Statins are the most prescribed drugs in the United States.Lipitor) alone is taken by nearly 30 million people. If you add simvastatin, rosuvastatin, pravastatin, and lovastatin, the number of people taking statins is over 50 million. #1 Cause of Death How can that happen in the U.S.? Haven’t you heard that statins prevent heart attacks caused by cholesterol?
Why does heart disease still kill people?
According to the National Center for Health Statistics: 702,880 Heart disease causes 1 million deaths each year in the United States, roughly 1 in 5 deaths. The CDC further reports:
“Someone has a heart attack every 40 seconds in the United States.”
The American Heart Association points out that heart disease has been the number one cause of death in our country for the past century. Many Drugs that lower cholesterol, control blood sugar levels, and lower blood pressure.
Is there any good news when it comes to heart disease?
The good news is that since 1950, the trend has been on a downward trend, dropping by about 60 percent until recently. Unfortunately, progress has stalled over the past few years, and according to the American Heart Association, death rates are starting to rise slightly.
Heart disease death rates have fallen in part because far fewer Americans are smoking. In the 1950s, nearly 40% of adults smoked a pack of cigarettes a day. Today, that figure is “only” about 20%.
The CDC states:
“Smoking is the leading cause of cardiovascular disease (CVD) and is responsible for one in four CVD deaths.”
There is no doubt that anti-smoking campaigns have had a major impact on smoking behavior in the United States, which in turn has a major impact on heart disease.
One overview (Heart View(October-December 2022) states:
“Recent studies have shown that quitting smoking reduces mortality and morbidity in people with CVD by 50% and reduces the risk of heart attack by 65%. [cardiovascular disease].”
We all know that quitting smoking makes a huge difference to your health, especially your cardiovascular health.
Why don’t statins stop heart disease?
Many cardiologists credit statins with the decline in heart disease deaths over the past few decades. These drugs help lower total and low-density lipoprotein (LDL) cholesterol levels. Because these factors often rise and fall together, they are the primary focus of attention when it comes to preventing heart disease.
The first prescription statin, lovastatin (Mevacor) entered the market in 1987. Many competitors soon entered the market.
Atorvastatin has been the nation’s top selling drug for several years, followed by rosuvastatin and simvastatin. With over 50 million people taking statins, one might expect that heart disease would be declining sharply. Why haven’t statins stopped heart attacks, or at least reduced the current epidemic to a trickle?
Our statin time machine:
Before Lipitor was released as a generic drug, the brand-name manufacturer paid for magazine ads, and in one of those ads, the company ran a large headline highlighting the benefits of this statin-type cholesterol-lowering drug.
“In patients with multiple risk factors for heart disease,
Lipitor
Reduces the risk of heart attack
Many readers, especially medical professionals, 36 out of 100 people can avoid a heart attack If only I had taken Lipitor.
But…if you notice the asterisks and read the smaller text, you’ll see this:
“That means in large clinical trials, 3 percent of patients who took a sugar pill or a placebo suffered a heart attack compared with 2 percent of patients who took Lipitor.”
Want to see the ad for yourself? Here’s the link.
In clinical trials conducted by the pharmaceutical company, people at high risk of developing heart disease were found to reduce their chances of having a heart attack by 1% after taking Lipitor for five years.
Which is more attractive: a 36% risk reduction or a 1% risk reduction? It goes without saying.
The company also funds advertising touting Lipitor’s ability to prevent strokes.
“For people with type 2 diabetes, Lipitor reduces the risk of stroke by 48%. *If you have at least one other risk factor for heart disease…”
The asterisks are:
“That is, in a large clinical study, 2.8 percent of patients who took a sugar pill or placebo had a stroke, compared with 1.5 percent of patients who took Lipitor.”
We now know that while aggressive statin therapy reduces the risk of ischemic (thrombotic) stroke, it may also increase the risk of hemorrhagic (bleeding) stroke. I wrote about this paradox here.
Why don’t statins stop heart attacks? Lp(a)?
You may have heard of LDL cholesterol. LDL cholesterol is said to be the “bad” cholesterol. However, one lipid component in the blood that you don’t hear much about is Lp(a). However, Lp(a) is Many Risk of heart attack and stroke.
The American Heart Association clearly states:
“Lp(a) levels above 50 mg/dL (125 nmols/L) promote blood clotting and inflammation, significantly increasing the risk of heart attack, stroke, aortic stenosis, and peripheral artery disease.”
It is estimated that about 20% of the general population has high Lp(a). In India, one in four people has high Lp(a).Indian Heart Journal(Until March 2024)
The problem is that statins tend to raise Lp(a) levels. European Heart Journal (January 1, 2020) This caused a big stir among cardiologists. The headline read:
“Statins and elevated Lp(a): An inconvenient truth to be aware of”
Other risk factors for heart disease:
Why aren’t we making more progress in preventing heart disease? Maybe we’re missing something? other Risk factors that can be addressed more effectively. We have already mentioned smoking and the benefits of smoking less.
But it doesn’t address the problems associated with weight gain, particularly insulin resistance and type 2 diabetes. Overweight people are also more susceptible to high blood pressure and elevated triglyceride levels, all of which can contribute to the risk of heart disease.
Another factor that can increase risk is reduced physical activity. In modern societies, relatively few people earn their living through physical labor. As a result, too many people do not get the physical activity they need to keep their cardiovascular system healthy.
Hostility and heart disease:
One elusive risk factor that most medical professionals ignore is chronic hostility. Recent studies have shown that even brief episodes of anger induction can have long-term adverse effects on the cardiovascular system (Journal of the American Heart Association(May 7, 2024)
The idea that anger is deadly has been around for decades. Yet insurers rarely cover anger management, mindfulness, or other stress-reduction techniques. And many cardiologists have a hard time understanding factors like hostility and loneliness. It’s much easier to prescribe statins to lower LDL cholesterol.
We hope that statins will stop heart attacks. It would be great if heart disease were no longer our number one cause of death. And we’d be happy if doctors would prescribe anger management for people who suffer from chronic hostility. Even better, insurance companies would pay for such treatment.
learn more:
You can learn more about the many risk factors that contribute to heart disease in our eGuide on Cholesterol Management and Heart Health. This online resource can be found under the Health eGuides tab. Learn more about Lp(a) and how to control this deadly risk factor for cardiovascular disease.
Our increasingly polarized society may also be contributing to the recent rise in deaths from heart disease. Finding ways to reduce hostility and increase social support could help make lives more comfortable and healthy.
