Group Of UK's Leading Doctors Speak Out Against Millions Being Prescribed Cholesterol-Reducing Statins | HuffPost Life

'Stop Prescribing Unnecessary Heart Medication' Say Leading Doctors

PA/The Huffington Post UK

PAUL J. RICHARDS via Getty Images

Lipitor(atorvastain calcium) tablets made by Pfizer and distributed by Parke-Davis are seen November 30, 2011 in Washington, DC. Pfizer's patent on the best-selling drug of all-time, the cholesterol-lowering medication Lipitor, expired on November 30, 2011, opening the path to generic competitors for America's most popular medication. Lipitor came on the market in 1997, and has raked in some $100 billion for Pfizer even in a crowded market that includes various other cholesterol-lowering statins

A group of leading doctors have criticised plans to advise millions more people to take cholesterol-reducing statins.

The drugs are currently offered to as many as seven million people in the UK who have a 20% risk of developing cardiovascular disease within 10 years.

Draft guidance from the National Institute for Health and Care Excellence (Nice) has called for the NHS to widen this to cover people with just a 10% risk.

But a number of prominent clinicians have written a letter to Health Secretary Jeremy Hunt to express their concerns.

London cardiologist Dr Aseem Malhotra said: "Although there is good evidence that the benefits of statins outweigh the potential harms in those with established heart disease, this is clearly not the case for healthy people.

"For example a doctor wouldn't give chemotherapy to a patient who didn't have cancer or prescribe insulin to someone without diabetes.

"When you add up doctors' appointments, unnecessary suffering for those who experience side effects that interfere with the quality of life, the illusion of protection of taking a drug that won't reduce the risk of death in healthy people - and the increasing burden of chronic disease which is predominantly lifestyle-related - prescribing statins to millions of healthy people would increase costs to the NHS, not reduce it."

Story continues below the slideshow:

Cholesterol-Lowering Foods

Diet Makes a Difference(01 of13)

For some people, diet tweaks are enough to lower cholesterol naturally without medication, while others will need drugs, or a combination of diet and medication, from the outset, according to Robert Eckel, MD, an endocrinologist and past president of the American Heart Association.If you follow the National Cholesterol Education Program’s (NCEP) Therapeutic Lifestyle Changes (TLC) diet — which entails reducing saturated fat and dietary cholesterol, losing weight, and eating more soluble fiber — you can slash your LDL cholesterol by as much as 20 to 30 per cent, an effect comparable to that of cholesterol-lowering drugs.In addition to cutting out cholesterol-raising foods, make sure you eat more of the following foods as part of your cholesterol-lowering plan. (credit:Shutterstock)

Oats And Barley(02 of13)

These whole grains are among the best sources of soluble fibre, which blocks your body's ability to absorb cholesterol and “is your best friend for lowering LDL cholesterol,” says American Dietetic Association spokesperson Ximena Jimenez, MS, RD.The soluble fibre that oats and barley contain — called beta-glucan — is particularly powerful. Eating oats with at least 3 grams of soluble fiber every day, for example, can lower LDL and total cholesterol by 5 to 10 per cent.Try this: Eat oatmeal for breakfast and sprinkle oat bran into yogurt. Use cooked barley, a versatile, nutty-tasting grain, as you would rice — in soups, in salads, or as a side mixed with veggies.The NCEP recommends consuming at least 5 to 10 grams of soluble fiber daily as part of the TLC diet, but 10 to 25 grams daily is preferable. Introduce fiber gradually and drink lots of water. (credit:Shutterstock)

Beans And Other Legumes(03 of13)

Beans, peas, lentils, and peanuts are also wonderful soluble fibre sources: Every half-cup of cooked lima beans provides 3.5 grams, for example. One study in The Journal of Nutrition found that consuming a half cup of cooked dried pinto beans (2 grams of soluble fibre) daily for 12 weeks decreased LDL cholesterol by about 7 per cent.Try this: Make rice and beans or bean-based soups. Toss beans, lentils, or peas into salads, or swap them in for meat in pasta dishes, suggests Jimenez. The TLC diet recommends three to five half-cup servings daily of vegetables, dry beans, or legumes. (credit:Shutterstock)

Green Tea(04 of13)

Fire up your water kettle, because according to a new meta-analysis of 14 studies, green tea significantly reduced total and LDL cholesterol levels (by 7.20 mg/dL and 2.19 mg/dL, respectively). In some studies participants drank tea; in others, they took green tea supplements.Try this: Although in some of the studies participants consumed the equivalent of 18 cups of green tea daily, experts don’t recommend that everyone start binging on green tea. More research is needed to know how much green tea to drink to improve cholesterol levels. Jimenez suggests sipping one to two 8-ounce cups daily. Also, keep in mind that most green tea contains caffeine (there are decaf versions), so you don’t want to overdo it, especially too close to bedtime. (credit:Shutterstock)

Oils(05 of13)

While butter and other solid fats raise cholesterol, the unsaturated fats in oils help lower it. Polyunsaturated fats, found primarily in corn, safflower, sesame, soybean, and sunflower oil, slash LDL cholesterol. Monounsaturated fats, found mainly in olive, avocado, and canola oil, not only lower LDL, but may also raise HDL.Try this: Cook with oils instead of butter, mix them with vinegar for salad dressing, or drizzle them along with herbs and spices on vegetables before roasting. Moderation is key, since oil is high in fat and calories. Stick to about 1 teaspoon with each meal, advises American Dietetic Association spokesperson Toby Smithson, RD. (credit:Shutterstock)

Nuts(06 of13)

Nuts are another good source of monounsaturated fats. Eating 1 ounce of any kind of nuts daily for one month may lower LDL cholesterol by 8 to 20 per cent.Try this: Nosh on an ounce a day — the equivalent of 23 almonds, 35 peanuts, 14 English walnut halves, 49 pistachios, or 2 tablespoons of peanut butter. Or add chopped nuts to salads, pasta, or yogurt. Nuts do have a lot of calories, so don’t eat them by the fistful. (credit:Shutterstock)

Plant Sterol- Or Stanol-Fortified Foods(07 of13)

These plant compounds are found naturally in small amounts in certain fruits and vegetables, oils, nuts, seeds, and grains — and in higher amounts in certain fortified foods. They help prevent cholesterol from being absorbed, which can lower LDL without negatively impacting HDL cholesterol. Eating 2 grams a day can help lower high levels of LDL by 5 to 15 per cent.Try this: You’ll need to eat fortified foods to really reap the heart-healthy benefits of sterols and stanols. Drink a cup of sterol-fortified orange juice, which provides 1 gram. Snack on a 3-ounce fortified yogurt, which has 2 grams. Smear a tablespoon of fortified, trans fat-free margarine, which has 1 gram, on your whole-grain toast for breakfast. (credit:Shutterstock)

Soy(08 of13)

Soy — high in fibre, low in saturated fat, and cholesterol free — is the only complete plant-based protein, which means it’s an equal swap for animal sources like meat and dairy. A study published in 2010 in The Journal of Nutrition found that eating soy daily — and adding it to your diet to replace foods high in saturated fat — can help lower LDL cholesterol by nearly 8 to 10 per cent.Try this: Nosh on edamame as a snack or add them to salads, drink soy milk, and use tofu in smoothies or as a replacement for meat in salads and stir-fries. Soy counts toward the daily three to five half-cup servings of vegetables, dry beans, or legumes that the TLC diet recommends. (credit:Shutterstock)

Psyllium(09 of13)

Getting 10 to 12 grams of blond psyllium (the kind of fiber in supplements like Metamucil) per day can decrease LDL cholesterol by 5 to 10 per cent, according to the Natural Medicines Comprehensive Database. You mix psyllium powder into water and drink it as a beverage.Try this: Consult your doctor before taking blond psyllium, since it could interfere with the absorption of certain medications. Then start with 3 grams of psyllium (widely available in health food stores and drugstores), and gradually increase the amount until you’re taking 10 to 12 grams daily, says Jimenez. “It’s important to not take psyllium in large doses, since it’s a laxative, it may cause potassium depletion, and may decrease absorption of fat-soluble vitamins A, D, K, and E,” she notes.And make sure you get enough fluids — if you don’t, psyllium can cause constipation, and possibly even obstruct your bowel or esophagus. Follow package directions to make sure you drink enough. (credit:Shutterstock)

Red Wine And Grape Juice(10 of13)

Alcohol can raise levels of good HDL cholesterol by as much as 5 to 15 per cent, research shows — and red wine is particularly beneficial because its polyphenol antioxidants may also lower LDL levels. If you’re not into vino, grape juice can provide some of the same heart-healthy benefits.Try this: Stick to one 5-ounce glass of wine a day for women and two for men. For grape juice, Smithson suggests 8 ounces per day of purple grape juice for women and 16 ounces a day for men — pick 100 per cent fruit juice, not the sugar-added varieties. You can also snack on purple or red grapes, which contain the same antioxidants with the added benefit of fiber, notes Smithson. (credit:Shutterstock)

Cocoa(11 of13)

In good news for chocoholics, a meta-analysis in the American Journal of Clinical Nutrition found that cocoa consumption lowered LDL cholesterol by more than 5 mg/dL in people at risk of heart disease. Most studies lasted about one month and looked at the effects of dark chocolate and cocoa powder. But the study authors caution that more research is needed to know whether the effects last or how much to eat to achieve results.Try this: Most chocolate products also contain a lot of sugar and saturated fat in addition to the cocoa’s heart-healthy antioxidants, so don’t mistake them for health foods. When you’re craving a treat, nibble on a small piece or two of dark chocolate (at least 60 per cent cocoa), which has more antioxidants than milk chocolate, or make chocolate milk or hot cocoa with 2 tablespoons of natural cocoa powder. (credit:Shutterstock)

Tomatoes(12 of13)

Known for their cancer-fighting prowess, tomatoes may also help reduce cholesterol. A 2011 meta-analysis of studies published in the journal Maturitas revealed that consuming 25 milligrams of lycopene (the antioxidant that gives tomatoes their red pigment) daily can reduce LDL by about 10 per cent. But since the research is so new, don’t expect your cardiologist to prescribe spoonfuls of tomato paste just yet.Try this: Drink tomato juice, add tomatoes to salads and sandwiches, and use tomato sauce on pasta and to top side dishes of veggies. To get the amount of lycopene used in the study, you’d need to drink a pint of tomato juice or cook with 3.5 tablespoons of tomato paste each day. Cooking or eating tomatoes with a little oil helps your body absorb more lycopene. (credit:Shutterstock)

Fruits And Vegetables(13 of13)

In addition to lycopene-packed tomatoes, produce high in soluble fiber should also be part of any cholesterol-lowering diet.Try this: The best produce sources of soluble fiber include Brussels sprouts (3 grams per half cup); medium pears, oranges, and grapefruits (2 grams each); and dried plums (1.5 grams per 1/4 cup). Other good sources, which contain 1 gram per serving, include a medium plum, peach, nectarine, banana, apple, and a baked potato with skin.The TLC diet recommends three to five servings of vegetables and two to four servings of fruit each day. To get that amount, follow this simple rule from the new U.S. MyPlate government guidelines: Fill half your plate at each meal with fruits and veggies. (credit:Shutterstock)

The signatories, including the president of the Royal College of Physicians and a former chairman of the Royal College of General Practitioners, claim that the latest guidance is based almost entirely on studies funded by the pharmaceutical industry.

The group cite findings from non-industry sponsored studies which include an increased risk of developing diabetes in middle aged women taking statins.

Other side effects include fatigue, psychiatric symptoms and erectile dysfunction, the clinicians warn.

They also claim that the "medicalisation of millions of healthy individuals" is unjustified.

Professor Simon Capewell, professor of clinical epidemiology at the University of Liverpool, said: "Two decades of research has confirmed the obvious: doctors receiving drug industry funding produce recommendations favouring the industry.

"It also represents a further embarrassment for Nice.

"Nice urgently need to develop a better mechanism for controlling these conflicts of interests. The recent statin recommendations are deeply worrying, effectively condemning all middle aged adults to lifelong medications of questionable value."

SEE ALSO:
Prostate Cancer Spread May Be Curbed By Cholesterol-Lowering Statins, Research Says
Beans Really Are Good For Your Heart...

But Professor Mark Baker, director of the centre for clinical practice at Nice, insisted that the draft guidance does not propose that statins should be used instead of lifestyle adjustments by people at risk of cardiovascular disease.

He said: "Cardiovascular disease maims and kills people through coronary heart disease, peripheral arterial disease and stroke. Together, these kill one in three of us. Our proposals are intended to prevent many lives being destroyed.

"We have consulted on these proposals and the results of this consultation are currently being reviewed prior to publication of our final recommendations next month. Our proposals are also being independently peer reviewed to ensure they are reliable and evidence-based."

Professor Baker stressed that Nice guidance is developed by independent expert committees and none of them support the recommendations to make money for themselves.

He added: "This guidance does not medicalise millions of healthy people. On the contrary, it will help prevent many from becoming ill and dying prematurely.

"We recognise that strong views are held by some on both sides of the argument about the best way to use statins, but our job is to reach a balanced judgement. Concerns about hidden data and the bias that the pharmaceutical industry may or may not have are important issues and need to be resolved.

"Nice is part of the effort to do that but just as the signatories to the letter will have done in their professional careers, we need to act in the best interests of patients on the basis of what we know now."

Related

Health News Heart Disease cholesterol uk lifestyle news high blood pressure

Suggest a correction

|