If someone I cared about was in the hot seat facing that choice, here’s what I would want to ensure they knew.

Chances are, facing this decision means you were told your cholesterol was high and were at risk of a heart attack, and lowering your cholesterol with a statin would help you prevent one.

Either way, it won’t.

That conventional storyline you were told and what is advertised to the public and reported by the government are based on the “relative” risk and benefit of the statin medication for heart disease.

The absolute benefit of any drug, especially statins, is usually dramatically different from the relative benefit. They use the relative risk because it usually paints a much prettier picture of the success rate for medications than the absolute risk. They lied to you.

The research for statin medication showed that out of 100 people who met the cholesterol-lowering medicine criteria, three died from a heart attack without the medication, and two died while taking it.

The relative benefit of taking the medication is a 33% reduction in deaths from heart attacks compared to not taking it. 

A 33% reduced risk of death is a pretty big and compelling statement for the potential life-saving effect of the medication. But it is very misleading.

The absolute value shows a one-person difference out of 100, or only a 1% potential benefit, and a 1% difference is statistically insignificant. AKA, the medication failed to show a statistical benefit or show enough direct correlation to claim that one person’s difference was due to the drug.

That’s not all. 

The number of people statistically who need to take a statin medication to prevent one person from having a heart attack is 60, and for a statin to prevent one stroke, 286.

It’s called the “Number Needed to Treat,” or NNT. The NNT is the statistical equation used to put treatment options into the context of how likely a patient will benefit from taking them.

Sixty people need to take statin medication consistently for one of those 60 people to prevent a heart attack, and 268 for one to prevent a stroke.

According to an expert on NNTs from the University of Toronto, biostatistician George Tomlinson and colleagues concluded that “an NNT of 5 or less was probably associated with a meaningful health benefit,” while “an NNT of 15 or more was quite certain to be associated with at most a small net health benefit.”

Oh, I forgot to mention, and probably your doctor did too, statin medications have only shown this negligible, statistically insignificant benefit for men. There hasn’t been a single study to date showing benefits in women. According to the University of British Columbia Therapeutics Initiative, “statins offer no benefit to women for the prevention of heart disease.”

So now you are in a group of 60 men being told to take medication for the rest of your life, hoping to be that one in 60 while never knowing if you were or not the lucky one. 

Even if you are, lowering cholesterol with statins does not prevent heart attacks or deaths or reduce your risk of dying. FYI.

By taking the statin, you will have a lower cholesterol number while running the added risk of a false sense of security or ignoring the proven lifestyle changes guaranteed to improve your health and everyone who applies them. That’s a NNT of 1, and the one is you.

But they say lowering cholesterol saves lives and prevents heart attacks. And statin medication does lower cholesterol. So if the 60 people needed to treat have lower cholesterol from taking the drug, isn’t that good? 

No, because high cholesterol doesn’t cause heart attacks.

The cholesterol-heart disease connection has been repeatedly shown in studies to be a wrong assumption. And to support that, dozens of extensive studies and meta-analyses worldwide report no reduction in heart attacks or deaths after decades of statin use. 

Some even show the statin treatment group had higher rates of heart attacks, diabetes, and overall higher risk of death for the people on the statins. 

Yes, hearing this after a lifetime of hearing the exact opposite from every doctor you have been to is very confusing. I get it. 

I just thought you would want to have all the information possible to help you decide to take a medication for the rest of your life. I would. 

Tomorrow I will post information about how much cholesterol affects our body and how statins lower cholesterol by preventing the body’s ability to make it.

Remember, a prescription is a suggestion, not a court order.

We can do better!

Dr. Don