I just looked at Dr. Graveline's web page. On it he says, "From the titles of the articles and books I have written, I can understand the concern that I may be anti-statin. Nothing could be further from the truth. Statins' anti-inflammatory action is the most effective treatment there is for atherosclerosis and lowering of cardiovascular risk in high risk individuals. "
The JUPITOR study treated people over 50 who had high LDL and an elevated hsCRP, which is an inflammatory marker. It showed statins to be effective. Dr. Gaveline and some others believe elevated cholesterol, even LDL, is not a risk factor for cardiovascular disease. Inflammation is the cause. While most experts agree that inflammation is a risk factor, there is ample evidence that LDL is associated with cardiovascular disease, so Dr. Gravelin, etc. represent a distinctly minority opinion. I don't find his evidence very convincing.
I think it is still being sorted out who benefits from statins and who does not. It is pretty clear that those who fit the JUPITER criteria do, and that those with multiple risk factors (yes, diabetes is an independent risk factor) not fully controlled by other means do also. To state that statins are not clinically useful is incorrect.
Considering he claims statins gave him amnesia, his take on statins is not positive.
The real issue with statin therapy is that for the first time doctors are advocating a relatively dangerous drug for patients who are not sick on a huge scale.
Wednesday, 10 June 2009
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