tag:blogger.com,1999:blog-1474751880645498536.post5632543028263846310..comments2023-10-10T10:14:36.340-04:00Comments on Medical Evidence Blog: The Cholesterol Hypothesis on the Beam: Dalcetrapib, PCSK9 inhibitors, and "off-target" effects of statins Scott K. Aberegg, M.D., M.P.H.http://www.blogger.com/profile/17564774546019869201noreply@blogger.comBlogger4125tag:blogger.com,1999:blog-1474751880645498536.post-73489743915897768942013-05-02T10:24:17.448-04:002013-05-02T10:24:17.448-04:00Hi Dr. Abberg
When we say statins "work"...Hi Dr. Abberg<br /><br />When we say statins "work" this pertains to secondary prevention in middel aged males who have had heart attacks and severe coronary artery disease. It's not for the elderly or women generally. For primary prevention they are next to useless.<br /><br /><br />They work under these circumstance , but there is a huge caveat: <br /><br /> It is not nearly as great as numbers in the medical journals claim.It is dramatically exaggerated.<br /><br /> The drug companies have manipulated these numbers and used relative risk to make it sound impressive. You will hear numbers like reduced cardiovascular deaths by 50%. The actual absolute numbers show the real figures. The documentary "Statin Nation" does into detail about this toward the end . It's avilable on YouTube. JUPITER was a trial where this shady fraud occured.<br /><br />Doctors who are very busy do not dig into it deeper and see the 50 % quote and wet their pants in delight.<br /><br />It's is extremely unethical to manipulate numbers like this. <br /><br />The reason statins work under the said conditions is likely due to their 12 other effects they have- their pleotropic effects. All NON- statin cholesterol lowering trials are failures- drug or diet for reducing CAD and total mortality. This is very telling.<br /><br />Another telling things is that atherosclerosis ONLY happens at areas of damage to the endothelium. It does not occur "just anywhere." What ever is causing the intial damage to the endothelium is ultimatley causing coronary herat disease.<br /><br /><br />Possible causes? Viruses, microbes, toxins, poor diet, immune system etc. Dr. Uffe Ravnskov and Kilmer McCully have a great hypothesis set forth. LDL lipoprotein is strongly involved in the immune system defense. It binds to and attacks invaders. Interesting fact: Rats injected with human LDL lipoprotein before given injections of bacteria or viruses - MOST live compared to the control rats who do not get injections of human LDL . <br /><br /><br />As Isaac Newton said - it is about the WEIGHT of the evidence, not the numbers of experiemtns.<br /><br /><br />You have a nice blog.<br /><br /><br />Take care,<br /><br />RazAnonymoushttps://www.blogger.com/profile/04100203304347134837noreply@blogger.comtag:blogger.com,1999:blog-1474751880645498536.post-53657248861499403412012-12-06T08:59:15.758-05:002012-12-06T08:59:15.758-05:00Dr. Aberegg, when will the house of cards we call ...Dr. Aberegg, when will the house of cards we call all surrogate markers fall?<br /><br />We continually fall into allowing surrogate markers to become dogma way too early in research. If it looks right on a chalk board and has a great MOA, then it must be right... Avandia, Vioxx, etc...<br /><br />When we actually look at the evidence, as doctors as yourself have, it is clear to see that we know statins save lives, and the others, as you mention do not. We also, IMHO, have no data to suggest what a specific LDL goal should be in anyone. We waste so much money and time titrating lipids rather than just getting folks on statins and then based on TNT using the highest dose statin a patient could tolerate, if they so chose.<br /><br />My money is that the PCSK9 drugs will do an awesome job of changing LDL, but will not affect CV outcomes/mortality as you state, BUT, there will be a HUGE outcry by researchers, lay people, and cardiologists that we are missing something! There must be some explanation for those results... subgroups will be studied, excuses will be made, but the lipid hypothesis will go on, maybe even more strongly after being handily rejected by those kind of results. Dogma is nearly impossible to change. <br /><br />I think copernicus died at the hands of his revelations that the earth wasn't the center of the universe.Anonymoushttps://www.blogger.com/profile/12264629041548251195noreply@blogger.comtag:blogger.com,1999:blog-1474751880645498536.post-45573870015359719402012-12-05T16:52:23.170-05:002012-12-05T16:52:23.170-05:00I'm no vascular biologist, so I can't spec...I'm no vascular biologist, so I can't speculate on mechanisms. But this naivate affords a broader, more far-sighted perspective allows me to see certain trends without distraction by the details and the "party line". And I think these data are startling and should rattle the "true believers." Indeed, there was great enthusiasm for the CETP inhibitors. We can thusly infer that the vascular biologists (and Big Pharma) thought the entire paradigm was consistent with what was "known" - and BEHOLD - they were wrong. And now that we have those unexpected but robust data, I think we CANNOT ignore them in terms of their relevance to the overarching paradigms. We have to reconsider our cherished beliefs. And that's why it's so interesting to an aspiring iconoclast.Scott K. Aberegg, M.D., M.P.H.https://www.blogger.com/profile/17564774546019869201noreply@blogger.comtag:blogger.com,1999:blog-1474751880645498536.post-51550030214105864892012-12-05T16:50:59.576-05:002012-12-05T16:50:59.576-05:00One reader asked:
Interesting. It does seem like ...One reader asked:<br /><br />Interesting. It does seem like the cholesterol lowering and cardiovascular benefit may be separate. Do you think it is their effect (stabilizing?) on the endothelium that is beneficial?<br />Scott K. Aberegg, M.D., M.P.H.https://www.blogger.com/profile/17564774546019869201noreply@blogger.com