RickGray

Take a statin every day for five years, and the big trials say it moves your death back by about three days. In 2015 three Danish researchers asked the question the statin trials never set out to answer: how much longer do the people taking them actually live? They took the 11 major statin trials that published survival curves and measured the gap between the people on the pill and the people off it. Without heart disease, the median gain was 3.2 days. With heart disease, 4.1 days. The best result in any trial was 27 days, after almost six years of simvastatin in heart patients. In ALLHAT, one of the biggest trials of all, the people on the statin died about five days sooner. The researchers called the gains surprisingly small. The drugs are sold on headlines about cutting heart risk by a third. The aching muscles come along for the ride, the commonest reason people stop taking them. So does the raised blood sugar. American labels have warned of it since 2012, and in the JUPITER trial new diabetes ran 25% higher on the drug. So do the memory loss and confusion, added to the same label the same year. So do the liver enzymes, which is why the surgery tests your liver before and after you start. So does the drop in coenzyme Q10, which your heart muscle makes its energy with, because the pill blocks the same pathway that makes your cholesterol. And at the far end, muscle that breaks down and floods the kidneys. Bayer's statin, Baycol, was pulled worldwide in 2001 after it was linked to 52 deaths. About 1,800 tablets, one a day for five years, with the aches, the blood sugar and the forgetting, in exchange for a long weekend you might not remember.

Doctor: Your triglycerides are high. That's the fat in your blood. I want you on a low fat diet. Patient: Where does the fat in my blood come from? Doctor: Your diet. Patient: Straight from the plate into the vein? Doctor: Not exactly. Most of it's made in the liver. Patient: Out of what? Doctor: Whatever's in surplus. Patient: Which is? Doctor: Carbohydrate, generally. Sugar, starch, alcohol. The liver packages it as fat and sends it out. Patient: So the fat in my blood was bread last week. Doctor: In part. Patient: And the plan is to take the fat off my plate and leave the bread on it. Doctor: Low fat is the standard advice for lipids. Patient: You've just told me the lipid's made from the carbohydrate. Doctor: Fat is still the most energy-dense. Patient: I'm not asking what's dense. I'm asking what my liver turns into the stuff you've measured. You said sugar and starch. Then you prescribed sugar and starch. Doctor: Wholegrain versions. Patient: Does my liver check the label? Doctor: ... Patient: What happens to triglycerides when people cut the carbohydrate instead? Doctor: They tend to fall. Quite quickly. Patient: How quickly? Doctor: Weeks. Patient: Then write that down and we'll both save a year.