Sunday, March 24, 2024

Dr Guy Hatchard: Medical Practice Needs Meaningful Patient Conversations - If It is to Improve Outcomes

Recently, a close friend who was taking statins developed muscle pain, digestive weakness, and peripheral neuropathy (loss of sensation in hands and/or feet). They stopped taking the statins and talked to their doctor, who suggested tests to assess their cardiac health. Most of the symptoms dissipated gradually after stopping the drug, and they got a clean bill of cardiac health. So are statins the most effective therapy to prevent heart disease?

A meta-analysis of 21 randomised clinical trials in primary and secondary prevention published by the JAMA Network entitled Evaluating the Association Between Low-Density Lipoprotein Cholesterol Reduction and Relative and Absolute Effects of Statin Treatment A Systematic Review and Meta-analysis concluded that:

“the absolute benefits of statins are modest, may not be strongly mediated through the degree of LDL-C reduction, and should be communicated to patients as part of informed clinical decision-making as well as to inform clinical guidelines and policy”.

Unverified Link Between Cholesterol and Disease Reduction

In layman’s terms, the study found reductions in the absolute risk of just 0.8% for all-cause mortality, 1.3% for myocardial infarction, and 0.4% for stroke in those randomised to treatment with statins compared with controls. More worrying, their meta-regression was inconclusive regarding the association between the magnitude of statin-induced LDL-C reduction and all-cause mortality, myocardial infarction, or stroke. In other words, an association between cholesterol reduction and disease reduction could not be verified.

More than 200 million people around the world take statins daily, and their use is climbing rapidly from 31 million in the USA (12% 0f the population) during 2008/9 to 92 million (35% of the population) in 2018/19. Currently, half a million (10% of the population) are taking statins in New Zealand. Studies show the side effects of long term statin use include muscle pain and damage (experienced by 5% of people), liver damage (2% to 6% of people), and peripheral neuropathy (as high as 7% of people). The FDA warns on statin labels that some people have developed memory loss or confusion while taking statins.

Vegetarian and Vegan Diets Linked to Significant Cardiovascular Health Benefits

In contrast, a meta-analysis of nine studies entitled Association of Vegetarian and Vegan Diets with Cardiovascular Health: An Umbrella Review of Meta-Analysis of Observational Studies and Randomized Trials found very large effect sizes including a 29% risk reduction for cardiovascular disease (CVD). It reported a 14% reduction in CVD mortality and a 32% reduction in Ischaemic heart disease (IHD) mortality. One of the studies evaluated showed a significant 39% risk reduction for stroke incidence.

These results imply that following a vegetarian or vegan diet is at least ten times more effective than statins in preventing heart disease or stroke. It is also of note that such diets are free of the negative health side effects of statins. The authors conclude that:

“Policymakers and healthcare professionals should prioritise promoting healthy diets for CVD prevention.”

In addition to the beneficial effects of vegetarian and vegan diets on heart disease, multiple studies show they have a beneficial effect of reduced cancer incidence, the number two cause of death after heart disease. Something that statins do not affect. Thus the reductions in risk factors start to add up, meaning that a vegetarian diet will significantly reduce your all-cause mortality risk. In other words, you live a longer, more healthy life with less chronic illness and pain.

Doctors Rarely Recommend Vegetarian Diets Over Statins Despite Health Benefits

But when was the last time your doctor initiated conversation with you about switching to a vegetarian diet or eating more fruit and vegetables? Probably never, despite the fact that this would be many times more effective at keeping you alive and healthy than their routine statin prescription. Doctors have little training in nutrition and diet. Moreover, current professional ethical (???) standards require that doctors prescribe certain pharmaceutical drugs for certain conditions even if a more healthy, proven, natural approach is available.

Rather than develop the resources and knowledge base in the direction of safe and effective alternatives to drugs, Health New Zealand prioritises and uses its resources to encourage and monitor drug compliance. For example, Health New Zealand tracks whether we renew our prescriptions on time at the chemist. You have probably been on the receiving end of a health professional’s stern lecture on the need to take drugs, sometimes even extending to warnings that your life might end prematurely if you don’t do as you are told. The measured outcomes for statins are too small to justify this approach.

Are There Other Approaches to Preventing Heart Disease That Might Further Improve Outcomes?

A study of 2000 regular participants in Transcendental Meditation enrolled in a health insurance scheme for five years was compared to 600,000 members of the same health insurance carrier. The study found an 87% reduction in inpatient admission for heart disease among the TM group. But that wasn’t all. Hospital admissions per 1000 were lower for the TM group than the norm for all of 17 major medical treatment categories, including 55.4% less for benign and malignant tumours, -30.4% for all infectious diseases, -30.6% for all mental disorders, and -87.3% for diseases of the nervous system. An across the board health outcome improvement.

TM is a simple, easy twice daily practice of twenty minutes that does not require belief, but your doctor has probably not advised you to learn meditation for your health. An article in the journal Hypertension entitled Evidence for Upgrading the Ratings for Transcendental Meditation: Response to AHA Scientific Statement on Alternative Methods and BP encourages doctors to examine the evidence and upgrade their advice to patients with hypertension.

In the 1980s, I had a series of meetings with Dr. Hiddlestone, who was then the Director General of Health and informed him about research on the health benefits of Transcendental Meditation. He was impressed with the published research but met a brick wall when he sought to convince his colleagues. When it comes to health care, the pharmaceutical paradigm dominates against the evidence.

Statins may slightly improve endpoint outcomes for just 1.3% (13 in 1000) suffering from heart disease, a figure that pales in comparison to 14% (140 in 1000) for vegetarian diets and around 87% (870 out of 1000) for meditation. However, these statistics have not penetrated the walls of doctor surgeries. With over half a million Kiwis on statins, the rate of heart disease is rocketing up. Almost doubling over five years. Are statins working? You tell me.

The extreme reliance on pharmaceutical approaches took a giant leap forward (or is it backward) during the pandemic into the intimate world of biotech medicine. A world in which those alert enough to do their own background research into drug safety are reviled and cancelled. Patients are routinely cajoled and harassed for asking questions, let alone non compliance. Adverse medical events are routinely ignored and remain unrecorded. Losing your job and personal freedom at the behest of medical tsars has become the cost of common sense. We have entered an era of medical doublespeak and fanatical faith. God help us.

Dr Guy Hatchard is a former senior manager at Genetic ID, food testing and certification company. Guy regularly posts on his blogsite Hatchard - where this article was sourced.


Robert Arthur said...

Doctors keenly advocate statins. Effectivenss is assessed from cholesterol control. But if statins typically have negligible effect on health, then where did the case justifying low cholesterol come from? When things like peripheral nerves are affected get concerned, esp in the age group where brain deterioration a worry. Some vegetarian diets quite tolerable. But where do foods with very high saturated fat, like peanuts, stand relative lean meat?

CXH said...

'It is also of note that such diets are free of the negative health side effects of statins.' However the psychological effects are devastating, the thought of never eating bacon again gives me the tremors.