Thursday, 5 July 2007

1.5m wrongly told they risk heart disease

Misdiagnosis has led to massive over-prescribing of drugs

The Guardian (UK)

The traditional way of calculating the risk from heart disease involves a score based on smoking, blood pressure and "good" and "bad" cholesterol, along with age and sex. The BMJ study compared this measure against a new, more sophisticated test, which also takes into account social deprivation, genetic factors and weight. It found that the former over-predicted the number of people at high risk of developing cardiovascular diseases by 35%.

It concludes that 3.2 million adults under the age of 75 are at risk of developing cardiovascular illnesses compared with the 4.7 million previously estimated.

Statins are widely prescribed at £2bn a year to try to reduce some of the 100,000 annual deaths from heart illnesses.

Statins are not even the most efective way of treating high cholesterol. First and foremost should be dietary advice and increased levels of physical activity. We make our own cholesterol, so avoiding foods like eggs or liver has no measurable effect. Much more important is eliminating transfats, and greatly reducing saturated fats - but note that you do need some fat in your diet - just as you do need some cholesterol. Look for unsaturated fat: hydrogenated fat is a definite no no: oils from vegetables, seeds or fish are usually good - omega 3 is something to look for. Get the weight down, and eat soluble fibre (oats are a good source)

Just lowering overall cholesterol is not the best way to treat the problem - what is needed is to get the right ratio of LDL and HDL.

In Britain, where prescription drugs are covered by the NHS it is not an issue for patients but the system. Here where drugs are not covered by the provincial medical services plan, and many do not have private health insurance (as employers avoid hiring full time, permanent employees if they can, to lower the cost of "benefits") statins can be unaffordable.

Fortunately there is a cheap, readily available alternative niacin - vitamin B3. About $7 over the counter for a couple of weeks supply. Talk to your doctor, and make sure you get regular blood work done as both B3 and statins carry the risk of liver damage. It is sensible to work up gradually to the most effective dose, and take with food. The only side effect is a sudden, brief hot flush, but this fades as you get used to the escalating doses.

UPDATE

Another news story from the BBC suggests that "People who significantly cut their cholesterol levels with statins may raise the risk of cancer"

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