Thursday, March 20, 2014

Millions of healthy Britons are set to be prescribed them, but why do many GPs say they won't take statins?

As Dr Chand says, the litmus test is if you get better by stopping the pills.  Many do. It shows that the pills are the cause of the problems, not just a coincidence

He’d been a GP for a quarter of a century and had written ‘tens of thousands of statin prescriptions’.  Then two years ago, Dr Kailash Chand, too, started taking the cholesterol-lowering pills to protect his heart.

As Dr Chand, who is the deputy chairman of the British Medical Association  — the doctors’ union — explains: ‘I was in my late 50s and I’m Asian, so I ticked various boxes for being at raised risk of heart disease. It seemed the sensible thing to do.’

Within two weeks, however, Dr Chand, who is now 60, began experiencing pains in his back and legs unlike anything he’d suffered before.  ‘Mostly it was a dull ache,’ he says, ‘but for a couple of days a week the pain was crippling and I had to take painkillers.’

This went on for two years and — bad news for his heart — forced Dr Chand to give up badminton, his favourite form of exercise.

Initially, Dr Chand had assumed the pain was something that would pass.  In fact, it worsened, and the bouts became more frequent. He also began to have problems sleeping and started to wonder about possible causes.

‘I didn’t even consider statins,’ he says. ‘I was wondering instead about things like too much travelling or bad posture when sitting.  'I did various checks, like a liver function test, X-rays and an MRI scan. All came back clear.

‘So last year I thought it was worth seeing what would happen if I stopped taking the drug.  'Within two to three weeks my back and legs began to feel a lot better and my sleep improved.

‘For me that was the litmus test that showed that the statin was the cause of the problem.’

Dr Chand is certainly not alone. Muscle pain is the most frequently reported statin side-effect and while estimates of the numbers affected adversely by statins vary, according to one eminent U.S. cardiologist, 20 per cent of healthy men on the drugs say they have significant side-effects.

With seven million Britons taking statins, that could mean up to 1.5 million are being affected.

Yet according to a study published last week, Dr Chand and all the others are almost certainly mistaken.

A major analysis of 29 trials of statins by researchers at the National Heart and Lung Institute at Imperial College, London, concluded that the drugs are practically free from side-effects.

When people say they are suffering symptoms such as muscle pains, insomnia, fatigue or gut problems caused by statins, claim the scientists, they are making a false link.

Just because twinges and aches appear shortly after you’ve started on a statin prescription doesn’t mean the drug caused it. (Other known side-effects of statins, such as memory problems, blurred vision, ringing in the ears and skin problems, were not included in this review.)

Dr Chand, for one, is far from convinced by these new findings: ‘I know the difference between twinges and a new sensation that is quite specific and doesn’t go away.’


Do Moms Who Work Less Have Healthier Babies?

Pregnant women and their newborns tend to be healthier when the economy is worse, a new study shows. Why? Probably less stress

Imagine you lived in Barcelona and lost your job, like thousands of Spaniards did each year of the most recent recession. And also, imagine you were pregnant. Would you sit around the house, anxiously sending out job applications and stress-snacking on churros? Or would you take long walks in the Mediterranean sun and stop at farmers' markets along the way?

Spanish moms, it seems, often choose the latter.

Libertad González, an associate professor at the Universitat Pompeu Fabra, recently examined the health of registered newborns in Spain from 1981 to 2010, and she cross-referenced the data with the unemployment rate in each of the country's provinces at the time. With each 10 percent increase in unemployment, she found, the neonatal death rate dropped by 7 percent, and the percent of babies with low birth weights decreased by 3 percent.

The reason? During recessions, mothers consistently reported being in better health, and they exhibited healthier behaviors: “They smoke and drink less, exercise and sleep more, and weigh less,” Gonzalez wrote.

Her findings mesh with past research in the U.S. showing that health improves during periods of low economic growth. A 2004 study of American babies, for example, also found that those born in periods of high unemployment had fewer birth defects, were more likely to weigh a healthy amount, and were less likely to die.

Research by Chris Ruhm, a public policy professor at the University of Virginia, has shown that people tend to exercise less during economic upswings, and they tend to eat out more—and restaurant meals are usually higher in fat and calories. In Cuba, for example, a period of pronounced, years-long austerity led to a steep drop in obesity and cardiovascular disease because people walked and biked more as public transportation was scaled back.

People who work less also have more time on their hands, so they sleep more and feel less stressed, Ruhm said. And there are fewer cars on the roads, so the air is cleaner and there are fewer car accidents.

“Interestingly, there’s evidence that short-term reductions in income are actually good for you,” he told me.

But how could this be? Wouldn't job loss also cause people to scale back on gym memberships and kale salads? Well, yes. And this is one of those counterintuitive trends that becomes more intuitive once you hear all the caveats.

“When times are bad, people are healthier but not happier."
These studies evaluate overall unemployment and GDP, not job loss at the individual level. That is to say, they only suggest that health improves as the economy overall slows down. So, much of this might have to do with hourly employees working less overtime and spending more of their free time on cooking and jogging. Or it could be that families are feeling pinched and eating out less, rather than becoming totally destitute.

The key here are temporary dips in income. Long-term unemployment, which has skyrocketed in Spain and other parts of Europe, is still terrible for mental and physical health. In fact, it could be that we'll see the reverse of the Spanish results playing out if the women aren't able to return to the workforce and provide stable homes for their kids.

There also might be some self-selection going on. People generally have fewer babies during recessions, so the couples who do procreate in lean times might already be comfortable enough to ensure that their offspring flourish, no matter what. (This factor didn’t explain the healthier babies in the Spanish sample, however.)

And since there are fewer babies being born, it could be that hospitals—especially publicly funded ones like Spain’s—are less busy during economic slumps and can provide better care for each baby as a result.

There’s also one very important downside to recessions—a gradual deterioration in mental health, and an attendant rise in suicides. “When times are bad, people are healthier but not happier,” Ruhm said.

So it could be that this and similar studies are not really an argument for pregnant women to leave the workforce, but simply to scale back their hours. Or to keep their jobs the same, but to live life more like a marginally employed Spanish woman—sleeping enough, walking a lot, and slurping up plenty of gazpacho.


1 comment:

Wireless.Phil said...

Replace statins with apples!