Just 2 weeks ago, one of my blog posts was dedicated to assessing the call from certain ‘experts’ that more younger women should be medicated with statins. What a shame these experts simply don’t have the data to support their position.
This week, I came across an interesting piece in the New York Times. The article questions the wisdom of women taking statins. It details some of the ‘under-whelming’ results of research demonstrating that statins don’t work as well for women as for men. In fact, statins have not been found to save women’s lives – even women deemed to be at high risk of cardiovascular issues such as heart attack and stroke.
One thing that caught my eye in this piece concerned comments made by Dr C. Noel Bairey Merz, director of the Barbra Streisand Women’s Heart Center in Los Angeles. According to Dr Bairey Merz,
We haven’t shown that we can prevent deaths, because we just haven’t enrolled enough women, and that’s a crime,
going on to add,
But the absence of data is not the same as negative data.
She’s right on the second point, but is she right on the first?
Well, she is completely correct when she concedes that statins have not been shown to reduce the risk of death in women. In a review of secondary prevention studies (studies of people who have had a previous heart attack or stroke who are generally at high risk of further problems), statin therapy was found not to reduce the risk of death in women .
Now, a potential reason for finding no benefit here is that the total number of women involved in these studies was not large enough to detect a difference, as Dr Bairey Merz alludes to. However, in this review, a total of more than 4,500 women were involved in the studies in which mortality was reported. If no mortality benefit was found in this quite large group, then this does suggest that if any mortality benefit exists, it’s going to be quite tiny.
So, what about Dr Bairey Merz’s, though, that “We haven’t shown that we can prevent deaths, because we just haven’t enrolled enough women…”? She’s not entitled to claim this, I think, for the simple reason she cannot possibly know that. This is not science, it is speculation. She may as well start her claim with the words “When I look into my crystal ball…”
The New York Times piece notes Dr Bairey Merz’s funding from several drug companies, and I suppose her speculation stated as fact may have something to do with these conflicts of interest.
Perhaps like many observers here, I am growing slightly weary of conflicted ‘opinion leaders’ making unfounded claims about statins or some other treatment. I’m half-considering devoting a section on this blog to such instances, and am inclined to call it ‘Experts who make shit up’.
1. Gutierrez J, et al. Statin Therapy in the Prevention of Recurrent Cardiovascular Events: A Sex-Based Meta-analysis. Arch Intern Med. 2012;172(12):909-919