Your Health: Should You Take Pills “Just in Case?”

Posted on November 22, 2013


So apparently, the number of US patients taking statins (drugs aimed at reducing cholesterol and preventing heart attack or stroke) is about to potentially double, thanks to some new guidelines from the American Heart Association and the American College of Cardiologists.  Melissa Healy’s article in the Los Angeles Times explains:  in a nutshell, the old guidelines called for a statin prescription for those patients who were judged to be at a 20% or higher probability of heart attack in the next decade.  the new guidelines recommend statins for those with as little as a 7.5% risk over the next decade.  In addition, the drugs are explicitly described as a stroke-prevention measure, extending the potential patient pool even farther.

In light of this, I am profoundly grateful to John D. Abramson and Rita F. Redberg for their article in the New York Times last week, “Don’t Give More Patients Statins.”  They point out that the actual study data does not support statin use in a “vastly expanded class of healthy Americans.”  Most important from my perch as an individual consumer and full-time real person:  I do not want to take drugs needlessly, wasting money, and worse: possibly suffering side effects that ruin my health rather than preserving it.

Such is the experience of my 90-year-old uncle.  He has low cholesterol and normal blood pressure.  He is remarkably fit and trim.  And yet, at a recent family reunion, he was complaining of dizziness, nausea and weakness.  It turned out that these were the side effects of a new statin prescription his doctor had insisted on “just to reduce the risk of stroke.”  Statistically, the only risk factor my uncle has is the mere fact that he has had 90 birthdays.  Perhaps the doctor looks at my uncle and sees a statistical probability that he could – could – have a stroke in the next 5 or 10 years.  What I see is someone already in the upper reaches of a normal human lifespan, but still healthy and independent.  If we want to talk statistics, how many more years do most 90-year-olds have left?  What are statins really buying for a healthy 90-year-old?  All they have bought him, so far as we can tell, has been a degradation in his quality of life.

Here’s Lila’s analysis of the situation.  Statistic: in an elderly patient, maybe statins might, possibly, maybe, prevent a stroke.  Fact:  statins make my uncle feel like crap.  Scientific?  No, but I know what choice I would make for myself.

Maybe we shouldn’t be surprised at the big new statin push.  We like to believe that there’s a pill for every ailment, or should be.  We reduce patients to mere statistical bundles and run them through flow charts, with too little deep thought given to individual circumstances or even to the patients’ wishes.

As one doctor told me not long ago, it seems that American medicine suffers from a philosophy of  “over-medicalizing everything.”  And the patients suffer the side effects.