so.
Five (5) Major Statin Studies
Five (5) Major Statin Studies—Primary Prevention Trials
If we look at five major primary prevention trials: PROSPER, ALLHAT, WOSCOPS, ASCOT and AFCAPS.
(Don’t worry about the acronyms, they are not important, they are just supposed to make the trials memorable).
We can pull them apart to look at the figures.
By the way, if you want to check my figures visit The Therapeutics Initiative at The University of British Columbia http://www.ti.ubc.ca/ and look for Therapeutics newsletter number 48.
Or, get the data from the trials themselves.
These five trials had, between them, over forty thousand patients enrolled.
Most of them lasted at least five years, and they have all been endlessly quoted in the medical literature.
In short they are big, important and influential.
Overall Death: 6.6% in statin users vs 6.9% in control groups
So, what was the overall mortality rate in those given statins versus the ‘control’ population?
Morality in those on statins was 6.6%
Mortality in the control population was 6.9%
Serious Adverse Events
Serious Adverse Events only reported by 2 of 5 trials: 44.2% in statin users vs 43.9% in control group—a 0.3% increase
And what was the percentage of serious adverse events (SAEs)?
A serious adverse event is something like developing cancer, or having a non-fatal MI, or a non-fatal stroke.
So, pretty damned serious.
In fact, only two of trials reported this, as the majority of statins trials keep quiet about SAEs.
Serious adverse events in the control population was 43.9%
Serious adverse events in those on statins was 44.2%
These Primary Prevention Studies Were Not Purely About Primary Prevention
18% of subjects should have been in a Secondary Prevention Study instead
I suppose you may be thinking, my goodness, there was a 0.3% reduction in overall mortality. It may be small, but it’s still there.
However, although these five trials are usually presented as purely primary prevention trials, they all included a secondary prevention population, 18% on average.
This more than accounts for any difference in overall mortality.
Even if it doesn’t, I must point out that the difference is not large enough to discount the possibility that this was merely a chance finding.
These figures do not get anywhere near statistical significance - the holy grail of clinical trials.
It Took 5 Years to See a 0.3% Reduction
It took 5 years to see a 0.3% reduction, which was not statistically significant
In addition to this, the 0.3% reduction, if it really exists, took five years to appear.
It Would Take 50 Years to Get A 3% Reduction in the Risk of Death
It would take 50 years to get a 3% reduction in the risk of death, but you would also have a 3% greater risk of cancer or some other serious adverse event
Which means that, even if you take the best case scenario possible, and ignore the fact that any difference is most likely due to chance, you would have to a take a statin for fifty years to reduce your risk of dying by 3%.
At the same time, of course, you would have a 3% greater risk of suffering a serious adverse event, such as a stroke, or developing cancer.
Does this really represent powerful enough evidence to warrant starting a four-year-old child on statins, and keeping them on for the rest of their life?
I don’t think so. Especially not in the case of this Washington Post reporter. For, in her article, she was using the example of a four-year-old girl.
Statins Provide NO Coronary Benefit to Women
Statins Provide NO Coronary Benefit to Women
And what do the statin trials tell us about the benefits of statins in primary prevention in girls, or women?
According to The Therapeutics Initiative group:
‘There were 10,990 women in the primary prevention trials (28% of the total). Only coronary events were reported for women, but when these were pooled they were not reduced by statin therapy. Thus the coronary benefit in primary prevention trials appears to be limited to men.’
What the statin trials tell us about women is that, in primary prevention, statins can’t even manage to prevent heart disease, let alone anything else!
Has the world gone completely mad?
Are we really suggesting that we should start a healthy four-year-old girl on a medicine, and continue this medicine for the rest of her life?
Something that could turn her into one of the ‘worried well’, and even if it doesn’t, will most likely cause side-effects.
Can we really be contemplating this, when all of the evidence that exists points to the fact that STATINS WILL DO HER ABSOLUTELY NO GOOD AT ALL!
Apparently, we are. ‘Anyone for tea?’ Asked the Mad Hatter.
Article Previous Published on THINCS.org
This article was previously published on THINCS.org
This article was previously published on THINCS.org (The International Network of Cholesterol Skeptics).
I republished the article here with Dr. Kendrick’s permission.
Malcolm Kendrick’s Contact Info
Malcolm Kendrick, MD is the author of the wonderful, eye-opening, paradigm-shifting book book The Great Cholesterol Con: The Truth About What Really Causes Heart Disease and How to Avoid It .)
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