“New research shows that over-75s on statin drugs are less likely to die within a decade.” This story was covered by all the national newspapers in July 2020. The research in question was conducted by geriatricians at the Brigham and Women’s Hospital in Boston, Massachusetts. After looking at data from 300,000 Americans aged 75 or older, they concluded that “those taking statins were 25% less likely to die from any cause and the drugs lowered the risk of having a stroke or heart attack by a fifth.”
A full-page spread in the T2 section of The Times newspaper on July 14th 2020 praised the benefit of statins to the hilt. However, it did mention that statins have been given some bad publicity because of their side-effects but to discover the truth, “We asked leading experts for the latest insight.” The most frequently quoted ‘expert’ in the article is Dr Dermot Neely. He is a spokesman for a charity called Heart UK. It seems unlikely that Dr Neely is an independent voice on this subject because the purpose of Heart UK, according to their website, is to “prevent early disease and deaths from cholesterol and other blood fat (lipid) conditions in the UK.”
The home page of the website states that “Over half of UK adults have raised cholesterol which can lead to heart disease. Together we can make things better.” The website goes on to lay the blame firmly at the door of saturated fat in the diet and recommends the use of statin drugs for the avoidance of ‘death from cholesterol’.
There are several problems with all of this:
- there is a dearth of investigative journalism throughout the media, which leads to the use of confirmation bias in the selection of ‘expert’ opinion. Reporters look for people who will support the story they want to write instead of seeking different opinions to strike a balance.
- reliable evidence that cholesterol and/or saturated fat causes heart disease is not available.
- a large number of other studies have shown that older people with high levels of cholesterol live longer and healthier lives than those with low levels.
There are several conditions that increase the risk of damage to the artery walls where plaque can occur. They include: high blood pressure; systemic inflammation; high blood sugar/high insulin levels/type 2 diabetes (most diabetics eventually die from heart disease); toxins from cigarette smoke and air pollution; high levels of the stress hormone cortisol; high levels of homocysteine (due to a lack of B vitamins); low levels of vitamin D; drug abuse (especially cocaine); high levels of the clotting agent fibrinogen; and bacterial infection. You will notice that cholesterol is not on the list.
The older we get the more likely we are to suffer from dementia and severe dementia can lead to an early death. Our brain cells make cholesterol because our brains need it to function correctly. The brain is relatively small compared to the rest of us but 25% of all the cholesterol in the body is found in the brain. Some statins can cross the blood-brain barrier and reduce that essential cholesterol increasing the risk of brain dysfunction.
Several studies have shown that high cholesterol in the elderly increases life expectancy. The following is a quote from the summary of one such study.
” A review of observational studies shows a trend where all-cause mortality was highest when total cholesterol (TC) was lowest (‘a reverse J-shaped’ association between TC and all-cause mortality). Low TC (<5.5 mmol/l) is associated with the highest mortality rate in 80+-year olds. No clear optimal level of TC was identified. A review of the few randomised controlled trials including 80+-year olds did not provide evidence of an effect of lipid-lowering treatment on total mortality in 80+-year-old people. There is not sufficient data to recommend anything regarding initiation or continuation of lipid-lowering treatment for the population aged 80+, with known CVD, and it is even possible that statins may increase all-cause mortality in this group of elderly individuals without CVD.”
A separate study of elderly people drew the same conclusion:
“Our results indicate an association between lower serum total cholesterol (TC) concentrations and increased all-cause mortality in a community-dwelling, very elderly population. Mortality decreased with the increases in both TC and LDL-C concentrations, after adjustment for various confounding factors. These findings suggest that low TC and low LDL-C may be independent predictors of high mortality in the very elderly.”
The HeartUK website states “Over half of UK adults have raised cholesterol which can lead to heart disease”. Everybody is different and, just like our height and IQ, our cholesterol levels vary according to a typical Bell-curve. Most people are in the middle, while others are at the extremes. In this situation, what constitutes a ‘raised cholesterol’?
People, like HeartUK, who believe that higher levels of cholesterol are dangerous simply draw a line down the middle, from the apex of the curve, and state that everybody to the right of that line has ‘raised cholesterol’ because it is higher than the median. Having cholesterol levels on the right hand side of a standard deviation curve is not a disease that needs treatment and it is not a risk to your health.
Why did this latest study get so much publicity and why did it differ markedly from other studies? The high level of publicity comes from a media that loves to maintain the consensus; they do not want to search for other opinions, and previous studies, within the same field. We cannot rely on mainstream media to provide reliable scientific information. The Pharmaceutical Industry makes a huge profit from statin drugs and they do not like the negative publicity that stains have received lately. They will definitely be providing incentives to some researchers to paint a more positive picture. This study was an interpretation of observations; it was not a controlled trial. Perhaps this study was more hype than robust science.