I don’t have an educated opinion about this class of drugs, and I haven’t read the first part of this series, but most of it sounds about right to me. Mixing for-profit economic models and health care lead to things on the ’market’ of people’s health needs that aren’t actually needed. That’s consumerism, baby! Anyway, this is the part that caught my eye:
Finally — and here is the stunner — it turns out we don’t have any clear evidence that statins help the first group by lowering cholesterol levels. It’s true that they do lower cholesterol, but many researchers are no longer convinced that this is what helps patients avoid a second heart attack. It now seems likely that they work by reducing inflammation. In other words, these very expensive drugs seem to do the same thing that aspirin does. (Are they more effective than the humble aspirin? We’ll need head-to-head studies to find out.)
So I have two questions: why aren’t there a lot of head-to-head studies about the various benefits of asprins vs these drugs? And how are doctors being informed about research trends and new questions about these drugs as researchers raise them? Don’t tell me their reps from Big Pharma are telling them anything other than company propaganda. So who is? I’ve been to many CME sessions, so spare me about how “educational” and unbiased they are…
If you’re poor, and lack health insurance, and cardio health is an issue for you, it seems worth researching and discussing with your doctor. I know a lot of people, older people mostly, who have really long and expensive Rx. Perhaps asprin is one way to cut down on some of that; it would surprise me not at all to learn of similar lack of proof of benefit for many of the more commonly sold drugs today. So much of our spending on health care is bullshit, and the drug part of that is no exception.
Front page
Food and Health
Not really sure of my point here, more of a rant.
I just finished reading Michael Pollan’s latest book about food - highly recommended - and he concludes that science, government, and business are all responsible for the horrible outcomes produced by industrialized food. He is, after all, a professor of journalism so he spreads the blame equally among the three.
I don’t. Actually, he doesn’t either in the body of the book, just when he sums it up. Anyway…….
Bottom line in this culture: Business comes before people. All problems need to be solved by a business model. If they can’t be, the problem, by definition, doesn’t exist.
Man, that sounds cynical.
Fortunately I keep a link that Lambert pointed me to handy.
That's why it's called "practicing" medicine --
damn near every day they discover some new result in a study that turns conventional wisdom wrong side out and upends the recommendations they’ve been using for the last 20 years.
cholesterol is, in essence, an element of sludge / fat / alcohol. think of it as the gunk that fills up your car’s crankcase over time — it’s a similar effect, essentially; you get these irregular flakes of the stuff stuck to the walls of your blood vessels, and they accumulate — until something causes one to flake off and it plugs up a tiny little supply line to your heart or brain, and kills you.
thinner blood is better than thicker blood. it moves through those tiny little passages faster and easier, so it puts less strain on your heart to drive it through your body.
think of it as 5w30 oil instead of straight 30-weight (if, like me, you drive something with more than 100,000 miles on it and you’re not planning on trading soon, you know that in the summer straight 30 weight will keep you from losing that elusive half-a-quart between changes that worn engines just seem to make disappear — no smoke, no drips, just gone out of the crankcase) — for hi-performance or small-displacement engines, especially in cold weather, you want the thinner oil ’cause it gets up in the gears and valves faster and lubes them better, so you don’t break, say, a camshaft or throw a valve (been there, done that, thought it sucked way before I wore the T-shirt out) some gray morning halfway between home and where you need to be.
aspirin causes thinner blood. this is why you’re warned against taking it for 72 hours before donating or having surgery done (and if you’re taking aspirin for pain during pregnancy, quit at least a week before the baby’s due) — it’s also why if you’re on blood-thinning drugs, you’re not supposed to take aspirin too. Likewise if you have ulcers, use some other NSAID.
aspirin is cheaper than damn near any statin — the VA had, several years ago, some generic statin they subbed for the Rx my VA-doc wrote, and I got a honkin’ big bottle of ’em for $7; I think it was 90 days’ worth, ’cause it came with 4 refills and I had to see the doc every year — but there are some conditions that aspirin won’t improve and will, in fact, aggravate.
but yes, in our profit driven world, there are drugs that do the job for less money — but the drug reps can’t earn good commissions selling old or generic versions to the docs, and the pharmacists and docs can’t make their overhead if everybody can get the un-blinged-up versions.