Why the News about Statins Isn't News

With the latest brouhaha over the cholesterol-lowering statin drugs--summarized in today's Times--it might be instructive to return to a 2005 interview with Nortin Hadler that appeared in Discover. Hadler is a professor of medicine at Chapel Hill (and the author of The Last Well Person) whose sharp-eyed, statistical-based assessments lead him to hold contrarian opinions on conventional medical wisdom. Here is the part about statins:

"Discover: Surgery is obviously invasive, but why do you object to the widespread prescription of statins, the cholesterol-lowering drugs?

"H: In men with normal cholesterol levels, the risk of death for those between ages 45 and 65 over the course of the next five years is only a fraction of 1 percent lower than it is for men with high serum cholesterol in the same category. The most thorough study to date had some 3,000 men with 'high' cholesterol levels take a statin every day for five years, while 3,000 similar men took a placebo. When all was said and done, there was no difference in cardiovascular deaths between the two groups. Statins do reduce the risk of heart attack in those who have a strong family history of people in their family having heart attacks very young—but that’s a small percentage of the population. You could argue, looking at the data, that they’re helpful for people who’ve already had one heart attack. But for everyone else, the possible advantage is marginally and clinically insignificant.

"Discover: You’re 62—do you get your cholesterol checked?

"H: I don’t want to know. We have data that tell me if you stigmatize me by labeling me somehow, it will change my sense of well-being. I have nothing to gain from that in this case. I would be infuriated if any doctor checked my cholesterol without my asking and told me if it was up or down. I would think that would be an abuse of science that offered me a chance of feeling less well for no good reason."

The interview is worth reading in its entirety, especially for Hadler's comments on what's really behind prolonged life expectancy.

But the point is, this "news" about statins isn't really news. Statins lower cholesterol but don't prolong life. Should that not make everyone reconsider the relationship between cholesterol and health?