Statin Nation ‘Census’ Highlights Major Disparities

–Women, minorities treated at significantly lower rates Anyone reading this is almost certainly aware of the enormous importance of statins in the current health scene. But until now they may have had a hard time to bring precise numbers and statistics to this all important story. Now data from a large federal survey confirm that…

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No Cognitive Benefit from Heart Drugs in HOPE-3

–Substudy finds mental function unimproved by BP, cholesterol treatments NEW ORLEANS — A large substudy of the HOPE-3 trial found no benefit relating to cognitive function in patients who took cholesterol or blood pressure-lowering drugs. In recent years cognitive decline and dementia have emerged as a concern equal if not even greater than cardiovascular disease…

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Debate Ensues As USPSTF Finalizes Statin Primary Prevention Guideline

–Broad disagreement about how, when, and if to use statins. The U.S. Preventive Services Task Force (USPSTF) has issued final recommendations regarding the use of statins for primary prevention of cardiovascular disease in adults. The recommendations, first proposed last December, are broadly consistent with the 2013 American College of Cardiology/American Heart Association guidelines. But accompanying the…

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Statin Trialists Seek To Bury Debate With Evidence

–A Lancet review claims overwhelming evidence in favor of statins for both primary and secondary prevention. Some disagree. A large group of statin researchers argue forcefully that the debate over statins should be ended because the evidence in favor of statins is overwhelming and incontrovertible. But some outsiders say the issue is more nuanced and…

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USPSTF Updates Aspirin for Primary Prevention Recommendation

–But many experts think the evidence base is slim at best. The U.S. Preventive Services Task Force (USPSTF) finalized the update to its guidelines regarding the use of aspirin for the primary prevention of cardiovascular disease and colorectal cancer. The USPSTF is now recommending that people between the ages of 50 and 59 who are at increased…

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How Does HOPE-3 Change Thinking About Primary Prevention?

–The study lends strong support for statins but delivers a mixed message for antihypertensives. The widely reported results of HOPE-3 may bolster the case for primary prevention with statins and blood pressure drugs. But the trial also makes clear that the benefits, though real, are also modest, and may not be evenly distributed between statins…

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Millions Of Americans Taking Aspirin When They Shouldn’t

More than a third of US adults– more than 50 million people– now take aspirin for the primary and secondary prevention of cardiovascular disease. (Primary prevention is the prevention of a first event; secondary prevention is the prevention of a recurrent event.) Although it was once broadly recommended, because of the increased risk of bleeding…

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Large Japanese Trial Casts Further Doubt On Aspirin To Prevent A First Heart Attack

Although once quite popular, the use of aspirin to prevent a first heart attack has grown less popular in recent years as evidence has accumulated that the small benefits are outweighed by the increased risk of bleeding. Now a large trial from Japan has once again failed to provide any evidence to support the use…

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BMJ Articles Critical Of Statins Provoke Kerfuffle

The authors of two BMJ articles have withdrawn statements about the adverse effects of statins. The two papers inaccurately cite an earlier publication and therefore overstate the incidence of adverse effects of statins. As a result, the two papers have drawn much criticism and set off a kerfuffle involving the editor of BMJ and a prominent British trialist who is demanding…

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FDA Comes Out Against Aspirin To Prevent First Heart Attacks

In the latest development in a long-simmering debate, the FDA has announced that aspirin should not be marketed for the prevention of a first heart attack or stroke in people with no history of cardiovascular disease. The announcement follows FDA’s rejection on Friday of Bayer Healthcare’s decade-old  petition requesting approval of a primary prevention indication. [PDF of FDA rejection letter]…

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Reassuring News About Statins From Two Very Different Studies

Although clinical trials have consistently demonstrated the benefits of statins, the perception that the drugs can cause serious side effects has prompted some patients to discontinue or not take the drugs. Now two new very different studies, one a large meta-analysis and one a tiny study with only a handful of patients, provide some convincing reassurance…

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Low Rate Of Problems With Statins In Study Of Quarter Million Patients

A very large analysis of previously published studies finds that statins are generally safe and well tolerated, but helps confirm previous links to a small increased risk for diabetes and elevation of liver enzymes. Some statins were better tolerated than other statins and lower-dose statins were better tolerated than high dose statins. In a paper published…

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UK Study Casts Doubts On Value Of Type 2 Diabetes Screening

The dramatic growth in type 2 diabetes has resulted in increased interest in screening programs. Now a new study published in the Lancet raises concerns that screening programs may not result in long-term improvement in outcomes. In the ADDITION-Cambridge study, investigators in the UK randomized general practices to either screening or no screening.  The practices allocated to…

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Real World Bleeding Risk Of Aspirin In Primary Prevention Examined

A new study published in JAMA provides substantial new evidence about the real world effects of aspirin, including the risk of  bleeding, in a broad  population. The study also sheds important new light on the effects of aspirin in a diabetic population. Giorgia De Berardis and colleagues analyzed data from more than 4 million people in…

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Fascinating Debate Over Statins For Primary Prevention

The recent guest post by David Newman has prompted several thought-provoking comments. Since most readers will likely miss the comments, I’ve moved these comments to a separate post. Statin Island May 27, 2012, 3:35 PM: Thank you. Clearly, this important commentary raises questions about the integrity of Lancet as well as the authors of the study. But…

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Guest Post: Data, Drugs, And Deception– A True Story

Editor’s Note: The following guest post by Dr. David Newman is reprinted with permission from his website and blog, Smartem.Org. Dr. Newman is an Emergency Physician and Director of Clinical Research at Mt. Sinai School of Medicine in the Department of Emergency Medicine.  He is the author of the critically-acclaimed Hippocrates’ Shadow: Secrets From the House of…

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Meta-Analysis Adds New Evidence For Cancer Benefits Of Daily Aspirin

Although daily aspirin was originally proposed to reduce cardiovascular events, the effects on cancer of daily aspirin have become increasingly apparent while the vascular benefits, especially in primary prevention, have become less clear. Now a new meta-analysis in the Lancet adds significantly new details to our understanding about the effects of aspirin and increases the…

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Guest Post: Another Round in the Debate on Diabetes and Statins

Another Round in the Debate on Diabetes and Statins by Roger Blumenthal Let me start by saying that I am proud to have Eric Topol as a friend and a trusted advisor over the past 20 years. His work has been an inspiration to cardiovascular health professionals for several decades. His new book, The Creative Destruction…

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Eric Topol, Megamind

Ralph Waldo Emerson famously wrote that “a foolish consistency is the hobgoblin of little minds.” If this is true then Eric Topol, who earlier today wrote a New York Times editorial highly critical of statins, is Megamind. Here’s what he wrote in a 2004 editorial in the New England Journal of Medicine: Even today, only a…

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Statins and Diabetes: Real Concern or Much Ado About Nothing?

Updated at 7 PM with a detailed comment at the bottom from C. Michael Minder of Johns Hopkins– In a New York Times Op-Ed piece on Monday, Eric Topol comments on last week’s announcement by the FDA that it was changing the label for statins. Topol focuses on the new warning that statins raise the risk…

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Metaanalysis Raises More Questions About Routine Use of Aspirin for Primary Prevention

Although aspirin can reduce the risk of cardiovascular (CV) events, the associated increase in bleeding suggests that it should not be used routinely in  people without prior CV disease, say the authors of a new meta-analysis published in Archives of Internal Medicine. Sreenivasa Rao Kondapally Seshasai and colleagues combined data from 9 clinical studies including…

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Rita Redberg and Roger Blumenthal Clash Over Statins for Primary Prevention in the Wall Street Journal

The debate over whether statins should be used for primary prevention moved to the Wall Street Journal with opposing perspectives from cardiologists Roger Blumenthal and Rita Redberg. Blumenthal argues that “there is a mountain of high-quality scientific evidence” to support the use of statins in people without known heart disease but “demonstrated to be at high…

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Study Examines Changes in Resting Heart Rate Over Time

Although resting heart rate (RHR) has been long known to be associated with cardiovascular risk, change in RHR over time has not been well studied. A new paper from Norway published in JAMA demonstrates that an increase in RHR over 10 years helps predict the risk of all-cause and ischemic heart disease (IHD) death. Javaid Nauman…

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