Statins Explained in 10 Minutes (by a cardiologist)

hello this is a response to the many requests I get to make a video about statins but this isn't a video about how statins work nor is an in-depth exploration of all aspects of the topic it's just my attempt to summarize the most important facts in as short and as accessible a video as possible so that you will end hopefully feeling more able to make an informed decision about whether statins are right for you or a loved one it's about understanding how we think about things that work now versus things that work over a long period of time like years or decades antibiotics opening a blocked artery defibrillating a patient reattaching a severed limb the effect of those things is obvious for anybody to see but taking a tablet now which doesn't make you feel any better may make you feel worse for a negative payoff I.E something doesn't happen in the future hopefully requires a completely different way of thinking which is quite counter-intuitive and frankly difficult if a Statin does its job properly you'll never feel any different but cardiovascular disease causes a third of all death it's the worldwide number one killer so we should be getting this right and not relying on hot takes and opinionated pundits I'm a cardiologist I work here in the UK where I receive exactly the same salary irrespective of what procedures I do or drugs I prescribe and I receive no money from the pharmaceutical industry at all the only gain or loss to be made here is to you not me I want to help anyone viewing achieve their best possible Health but my job is not to tell you nor my real life patients what to do my motivation for making this is because so many videos about Saturns online that I see both Pro and anti are either unclear or confusing or just plain wrong a quick tip actually about people with very strong views that you'll find online about anything health related just check if they're selling something like a book or a diet plan and then ask yourself if they are truly neutral this video is about statins for primary prevention that's people who've been told that they should take a Statin to prevent the first instance of something like a heart attack or a stroke so they're otherwise healthy they've they've not had a cardiovascular event before so if you've been told by or your loved ones have been told that they're at risk and so should start a Statin please keep watching this video is for you it's not a video about secondary prevention where you've already had a heart attack or a stroke in which case the evidence for a Statin preventing a second event is overwhelming and even the most vehement opponents of statins do not suggest otherwise so maybe your doctor has suggested statins you've heard them say it'll help you but maybe in a kind of vague way but then you've also heard other people say that the benefit is negligible you've heard about side effects and maybe you've experienced them yourself maybe you've tried a satin and then you've had to stop there are many hours worth of things to say about satids but if I had to boil down the core message to the simplest possible terms it goes something like this a newspaper article will state that statins only offer a small extension in life an average of seven months which in the context of a lifetime I agree sounds pretty unimpressive but that suggests statins give everyone a small kind of pointless benefit that it's evenly spread across everybody who takes them but that's not correct let's imagine a thousand people and give them all statins 700 of those people will die from non-cardiovascular Death so statins won't have any effect obviously if you die from cancer the fact that you took a Statin for 10 years beforehand is pretty irrelevant out of the 300 that do die of cardiovascular disease 200 will probably die around the same time that they would have without a Statin the remaining 100 so one-third of all cardiovascular deaths will live on average 70 months longer than they would have without statins that's six extra years of life or more depending on which figures you look at but because it's only a hundred out of that original 1000 we started with the overall average is 70 divided by 10 which comes out at that seven months so in other words for 10 people taking a Statin nine won't really get any significant benefit but one will get a huge benefit now having heard that you might say well I don't think I want to take one and that would be a reasonable position to adopt but just ask yourself if you'd enter Lottery with these odds in the UK the national lottery has about a one in 14 billion chance of winning the jackpot statins are a one in 10 chance of winning six to ten extra years of life which in my opinion is a windfall but okay you may say entering the lottery doesn't have side effects so let's consider them a very elegant study was published last year which had no funding from industry and this demonstrated and this is something that I have tried with my patients having got the idea from the internet actually in a slightly different context something called an N equals one study where you perform a little mini study in a specific patient in question rather than trying to apply population-based figures to a single person what the study did was give patients who have already suffered side effects to statins a Year's worth of bottles for four months they took a Statin for four months they took an identical dummy tablet they didn't know which was which and for four months they took nothing so 444 one year and what the study found was that there was no significant difference between the side effects experienced with the dummy tablet versus the Statin but there was a big difference between the months that they were taking tablets versus the months that they weren't in terms of side effects this is the nocebo effect genuine unpleasant effects from taking tablets even if the tablets are inactive just like Venom is the Spider-Man or why Luigi is to Luigi the nocebo is the placebo effects evil twin the side effects aren't caused by an inherent property of the Statin molecule but by taking tablets when you feel muscle pains you're not making that up but the results of this trial as well as dozens of others looking at side effects show that you can safely reintroduce statins and with reassurance side effects mostly go away which is what they observed in the trial so there are four pieces of information to take on board here let's summarize number one statins have a real beneficial effect but is a it's a small course correction that occurs over a long period of time over a year the reduction in Risk is small it's not a particularly useful way to look at a chronic disease but over 10 years over 20 years it can add up to a lot number two statins save millions of lives when applied to populations but if you ask me if it will save your life I can't tell you that and it's true to say that most people who take statins won't derive a benefit but number three some people who take statins will derive a huge benefit and number four side effects are absolutely real but they're not caused by any inherent property of statins they're caused by taking tablets the nocebo effect the decision is of course yours you are in charge of your health we as Medics are here to help provide information give advice but it's always your decision if you were my patient and this is pretty much exactly how I present the information to my own patients my job isn't to exert pressure on you but to try to communicate your risk and let you decide in in conjunction if you have a genetic predisposition to a high cholesterol a significantly abnormal cholesterol blood test your diabetic you've got a strong family history of heart disease you're already a healthy weight and you're eating well and exercising I would say that your risk profile is very high in spite of your best efforts so your benefit from a satin will correspondingly be higher but if you're a bit overweight sedentary eating junk food and maybe have got a little bit of high blood pressure I would say that your risk is more moderate and if you were not keen on starting a Statin straight away there are several other things we can address first which will almost certainly benefit you more but remember to present this as a dichotomy is false which I see happen a lot just because there are lifestyle factors to address it doesn't mean that statins shouldn't be taken or considered you can add the benefit of both but if you want to do one thing at a time that's okay too some people don't mind taking a Statin and have the view that every little helps some people try a Statin maybe switch to a different one and they don't agree with them and even after reassurance they want to stop some people say look doc I know it may help me but I really like not being on tablets I feel fine I'd rather not take a Statin these are all fine but as long as that decision is an informed one based on correct information not Facebook posts not quacks Hawking books and not YouTube videos and yes I realize the irony of saying that don't unquestionally unquestioningly accept any prescription it's always a two-way discussion between you and your doctor but equally don't believe the Legion of people online who say statins are poison and just tools to make money for big Pharma knowledge is power provided your sources are reliable I hope this has helped [Music] [Music]

Channel: Medlife Crisis

Views: 732,001

Keywords: Medlife Crisis, Medicine, Science, Education, Comedy, Doctor, Cardiology, Medical School, Biology, Rohin Francis, Surgery, Health, Humour, Statins, Cholesterol, Diet, Cardiovascular health, Lipids, Lipitor, Atorvastatin, Nutrition, Fat, Weight loss

Id: R6FGaR7vOHk

Length: 9min 55sec (595 seconds)

Published: Fri Apr 09 2021