5 Steps to prevent Heart Disease

Friday, June 5, 2015

Do Statins cause cancer by lowering LDLc?




2012 Meta-analysis  link


Need to look at overall mortality- Statins good for this link to original letter and rebuttal



I respect Uffe Ravnskov and his recent letter about colon-cancer contained an impressive list of random controlled trials.

I include in this blog the authors rebuttal to Ravnskov but I felt I could look up the specific trials and find out what the total mortality was. Cancer cachexia will have low LDLc. Suicides also occur. This is why it is important to look at total mortality. 4S trial and HPS did this.

4S trial results

"The Scandinavian Simvastatin Survival Study (4S trial) randomized 4444 patients with acute coronary syndromes to simvastatin versus placebo. All-cause mortality, fatal coronary events and coronary revascularization procedures were reduced in the simvastatin group. This was regardless of the baseline HDL or LDL cholesterol levels."

HPS on wiki
"The number needed to treat in the study was 57 patients to postpone one death and 19 to prevent one cardiovascular "event" (in those taking the drug simvastatin for 5 years). There was no mortality benefit in women. Cancer risk was suggestively lower in the treatment group. No worsening of lung disease was found, an initial concern with statin drugs, and simvastatin did not decrease osteoporosis."

Statins have been given to millions of people since 1987. To my knowledge there is no association of a surge of cancer?

Ravnskov states the lower the LDLc the more the chance of cancer. In JUPITER, LDLc were as low as 35 to 55 but no increased mortality.




2 comments:

  1. The thing about drug trials is that outcomes from changes in lipids due to drugs rarely correspond to the correlation with those lipids in wild population. Drug-inflated HDL is no help.
    There is no temporal association between the rise of statins and a surge in cancer, except possible prostate cancer, but then statins are rarely given to very low LDL cases, so statin prescribing in general practice selects for the patients at lowest risk of cancer.
    What happens when a patient in an RCT is diagnosed with cancer? Presumably the drug is then unblinded, with the risk that subsequent treatment is influenced by the sense of liability. Cancer mortality outcomes are thus unlikely to be true double-blind tests of a drug, unless it's an a priori cancer trial, not a CHD trial.

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  2. In Jupiter and IMPROVE-IT the patients had "normal" LDLc.

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