Although they don\u2019t know who they are, 11 million Americans awakened last week as victims of a new disease, the dreaded \u201cstatin deficiency disorder,\u201d or SDD. It\u2019s not easy to diagnose because there are no symptoms. Even the lab test once closely linked to the word \u201cstatin\u201d\u2014cholesterol measuring–may miss SDD. In fact, with no symptoms and no positive test results, you might need the expertise of Dr. House.<\/p>\n\n\n\n
Here\u2019s an overview of the report, including a link to the apparently inoperative online screening guide.<\/p>\n\n\n\n
The cure for SDD is, of course, as close as your drugstore, that cheerless building at the corner of Happy and Healthy. The same location is also the neighborhood\u2019s prime outlet for cigarettes, liquor, salty snacks, and endless bags of candy. Way in the back, though, her head peering over a high countertop, is your statin distributor. She\u2019s taking her orders from the man<\/i> via phone or on a scrap of paper. Just swallow one statin daily and your SDD is history.<\/p>\n\n\n\n
In fact, so prevalent is SDD that some researchers have suggested statins be made available over the counter and be taken by everyone over 21 along with a tiny heart-saver aspirin. For convenience, bags of statins could be displayed at the checkout counter. (\u201cLet me have a lottery ticket, a TV Guide, two Kit-Kats, a pack of Marlboro lights, a half pint of peppermint schnapps, and a small bag of Lipitor.\u201d)<\/p>\n\n\n\n
The New York Times (always a font of useful health information) expresses the situation in a comic strip<\/a> that should be reprinted repeatedly until the travesty of pharmaceutical self-interest finally sinks in. Clearly, wiping out our national epidemic of SDD isn\u2019t the same as eliminating AIDS or curing cancer. But I guess we should start somewhere.<\/p>\n\n\n\n Lest you worry you\u2019re a walking time bomb, your SDD ticking away, here\u2019s what happened last week. To great fanfare, an immense report (85 pages, to be exact) was jointly released in the US and Europe by the American Heart Association (AHA) and the American College of Cardiologists (ACC). To condense it into a two or three sentences (not a great challenge, by the way), the report identifies four major groups of people who should receive statin drugs to lower their cholesterol.<\/p>\n\n\n\n Of these, we knew the first three already:<\/p>\n\n\n\n (1) People with known coronary heart disease (including those with angina pectoris), people who have already had a heart attack, as well as patients after coronary angioplasty, a stent insertion, or coronary bypass grafts.<\/p>\n\n\n\n (2) People with (bad) LDL cholesterol of 190 or greater.<\/p>\n\n\n\n (3) Those between ages 40 and 75 who have diabetes.<\/p>\n\n\n\n It\u2019s the fourth group that causing controversy: The risk factors involved in making the calculation are all the usual suspects: high blood pressure, obesity, smoking, diabetes, inactivity, total cholesterol, race, age, and gender. Researchers are perfectly willing for you to try to make the lifestyle changes needed to reverse the first six of these, but they assume you won\u2019t. And since you\u2019re not going to get off your duff and toss out the Marlboros and chicken-fried steak, they suggest you ask your doctor for a statin.<\/p>\n\n\n\n Of course, the real beneficiary of this report is the pharmaceutical industry, with a potential 11 million new customers in the US alone. Also\u2014and please try not to think about this too much–both the ACC and the AHA as well as a majority of the researchers listed as authors of the report are all beneficiaries of the industry\u2019s generous financial largesse<\/span>.<\/p>\n\n\n\n You might be surprised to learn that an indirect beneficiary of SDD treatment is the health insurance industry. They\u2019d much rather cover the cost of generic statins (at pennies a day) than pay for some serious preventive medicine like nutritional counseling or fitness training. And what they\u2019d really hate to do is pay for the genetic test I described last week (Corus CAD), which can show those diagnosed with SDD if they really are at risk for heart disease.<\/p>\n\n\n\n One major objection to treating SDD is that doing so overly simplifies more complex health issues facing us all. Basically, we\u2019re using a potentially harmful drug (for some people, at least) to cover our national and individual failures to acknowledge that cigarettes still exist, food can be disgustingly unhealthy, and our children are getting fatter and sicker.<\/p>\n\n\n\n Instead, we\u2019re inclined to do as an old friend of mine (not a patient) does when we go out to eat together, ordering his creme brulee, popping a Crestor, and giving me the sly wink that says he\u2019s covered himself, healthwise.<\/p>\n\n\n\n To some extent, if you\u2019ve been diagnosed with statin deficiency disorder and you\u2019re leaving your doctor\u2019s office with a prescription in hand you\u2019ve shirked some fundamental responsibilities and placed blind trust in the pharmaceutical industry. Let\u2019s face facts: behavioral changes can make the vast majority of statin prescriptions irrelevant. That\u2019s right, and in fact a second study that\u2019s certainly as important as the statin study was virtually ignored by the media.<\/p>\n\n\n\n
(4) \u201cAnyone between age 40 and 75 with an estimate risk of 7.5% of developing heart disease over ten years.\u201d The report supplies formulas for calculating 10-year risks, but (not unlike the online insurance exchanges) I couldn\u2019t get the system to work properly. Maybe you can.<\/p>\n\n\n\nBought by Big Pharma?<\/b><\/h3>\n\n\n\n
Have you been diagnosed with SDD?<\/b> <\/h3>\n\n\n\n