Body Fat Percentage or BMI?

Yes, but studies of the impact of statins usually are based on people who all agree to follow-up with the study, and thus see a doctor regularly. I’m pretty sure it’s a real effect. I guess I’d have to look up the relevant studies, though, to be sure.

Like a priest sprinkling holy water.

Yeah, there might be something there, especially from a well controlled study. I guess I’d think you would really need something comparable to what’s done for drug trials to eliminate most of the bias, which seems would be too small to determine impacts on all cause mortality.

I don’t doubt they are a wonder drug for those at risk.

If you end up looking up studies, see if they tell how many females were included.

The dr who prescribed the statin is so pro statin it makes me wonder if he is getting kickbacks from the pharms. I doubt it though, or he wouldn’t be working in this particular clinic.

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This is my issue with most medical studies.

  1. There are too many variables to control for
  2. Our bodies are so vastly different from person to person
  3. The sample size is way too small to account for both 1 and 2
  4. The conclusion is too easily manipulated, or can be interpreted multiple ways, whether intentional or not.
  5. The sample selection is far from random.

That’s why you can get complete reversals in conclusion just years/decades down the road.

Here’s what you want:

It’s a meta study of a lot of big studies, where they only looked at the people who didn’t already have cardio vascular disease at the start of the study. They ended up including 11 studies that were able to give them the detail they wanted. Those studies collectively included 65K participants followed for 244K person/years, during which 2783 deaths occurred. All but two of the studies included women. (All but one were biased towards men, though.)

Details about the study participants

Overall, there were 65 229 subjects in predominantly Western populations with only 1 trial (MEGA16) conducted exclusively in an East Asian population (Table). The mean age of subjects in these 11 trials ranged from 51 to 75 years, with the proportion of women ranging from 0% to 68%. Whereas 2 trials (CARDS15 and ASPEN22) exclusively had subjects with diabetes, JUPITER7 excluded people with diabetes at entry and, hence, the proportion of people with diabetes in this meta-analysis ranged from 0% to 100%. Average baseline LDL-C level (weighted mean) across studies was 138 mg/dL. During an average follow-up of 3.7 years the mean LDL-C level among participants allocated to placebo was 134 mg/dL compared with a mean of 94 mg/dL among those allocated to statins, reflecting an average LDL-C level difference of 40 mg/dL between the 2 treatment groups.

They found that age explained most of the differences in mortality. (66%).

There were fewer deaths/person year in the statin group, but it wasn’t statistically significant (and wasn’t even true in every study.)

Their comment is

Weirdly, labeled a 'comment' not a 'conclusion'

This literature-based meta-analysis (including previously unpublished tabular data) of 11 clinical trials involving 65 229 participants with approximately 244 000 person-years of follow-up and 2793 deaths provides more reliable evidence than previously available on the impact of statin therapy on all-cause mortality among high-risk individuals without prior CVD. These data indicate that over an average treatment period of 3.7 years, the use of statin therapy did not result in reduction in all-cause mortality with no strong evidence of statistical heterogeneity across studies that varied considerably with respect to participant characteristics and mean baseline LDL-C levels. Within this combined high-risk dataset with a mean placebo mortality rate of 11.4 per 1000 person-years, there were on average an estimated 7 fewer deaths for every 10 000 person-years of treatment. The observed proportional risk reduction was similar with the exclusion of 2 trials consisting entirely of individuals with diabetes. In contrast to single studies and previous meta-analyses, the present report suggests that all-cause mortality benefits are more modest in the short term, even among high-risk primary prevention populations, thereby indicating the need for further caution when extrapolating the potential benefits of statins on mortality to lower-risk primary prevention populations than to those shown herein.

They go on to say that similar findings have come from studying fibronates, which are used to reduce triglyerides. They reduce triglycerides, and non-fatal heart attacks. but don’t appear to reduce all-cause mortailty.

Among the limitations they report is not having the detail to look at the impact by cohort, for instance, by age or male vs. female.

In conclusion, based on aggregate data on 65 229 men and women from 11 studies, yielding approximately 244 000 person-years of follow-up and 2793 deaths, we observed that statin therapy for an average period of 3.7 years had no benefit on all-cause mortality in a high-risk primary prevention population. Current prevention guidelines endorse statin therapy for subjects at high global risk of incident CVD as a means to reduce fatal and nonfatal vascular events.33,35,36 Due consideration is needed in applying statin therapy in lower-risk primary prevention populations.

So basically, I’m taking a statin to make my dr feel better.


There might be a placebo effect, which is still beneficial

:face_with_raised_eyebrow: yeah, I don’t think so. It’s not like folks are imagining they have high cholesterol.

They only followed people for a couple of years. And cardiovascular issues are cumulative over time. It’s possible that taking a statin now reduces your risks of death 7 or 15 years out.

Well my calcium score is 0 and the echocardiogram I had 18 months ago showed nothing. (Over zealous pulmonologist ordered it for an odd test result probably caused by anemia. And if he had caught the anemia it would have saved me 6 months of feeling horrible.) So I’m not super worried about it if I can start exercising again. Had a good visit with the spine dr yesterday & should be making progress towards that soon.

But I’m probably gonna take the statin for a while. Last year every time I started walking regularly my pain flared up again.

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