I've Treated 100K Hearts, Here's Where They Lied About Statins! — Transcript

Full transcript

1. 0:00They lied to you about statins. Not the
2. 0:02way you think. You've been told statins
3. 0:05wreck your muscles, steal your memory,
4. 0:07give you diabetes, cause cancer, and
5. 0:09only add a few days to your life. I'm a
6. 0:12board-certified cardiologist and
7. 0:14internist, and I've spent my career
8. 0:16treating hearts. And I'm going to show
9. 0:18you, one by one, why every one of those
10. 0:21claims falls apart when you look at the
11. 0:23actual research. Here are the 15 biggest
12. 0:26lies about statins and what the evidence
13. 0:28really says. Stay till the end because
14. 0:31number 15 is the one that matters most
15. 0:33if you're young. Lie number one, most
16. 0:36people get muscle pain and side effects
17. 0:38from statins. This is the big one. In
18. 0:412026, the Cholesterol Treatment
19. 0:43Trialists Collaboration published a
20. 0:45landmark study in The Lancet. They
21. 0:47looked at 23 double-blind randomized
22. 0:50trials with more than 154,000
23. 0:53people. Double-blind means nobody knew
24. 0:55who was getting the statin and who was
25. 0:57getting the sugar pill. Here's what they
26. 0:59found. Of the 66 side effects printed on
27. 1:02statin labels, 62 happened just as often
28. 1:05in the people taking the placebo. Memory
29. 1:07loss, depression, sexual problems,
30. 1:10kidney failure, same rate on the sugar
31. 1:12pill. The only ones that held up were
32. 1:14small. Liver blood test changes, mostly
33. 1:17at higher doses with no increase in
34. 1:19liver failure. A very small increase in
35. 1:22swelling and a slight increase in
36. 1:24protein in the urine that did not lead
37. 1:26to kidney damage. We already knew
38. 1:28statins can cause muscle symptoms, but
39. 1:30serious muscle problems are rare, and
40. 1:32most of the muscle pain people report
41. 1:34happens just as often on the placebo.
42. 1:36So, why do so many people feel bad on
43. 1:39statins? It's called the nocebo effect.
44. 1:42When you're told a pill will hurt you,
45. 1:44you feel every ache, and you blame the
46. 1:46pill. Lie number two, statins cause
47. 1:48dementia and memory loss. The opposite
48. 1:51is true. In a meta-analysis of about 5
49. 1:54million people, statin use was linked to
50. 1:57a 20% lower risk of dementia and a 32%
51. 2:01lower risk of Alzheimer's. And here's
52. 2:03something most people don't know. Your
53. 2:05brain makes its own cholesterol. The
54. 2:08cholesterol in your blood doesn't cross
55. 2:10into your brain. Lowering LDL in your
56. 2:12bloodstream doesn't starve your brain of
57. 2:14cholesterol.
58. 2:16Can a small number of people feel a bit
59. 2:18foggy on a statin? Yes. And if that's
60. 2:20you, tell your doctor. There are other
61. 2:22statins and other options. But statins
62. 2:25cause dementia is not what the data
63. 2:27shows. Lie number three. Statins give
64. 2:30you diabetes. Statins don't create
65. 2:33diabetes out of nothing. Type 2 diabetes
66. 2:36is largely genetic and a statin can't
67. 2:39change your genes. What a statin can do
68. 2:41is nudge your blood sugar up a little if
69. 2:43you're already insulin resistant and
70. 2:46push someone who's right on the edge
71. 2:47over the line. How big is that nudge? In
72. 2:50the Jupiter trial, A1C went from 5.8% to
73. 2:545.9%.
74. 2:56A tenth of a point. In that same trial,
75. 2:58vascular events dropped by 44%.
76. 3:01And if you have diabetes, you're in one
77. 3:03of the highest risk groups for heart
78. 3:05disease because diabetes is a heart
79. 3:07disease risk factor all by itself.
80. 3:09That's why the guidelines call for more
81. 3:11aggressive cholesterol lowering in
82. 3:13diabetes, not less. Lie number four.
83. 3:16Statins only lower your risk by 1%.
84. 3:19You'll hear people say statins only
85. 3:21reduce your absolute risk by about 1%.
86. 3:25That number comes from short-term
87. 3:26trials, but heart disease builds over
88. 3:29decades and so does the benefit of
89. 3:31lowering LDL. For every 1 mmol per
90. 3:34liter, about 39 mg per deciliter, that
91. 3:37you lower LDL, the drop in major
92. 3:40vascular events grows over time. About
93. 3:4312% in year one, 20% by year three, 23%
94. 3:47by year five, and 29% by year seven. The
95. 3:51longer you're on it, the bigger the
96. 3:53benefit. A five-year snapshot can't show
97. 3:56you a lifetime. Lie number five, statins
98. 3:59only add four days to your life. That
99. 4:02claim comes from one analysis of just 11
100. 4:05trials. Many used weaker statins like
101. 4:08pravastatin and simvastatin, followed
102. 4:10people for only two to six years, and
103. 4:12then projected that out over a whole
104. 4:14lifetime.
105. 4:15Now look at long-term follow-up. In
106. 4:18WOSCOPS, men who took pravastatin for
107. 4:20about five years were followed for 20
108. 4:22years. They had lower overall death,
109. 4:25lower cardiovascular death, and fewer
110. 4:27hospital stays for heart attacks. And
111. 4:30that benefit lasted long after they had
112. 4:32stopped the drug. Four days? That's not
113. 4:35what 20 years of data shows. Lie number
114. 4:37six, LDL doesn't cause heart disease.
115. 4:41It's just a harmless transport particle.
116. 4:43Yes, LDL carries cholesterol. That's its
117. 4:46job. But when there's too much of it,
118. 4:49LDL particles get trapped in the artery
119. 4:51wall and build plaque. The European
120. 4:53Atherosclerosis Society reviewed more
121. 4:55than 200 studies, more than 2 million
122. 4:58people, and over 150,000
123. 5:01cardiovascular events. Genetics, natural
124. 5:04experiments, population studies, and
125. 5:06randomized trials all point the same
126. 5:08way. The more LDL and the longer you
127. 5:11have it, the more heart disease. Every
128. 5:1339 mg drop in LDL means about a 22% drop
129. 5:17in major cardiovascular events over five
130. 5:20years. And for perspective, a newborn's
131. 5:23LDL is about 20 to 40. You don't need a
132. 5:26high LDL to be healthy. Lie number
133. 5:28seven, if you're metabolically healthy,
134. 5:31high LDL doesn't matter. This one is
135. 5:34popular right now. The idea is that if
136. 5:36your blood sugar, weight, and blood
137. 5:38pressure are perfect, your LDL doesn't
138. 5:40count. The PESA study looked at
139. 5:43middle-aged adults with no traditional
140. 5:45risk factors, and nearly half of these
141. 5:47perfectly healthy people already had
142. 5:49plaque in their arteries. LDL was the
143. 5:52strongest risk factor they could change.
144. 5:55In the cardia study, the more LDL young
145. 5:57adults were exposed to over the years,
146. 5:59the higher their heart disease risk
147. 6:01later on. And in a pooled analysis of
148. 6:03more than 36,000 young adults, an LDL of
149. 6:07100 or higher was linked to a 64% higher
150. 6:11risk of coronary heart disease.
151. 6:13Lifestyle matters. Insulin resistance
152. 6:16matters. But LDL matters, too. It's not
153. 6:19either or. Lie number eight. Your LDL is
154. 6:22normal, so you're safe.
155. 6:24Normal on a lab report means common. It
156. 6:27doesn't mean safe. In the pace study,
157. 6:30about 11% of people with an LDL between
158. 6:3360 and 70 had plaque. Between 150 and
159. 6:37160, it was 64%.
160. 6:39Every 10-point rise in LDL raised the
161. 6:42odds of plaque in multiple arteries by
162. 6:44about 18%. The safer zone for your
163. 6:47arteries is around 60, not the 100 to
164. 6:50130 most people are told is fine. Lie
165. 6:53number nine. Once you have plaque, it
166. 6:55can't be reversed.
167. 6:57In the GLA gov trial, people who got
168. 6:59their LDL down to about 37 saw their
169. 7:02plaque shrink compared with people who
170. 7:04stayed around 93 on a statin alone.
171. 7:07Below about 60 to 70, plaque can stop
172. 7:10growing. And below roughly 50 to 60, it
173. 7:13can start to regress.
174. 7:14That's why newer research, like the easy
175. 7:16pave trial, supports targets under 55
176. 7:19for people who already have heart
177. 7:21disease. Lie number 10. Supplements work
178. 7:24just as well as statins.
179. 7:26The Cleveland Clinic tested six popular
180. 7:28cholesterol supplements head-to-head.
181. 7:31Fish oil, garlic, cinnamon, red yeast
182. 7:33rice, and others against a placebo and a
183. 7:36low dose of rosuvastatin. Not one
184. 7:38supplement beat the placebo. Garlic
185. 7:41actually raised LDL a little.
186. 7:43Rosuvastatin at just 5 mg cut LDL by 37%
187. 7:49and had fewer side effects than the
188. 7:50supplements. If a supplement really
189. 7:53worked, someone would have turned it
190. 7:54into a drug a long time ago. Line number
191. 7:5711, statins cause cancer and low
192. 8:00cholesterol is dangerous. In the Women's
193. 8:02Health Initiative, more than 146,000
194. 8:06women were followed for almost 15 years.
195. 8:09Women taking statins had a 22% lower
196. 8:11risk of dying from cancer and a 20%
197. 8:14lower risk of dying from anything. So,
198. 8:17why do some studies show people with low
199. 8:18cholesterol dying sooner? Reverse
200. 8:21causality. Serious illnesses like cancer
201. 8:24drive cholesterol down. The illness
202. 8:26lowers the cholesterol, not the other
203. 8:28way around. When researchers studied 4.4
204. 8:31million veterans and properly adjusted
205. 8:33for this, higher cholesterol tracked
206. 8:35with more cardiovascular death, not
207. 8:37less. Line number 12, statins don't work
208. 8:41in women.
209. 8:42In JUPITER, women had a 46% reduction in
210. 8:45major cardiovascular events, about the
211. 8:48same as men. A meta-analysis of 174,000
212. 8:52patients found the same proportional
213. 8:54benefit in both sexes. The real problem
214. 8:56isn't that statins don't work in women,
215. 8:59it's that women are less likely to be
216. 9:00offered them, more likely to get a lower
217. 9:03dose, and more likely to stop. Line
218. 9:05number 13, you're too old for a statin.
219. 9:09The benefit shows up at every age we've
220. 9:11studied, including people over 75. In
221. 9:14trials of lipid lowering in people over
222. 9:1665, events dropped by about 25% overall.
223. 9:20It's never too late to start. Starting
224. 9:23earlier just gives you more. Line number
225. 9:2514, statins wreck your liver.
226. 9:28The Lancet analysis found liver enzyme
227. 9:30changes in a small number of people, but
228. 9:33no increase in liver failure. Mildly
229. 9:35elevated enzymes are not liver damage.
230. 9:38These changes are usually reversible and
231. 9:40cause no symptoms. And the guidelines
232. 9:42don't even recommend routine liver
233. 9:44testing for people on statins. Lie
234. 9:46number 15, you're too young to worry
235. 9:48about cholesterol. Wait until your risk
236. 9:51score is high.
237. 9:52This is the one I care about most. Your
238. 9:55risk comes from how much LDL your
239. 9:57arteries have been exposed to and for
240. 9:59how long. Think of it like pack years
241. 10:01for smokers. Years of exposure add up.
242. 10:04Those 10-year risk calculators are
243. 10:06driven mostly by age. So, almost every
244. 10:09young person comes back low risk even
245. 10:11with an LDL of 130 or higher. By the
246. 10:14time the score finally says treat, the
247. 10:16plaque has been building for decades. If
248. 10:19you're young and your LDL is high, don't
249. 10:21wait for a calculator to give you
250. 10:23permission. Lowering it early, even
251. 10:25modestly, gives you a far bigger
252. 10:27lifetime benefit than waiting and
253. 10:29treating hard later. So, yes, they lied
254. 10:32to you about statins. They told you they
255. 10:34were dangerous, useless, and something
256. 10:36to put off until you're older. The
257. 10:38research says statins are one of the
258. 10:40most studied, safest, and most effective
259. 10:42medicines we have. That doesn't mean
260. 10:45everyone needs one and it doesn't mean
261. 10:47lifestyle doesn't matter. Eat well,
262. 10:49move, sleep, don't smoke. But if your
263. 10:52LDL is high, talk to your doctor about
264. 10:54treating it and don't let fear make the
265. 10:56decision for you.
266. 10:58If you want to text me all day and all
267. 11:00night and go on Zoom with me live every
268. 11:03week, join my community. The link is
269. 11:05below.