According to a new University of Sydney study thousands of preventable heart attacks and strokes may occur as a result of a biased television program.
On 24 and 31 October 2013, ABC television’s Catalyst program aired a two-part series that questioned the link between blood cholesterol and heart disease, and whether current dietary advice or statin medication was effective in lowering heart disease risk. Although the first program on diet was very biased Catalyst may have got away with it as the science around diet and heart disease is considered rather ‘soft’ and is still unfolding.
However, the second program on statins, cholesterol and heart disease was on very firm scientific ground. The last time I looked there were 24 meta-analyses on statin medication and heart disease risk and all showed benefit. But rather than present this perspective Catalyst decided that the public interest would be better served by sowing seeds of doubt.
There were howls of protest. To their credit, other journalists at the ABC took aim at Catalyst. Media Watch presenter Paul Barry said … Catalyst struck us as sensationalist and grossly unbalanced; and some of their so-called ‘experts’ had questionable qualifications.
The ABC’s health guru Dr Norman Swan considered the health implications saying that People will die as a result of the Catalyst program …. It doesn’t get much stronger than that. Was Swan going over the top, or did he just have a good understanding of his subject?
New University of Sydney study
A new study led by researchers at the University of Sydney’s Faculty of Pharmacy has provided some answers. The purpose of the study was to quantify any changes in the dispensing of statins after the airing of the Catalyst program in October 2013. The researchers found significant and sustained changes in statin dispensing following the airing of the program, 60,897 Australians having been affected up to 30 June 2014.
In relation to the health implications the researchers had the following to say:
If the 60,897 individuals we estimated to have been affected continue to be non-adherent, this could result in between 1522 and 2900 preventable, and potentially fatal, major vascular events.
So, unless the situation can be reversed a couple of thousand preventable heart attacks or strokes may occur as a direct result of the Catalyst program. It’s impossible to say how many of these events will be fatal so we can’t accurately answer the question posed at the top of this post. But it would appear that Norman Swan did indeed know what he was talking about when he made the claim that People will die.
Spare a thought for the poor souls working in the ABC’s legal section. Just imagine the litigation to come.
How did the ABC let it happen?
Although current affairs programs on commercial television often present shock-horror health stories, the community expects more from the ABC, especially from its science program. No doubt the credibility of both the ABC and Catalyst led to the high ratings and high impact of the cholesterol programs – people thought it was true. Yet these two programs would have to rate as the most irresponsible and dangerous piece of health journalism ever aired in Australia. Has any other single act of journalism ever put the health and lives of so many people at risk?
What is unclear, however, is why these programs ever saw the light of day? Who pitched the idea to Catalyst? Why would any producer of a reputable science program take it on? Why was the program’s research so bad and so one-sided? Who chose the dodgy ‘experts’ to mount the non-science argument? Why didn’t the ABC’s internal systems start flashing red lights before the program went to air?
The offending Catalyst programs have been removed from the internet so no more damage can be done. How the producer of the cholesterol programs managed to keep her job at Catalyst is a mystery? Wasn’t the casualty rate high enough?
In the meantime the next chapter in the cholesterol story is about to unfold. I’ll cover it in my next post.
Unfortunately, the damage will continue and is spreading beyond Australia’s borders. Both parts of the Catalyst program are on YouTube.
My mother stopped her Lipitor as a result of this show!!!!! And her rheumatologist said “that is fine”, and her GP said “fair enough they are not usually beneificial for women” and her son-in-law (who is an emergency medicine consultant) said “no worries they don’t really help people like you”. And she is still going strong!
Personally I think you are stirring up trouble Bill as many GPs and even cardiologists (in fact anyone who has read the research) agrees with the messages put forward in the show.
“My mother stopped her Lipitor as a result of this show!!!!! And her rheumatologist said “that is fine”, and her GP said “fair enough they are not usually beneficial for women” and her son-in-law (who is an emergency medicine consultant) said “no worries they don’t really help people like you”. And she is still going strong!”
Hi Jenny. I’m a long term lurker/reader of this blog and I have to say, I am consistently astonished, even amazed, at the fact you always have an anecdote relevant to what Bill posts. It’s just incredible! You do have the most varied health experiences, and so do your family and friends.
But as a statin user (prescribed by a woman GP to me, a woman), I wanted to get some clarification about stopping the Lipitor. The problem for me is that I can’t possibly know if you even have a mother, let alone that three medical professionals gave her advice contrary to what the AMA says, and what my GP recommends
Since I can’t reasonably ask you to prove any of this directly – say by asking her rheumatologist to give the reasons for their advice, or even what conditions your mother suffers from that might make statins contraindicated (who knows? I might not have the same conditions, phew!) – I could ask this:
Can your mother’s specialist cite any references we could look up (I mean the way I can follow the link in Bill’s post to the Medical Journal of Australia, or look up other references on the subject) to support their decision? You could email them to ask.
Did your mother’s GP cite any reference for statins not being beneficial in women? (It’s news to my GP, you see.)
And what did her son-in-law mean by ‘people like you’? Only you don’t specify your mother’s age, conditions, other medications and so on. Maybe her race is a factor? Was it Lipitor or all statins he meant? Who knows? Can you explain? I would hate to think I’d stopped a potentially life saving medicine because of your mother, only to find your mother is an 82 year old with liver disease or diabetes, whereas I am a woman in my early fifties with high cholesterol and other risk factors for heart disease! It’s just possible that your mother’s medical team’s advice might not work for me, you see.
Thanks in advance. Your anecdotes are always so amusingly detailed and specific!
Hi Chris,
I was really stressed when my Mum said she stopped her Lipitor (because I was worried she did it because of me as I am very cautious about all medications) until she explained that she had checked with her GP, Rheumatologist and my brother-in-law. She is 75 years old, very fit for her age ( a keen golfer), she has polymyalgia rheumatic (an autoimmune disease that my grandmother also had). I don’t know if her docs cited any references although I do know my brother-in-law cited some refs. http://jama.jamanetwork.com/article.aspx?articleid=198731
Hi Chris,
I’m shocked that your GP doesn’t know about the problems of statins for women as I have had 2 GPs recommend I don’t take them because I am a women even though I have elevated cholesterol (I am 44), in all fairness I did have one GP tell me I was a fool for not taking them (I was 35 at the time). My cholesterol has always been high. And I have been researching this (probably a bit obsessively) for more than 10 years. I have a science degree (which included biochem and human physiology).
Chris,
I don’t think you or anyone should stop taking medication because of a show or because of something some person they don’t know says. I just think everybody should be asking lots of questions about medications and diet rather than just going along with the flow. I think the ‘flow’ has it wrong! And I actually agree with lots of Bill’s thoughts and convictions. Which is why I follow his blog.
“I’m shocked that your GP doesn’t know about the problems of statins for women”
‘Problems’? I thought you said your GP said they were just ineffective, which turns out not to be quite accurate. The article you cite actually says “For women with known cardiovascular disease, treatment of hyperlipidemia is effective in reducing CHD events, CHD mortality, nonfatal myocardial infarction, and revascularization, but it does not affect total mortality”. It apparently also doesn’t discuss other morbidity from hyperlipidaemia, eg, from strokes.
This 2012 metareview:
http://content.onlinejacc.org/article.aspx?articleid=1201102
concluded “Statin therapy is associated with significant decreases in cardiovascular events and in all-cause mortality in women and men.”
GPs are often not that good at keeping up with the latest research, so you are wise to do your own. However, if you had done so, you would find a number of papers saying statins definitely benefit women with cardiovascular disease.
I can’t find any actual scientific reference for statins being ineffective or contraindicated for women generally except for those of childbearing age. So as I am not, I suspect my GP is giving me exactly the correct advice for someone of my age and medical profile.
Your mother’s particular medical condition likely means statins are less of a benefit than risk to her (or possibly the consultant thought the benefits were not worth the hassle to be gained from arguing with someone who’d already made their mind up.) But that’s a long way from what the Catalyst program suggested (and what you imply from the generalised statements you quote from your GP and your mother’s relative.)
I think it would be more responsible to have said “My 75 year old mother with autoimmune rheumatism decided to stop statins and her specialist thought that was okay.” That way, you’re not *advocating* a course of treatment (or ceasing one) on the claimed grounds of general medical advice, but simply reporting a single experience – with relevance only to your mother in this case. Your own GP’s advice to you as a premenopausal (one assumes) woman, will be different to my DP’s advice to me as a perimenopausal woman, even without taking into account our individual medical histories.
Statins have side effects for some people – I’ve had none, thankfully, and my cholesterol is down. That certainly doesn’t mean no one else will have problems, or that statins may not be worth the risk for some individuals. Not all statins are the same – your mother was on Lipitor, and I’m on rovastatin. It’s *really* important not to give the impression that people should be scared to take subscribed medicines. You’re not a doctor, and even if you were, you’re not *their* doctor.
If you have references on statins in women which actually support the idea that we shouldn’t take them, you should post them so they can be assessed. I have a science degree too (first class hons), in biochemistry and physiology. I’m also married to a scientist so I am pretty comfortable with research and assessing evidence.
This 2015 paper
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61368-4/abstract
Also concluded that “In men and women at an equivalent risk of cardiovascular disease, statin therapy is of similar effectiveness for the prevention of major vascular events.”
So the 2004 paper you cite has been rendered obsolete by further research and metareviews.
Another question: how many people have better quality of life as a result of going off their statins?
How many people will have given up statins AFTER a serious discussion with their doctors. More studies are identifying sub-populations for whom statins may not be appropriate, even if some of the conventional indicators are in favour. Conventional indicators does not include “popular consensus” btw.
How many people have died as a result is probably a more interesting question. Has there ever actually been any independent peer reviewed research done regarding the efficacy of statins? I’m not saying that the article on the ABC was right or wrong, I’m not on statins, but I will never be either, no matter who tells me to take them no matter how many heart attacks I have. Why don’t we actually contact these people and see if they 1 answer the phone (then we can assume they’re still alive) and 2 ask them, as Jenny suggested, if they have had any improvement in their quality of life. Short term memory improvement, aches and pains, we might need to wait a while because I believe that some side effects can take quite some time to resolve. This may well be one of the most important articles ever to have aired on the ABC. Why don’t we follow it up rather than shoot it down. If I was a dietician today I would be very nervous about everything that I believe to be true too, Bill, you’ve nearly been a nutritionist as long as the food pyramid has been espoused to be right, it might be time to change your mind and not just take for granted flawed and manipulated research, rather look at the real science that is taking place right now that is changing everything.
Hello William. The last time I looked there were 24 meta-analyses of statin trials in the scientific literature, all of which show that statins lower cardiovascular events. Very high level evidence.
And I was never a fan of the food pyramid and low fat diets – see my many posts on this blog. Regards, Bill
People need to think about the NNT for any medication they are taking and also consider the impact of disrupting an essential metabolic pathway. http://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease/
“also consider the impact of disrupting an essential metabolic pathway”
Ooh, scary language. Lots of drugs do this, and lots of drugs help people live better lives too.
Sounds like you want people to ignore the advice of their own physicians and also results which contradict your view that statins are dangerous. Tell me, Jenny, in your extensive research, did you not find *any* papers suggesting statins were effective? Or did you just focus on the ones which support the Catalyst program’s take on things?
I also note that while what the NNT site attempts is valuable, they are not peer reviewed, and while they give a large number of references, I doubt the average lay reader has the skill to look through them all, analyse them the same way the NNT doctors have, to understand the conclusions given. A good deal is taken on trust, that the analysis is sound, and the conclusions likewise.
This study
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61368-4/abstract
concluded that
” These net benefits [of statins] translated into all-cause mortality reductions with statin therapy for both women (RR 0·91, 99% CI 0·84–0·99) and men (RR 0·90, 99% CI 0·86–0·95; adjusted heterogeneity p=0·43).”
Note the ‘all-cause mortality reductions’.
While the side effects of statins are certainly not to be dismissed, you do seem focused on them as the only possible outcome of taking this group of drugs.
Hi Chris,
I have had a concern about statins for about 10 years because both my parents were taken off Lipitor because of side-effects and because heart disease is a problem in my family.
I am VERY cautious about all medication because I have personally experienced significant and life-threatening reactions to many including: pseudoephedrine, morphine, pethidine, nitrous oxide, amoxicillin, vaccination for typhoid, malaria prevention medication (can’t remember the name of it) and several others.
Also seen family members have reactions to maxolon, penicillin and warfarin.
I’m not surprised that you and I have come to different conclusions because we are different. I would quite reasonably have an enormous concern about side-effects considering my personal and family history.
I speak out about it and feel passionate about it because I believe they are significantly over-prescribed and have known too many individuals who have had negative effects from them. And consequently I am glad that the Catalyst show aired because, as already mentioned, I believe people should be asking more questions and researching thoroughly to ensure that they are getting the best possible care.
Now we don’t want to start talking about Alzheimer’s I am sure but “disrupting an essential metabolic pathway” is NOT scary language!
“both my parents were taken off Lipitor”
Wait a minute. You said earlier your mother *decided* to take herself off Lipitor. You couldn’t be being economical with the verité, could you?
“I have personally experienced significant and life-threatening reactions to many including”
A bunch of medications I and lots of people have taken without the smallest side effect whatsoever. You seem to have extreme reactions to everything including whatever food item Bill is talking about in his post at the time.
“I would quite reasonably have an enormous concern about side-effects considering my personal and family history”
You can be concerned for you without assuming your personal experience has the smallest relevance to anyone else. But you always post as if your experience trumps carefully considered, peer reviewed research.
It doesn’t. Your fondness for anecdata and confirmation biases is against the scientific method, and while you may have a science degree, you obviously neglected to learn how science actually works. It wouldn’t matter except, as Bill points out in this post, ignorant fear mongering may lead to a couple of thousand people dying early, and as has been seen with the antivaccination movement, the deaths of hundreds of children unnecessarily.
You claim to enjoy Bill’s writing, and yet you are as far from a ‘sceptical nutritionist’ as it’s possible to get. I’d be sorry for your ignorance except I imagine you are inventing almost everything you claim to have experienced, and know perfectly well you are posting nonsense.
“Now we don’t want to start talking about Alzheimer’s I am sure but “disrupting an essential metabolic pathway” is NOT scary language”
Oh you’re too precious. I hope you don’t drink coffee or alcohol, or take over the counter pain remedies, all of which are pretty potent interferers with ‘metabolic pathways’ (something you probably don’t know the meaning of.) There’s a huge difference between being informed, and being a careless scaremonger with an agenda – one you are only now revealing, the more I’ve poked. Honest people don’t behave that way, Jenny.
Even more interesting anecdotes! I’d like to meet you one day Jenny. Which hospital takes care of you?
Be aware that I get plenty of comments off-line that you are obviously a troll and that I should bump you off this blog. But I think it’s more instructive to let you do what you do, just so everyone knows that agents like you exist and carry on like this. I imagine it’s a nice little earner.
Thanks to Chris for keeping you ‘honest’. Regards, Bill
Wow!!! Well that is me told, thanks Chris and Bill! I haven’t told any lies and my only agenda is to consider health and nutrition issues thoroughly. Earner!!!! Hardly! How? (Don’t tell me I don’t want to know!)
Yes both parents taken off Lipitor (about 10 years ago) changed to Crestor and then Mum changed back to Lipitor and the she went off it last year! Not that it matters!
Troll!!! No! Just really concerned and vocal about a few things!
Yes I am careful about alcohol, caffeine and otc meds, isn’t everyone who is concerned about their health!
Would like to meet you one day Bill!
“Yes both parents taken off Lipitor (about 10 years ago) changed to Crestor and then Mum changed back to Lipitor and the she went off it last year! Not that it matters!”
Yes, it does, it really does. If you’re going to cite your parents’ medical history in support of your scare mongering about statins, then you need to be accurate. And what you have said in your comments about them have been deeply misleading.
“Just really concerned and vocal about a few things!”
Funnily enough, I went back over your comments on this blog over the last two years and I found:
- no single instance where you commented in support of Bill’s position
- a number of instances where you cite your science degree, and in one case claiming to be an actual scientist (as well as a teacher)
- your self-reported visit to a naturopath
- your self-reported ‘true believer’ status as a follower of Pete Evans and paleo diets
- a truly alarming number of claimed medical and dietary allergies and sensitivities
- conflicting claims about the reason your ‘doctor’ (or was it the naturopath?) who put you on a low carb (or is it a ketogenic) diet
- claims to have variously ‘high cholesterol’, ‘slightly elevated cholesterol’, ‘metabolic syndrome’ which had not progressed to diabetes II, and actual ‘diabetes’
- you also claim to be a diagnosed coeliac, and to also have IBS – two quite different conditions.
Now whether you’re a paid astroturfer or not, what you certainly are *not* is a scientist, or a doctor. And since you believe in naturopathy, your constant claims that you believe in the ‘research’ is a load of bollocks.You don’t even understand half of what you quote, let alone what Bill cites.
Your medical history is contradictory, and even if it’s not largely fiction, is so eccentric that your advice and claims about the merits of this or that diet or dietary supplement, could never be applicable to the general population. So when you try and scare people off statins because a doctor *possibly* told *you* that you shouldn’t take them, all that means is that Jenny of the many allergies shouldn’t take them. Other people need to speak to their own doctor, preferably a specialist if they have a cardiac condition or familial history of CVD.
You are concerned, but ignorant. Vocal but without the learning to back it up. I’d suggest you lurk moar, as the young kids say. But if you continue to comment and support rubbish nutritional ‘advice’, Jenny, you can be assured I will be there to fact check your every statement. Little more annoys me than bad science and bad medicine being spruiked.
*applause*
p.s. great (and thought provoking) post btw Bill, (as per usual).
Ummm, I can’t really apologise for having a bizarre medical history!
Like lots of coeliacs I was diagnosed with IBS first!
Astroturfer??? Should I look that up in an urban dictionary?
I have a science degree and an education degree and further studies, so yes both a teacher and a scientist.
I have commented in support of Bill’s position several times, particularly in reference to the National Dietary Guidelines! So you didn’t check very carefully! But then I really can’t understand why you are wasting your time doing this!
The GP I have seen for the last three years works in a health centre which has GPs, naturopaths, paediatricians and clinical psychologists. And the GP that I have recently changed to (1 hour away rather than 3 hours away- I live in rural NSW) has specialised training in Lifestyle & Nutrition Medicine. So I am sure that you and I seek a different kind of doctor.
Yes I absolutely agree that people should talk to their doctors. I also think they should ask lots of questions and do lot research.
Isn’t this a place for discussion? If Bill didn’t want different perspectives discussed perhaps he should have called his blog “Bill’s Fan Page” rather than “The Sceptical Nutritionist”!
“Lurk moar”??? Urban dictionary time again!
Chris, please stop reading my posts if they are annoying you! I would hate for you to be annoyed!
Bill,
I’m glad you stepped in as I was beginning to think “Jenny” was in fact you, an alternate persona if you like. I did not think it possible for an actual person to have such an attachement to one blog. Has she considered not reading this blog if she disagrees so much with it?
I’ve swung between being amused and annoyed at her constant presence here.
“please stop reading my posts if they are annoying you!”
Oh no, that won’t work. I’ll read them and comment on their stupidity and inconsistencies, until you get the message that tripe doesn’t fly here.
Surely Bill is in charge of what “flies here” and if he has a problem he can block me!
He’s already said that he’s going to use you as an example of astroturfing (look it up).
And since he’s asked you before to stop using anecdotes as data, and you’ve ignored him (some scientist, huh), mocking you is all that’s left. If you don’t like it, then leave
!!! XOXOXOXO
I enjoy reading this blog and will consequently continue to do that. I will comment if I want to and post links to studies if I think them helpful (Bill moderates and doesn’t publish those posts sometimes). Feel free to spew your vitriol (perhaps it is cathartic for you), although I think you are making yourself look nasty and angry (I hope for your sake that is not what you are like).
Poor Jenny, when you don’t have any other defence, fall back on personal insults and appeal to the Big Daddy to protect you.
“I enjoy reading this blog and will consequently continue to do that.”
Read it all you want. What you don’t get is that the rest of us are here for *Bill’s* opinion and links, and the actual science. No one wants to read your repetitious (and factually dodgy) anecdotes about your paleo evangelism, your ‘unique’ medical history, or anyone elses. Anecdotes are not data. Reading your comments is like sitting next to some bloke in a pub with an opinion on everything, and knowledge on nothing.
Oh, one thing you never post about is your actual field of research. You know, the one you are a scientist in. I presume it’s funded by the highschool who employs you.
“I will comment if I want to and post links to studies if I think them helpful”
And I will comment and critique your ‘research’ and, as I have in this post, most likely find that the studies you cite do not support the statements you have made, or have been superseded by much more recent studies.
The thing is, Bill’s made it clear you annoy him. You have Sarah saying the same thing above, as have I. When I went back over your comments, I found other people taking issue with your comments, and I saw you dismiss them and insult their intelligence, or simply refuse to respond to them. You call me rude, but your behaviour is just as rude. Since your agenda is to push the paleo diet, which makes a number of flat out false claims, and even more unsupported scientific assertions, and has been condemned as a potentially dangerous and unbalanced diet by the Dietitians Association of Australia, it’s not surprising that when you come onto the blog of a properly qualified nutritionist and spout your silly ideas, that you upset people.
Well I’ve had enough. I’m not going to read your comments and shake my head as I have in the past. I’m going to poke and challenge and hopefully make you stop posting nonsense. No one’s going to stop you reading. Bill may have to stop you commenting if you don’t grow up. But if he doesn’t, and you keep on, you’ll find people are going to complain. Loudly.
Hi Chris, I don’t think that the same diet works for everyone and I do think that considering different perspectives is worthwhile. It shocks me when other educated people don’t agree.
A ‘paleo’ type diet works much better for me than ‘conventional wisdom’ so that is how I eat! I am not the only person who has found that or been recommended it by a health professional (my previous GP recommended this) and my gym coach. Although I was almost eating that way anyway because of coeliac disease and allergies and intolerances.
An interesting recent study: Paleolithic nutrition improves plasma lipid concentrations of hypercholesterolemic adults to a greater extent than traditional heart-healthy dietary recommendations.(Nutr Res. 2015 Jun;35(6):474-9. doi: 10.1016/j.nutres.2015.05.002. Epub 2015 May 14.) – search in pubmed if you are interested.
This is getting tiresome! How about you have the last word and we be done with it!
Jenny, repeat after me:
Anecdotes are not data.
Your doctor is not my doctor.
Your body is not my body.
I am not a scientist or a nutritionist.
Why are people citing Lancet??
http://nsnbc.me/2015/06/19/shocking-report-from-medical-insiders/
How do you know that high cholesterol is the cause rather than the effect of CVD? If it is the former, then the human body has evolved to poison itself. Does that seem plausible to you?