This story by The Guardian highlights a new study in the journal “Circulation” that digs into the data of a 20-year study of cholesterol and heart disease in thousands of European men. The Guardian appears to lean heavily on an Imperial College press release that trumpets the benefits of taking statin drugs, which can lower LDL or “bad” cholesterol — and reduce the risk of deadly heart disease. It claims the study showed statins reduced the risk of death from heart disease by 28%.
But that’s a lopsided and potentially misleading way to present the data. When broken down into absolute numbers, the benefits are far less dramatic (see quantified benefits criterion, below). In that light, the advantages compared to the disadvantages of taking statins for many years — risk of muscle pain, liver damage, diabetes, and more — become less clear.
The story also misses a very big red flag when it comes to making clear that most of the authors have a financial relationship with the primary funder of the study: a drug company that makes statins.
Readers need accurate data to make informed healthcare decisions. Relative numbers sound good, but are only one half of the story. Readers also deserve to know any potential conflicts of interest, such as who paid for the study.
Costs were not discussed. However, statins cost between roughly $313 (generic) to $1,428 (name-brand) per patient per year in the US, according to a 2012 study in Pharmacoptherapy. The costs are much less in the UK: $164 (generic) and $509 (name-brand) per patient per year.
The story only told readers the relative risk improvements for taking a statin. It did not present the terms in absolute numbers. By the relative measure, taking statins seems very effective: 28% fewer men died from heart disease when taking statins compared to a placebo.
But the absolute risk is more sober and should always be presented along with relative numbers. Of the group taking statins, 6.69% of people with very high LDL died from cardiovascular heart disease within 20 years. Of the group taking a placebo (and it’s not immediately clear to us what their LDL status was), 9.03% died from heart disease.
No side effects of statins are mentioned, but they’re significant. Taken over many years, let alone decades, those risks become even more significant considerations. The most common side effect — 29% of people on statins report experience it — is damage to muscles and muscle pain (e.g. soreness, tiredness, and weakness), according to the Mayo Clinic. However, those on placebo report a similar rate of muscle pain and damage. Other, less common side effects (for which there’s also less evidence that statins may be responsible) include liver damage, increased blood sugar or type 2 diabetes, and memory loss/confusion.
The story lays out the basic results and methods (e.g. a randomized trial on 2,560 men with high cholesterol), though it doesn’t go much beyond that. What were the limitations?
We didn’t see any unwarranted language, though the potential is high for overtreatment when using a drug in healthy people.
The story doesn’t note how the study was funded through Sanofi, a company that makes, markets, and sells statins, Furthermore, most of the authors disclosed that they have accepted either grant money or fees from major pharmaceutical companies. In fact, five out of the the eight authors had or have a financial relationship with Sanofi.
This is not adequately explained. While a 20-year study sounds impressive, we’re not told about other similar treatments and lifestyle changes.
Statins are widely available drugs, and the story tacitly implies they’ve been available for about 20 years.
The story makes it clear that the length of the trial is what’s novel.
Quotes in this story directly match those from an Imperial College news release about the study, but there is no attribution given to the news release.
Systematic, Criteria-Driven
The tale of two “negative” studies. Or, how spin is applied to make research findings look more impressive. A must read. https://johnmandrola.substack.com/p/the-tale-of-two-negative-studies
The @nytimes chose to interview one of the editors of the @AnnalsofIM (publisher of this paper) who "gushed with extraordinary glee: It’s huge! There are very few things that reduce your mortality by 30%."
Turns out coffee is not one of those few things despite all that glee. https://twitter.com/garyschwitzer/status/1533202075928215558
Comments
Please note, comments are no longer published through this website. All previously made comments are still archived and available for viewing through select posts.
Our Comments Policy
But before leaving a comment, please review these notes about our policy.
You are responsible for any comments you leave on this site.
This site is primarily a forum for discussion about the quality (or lack thereof) in journalism or other media messages (advertising, marketing, public relations, medical journals, etc.) It is not intended to be a forum for definitive discussions about medicine or science.
We will delete comments that include personal attacks, unfounded allegations, unverified claims, product pitches, profanity or any from anyone who does not list a full name and a functioning email address. We will also end any thread of repetitive comments. We don”t give medical advice so we won”t respond to questions asking for it.
We don”t have sufficient staffing to contact each commenter who left such a message. If you have a question about why your comment was edited or removed, you can email us at feedback@healthnewsreview.org.
There has been a recent burst of attention to troubles with many comments left on science and science news/communication websites. Read “Online science comments: trolls, trash and treasure.”
The authors of the Retraction Watch comments policy urge commenters:
We”re also concerned about anonymous comments. We ask that all commenters leave their full name and provide an actual email address in case we feel we need to contact them. We may delete any comment left by someone who does not leave their name and a legitimate email address.
And, as noted, product pitches of any sort – pushing treatments, tests, products, procedures, physicians, medical centers, books, websites – are likely to be deleted. We don”t accept advertising on this site and are not going to give it away free.
The ability to leave comments expires after a certain period of time. So you may find that you’re unable to leave a comment on an article that is more than a few months old.
You might also like