16 May 2014
It is difficult to remember any time in the past when the British Medical Journal has withdrawn information in any articles it has published and yet this has now happened in the case of two articles on statins. It turns out that two articles both quoted side effects risks for statins about 20 times the real figure.
It is all too easy to dismiss this as a little hiccough on the part of Drs Abramson and Malhotra, the authors of the offending articles.
But let’s face it, statins are an emotive subject anyway. Many newspaper editors reading the articles would seize the opportunity to publish scare stories about drugs which prevent thousands of heart attacks and strokes every year.
About 7,000,000 people in the United Kingdom take statins to prevent heart attacks. Of these, about 4,700,000 have already had a heart attack or have angina while the remainder are at risk of having one. How many of these would stop taking their statin because they saw in the press that they had a 20% risk of developing muscular problems or diabetes?
Let’s be charitable and guesstimate at 2%. That’s one in 50. It could be much more than that.
We can work out the effect by reversing the well-documented Numbers Needed to Treat (NNT). This figure calculates the number of people who have to take a treatment in order to prevent one serious problem over a period of ten years. For coronary heart disease, these are about 30 if you have already had a heart attack and 120 if you have not.
Making the calculations means that, if 2% of people currently taking statins stop taking them, about 3,500 people will not be alive after ten years who would have been had they continued to take statins. These are not incontrovertible figures but are intended to give a ball-park figure for just what is at stake when experts make misleading statements and the media publicise them.
Are you one of the 3,500? Or are you, as a doctor or nurse, advising people to stop taking statins when they would benefit from them?
In my experience, statins are actually quite remarkable for the lack of problems that they cause in people. Of course, coal-face experience does not count as evidence. But something published in the British Medical Journal should.