alt Hacker News“New analysis shows statins have "minimal" benefits” - Maryanne Demasi, PhD - https://blog.maryannedemasi.com/p/new-analysis-shows-statins...
“We carried out a systematic review and meta-analysis of 21 statin trials involving 143,532 participants, using similar criteria to the CTT, and found no consistent relationship between lowering LDL-C with statins and death, heart attack or stroke.” - published in JAMA behind paywall, apparently
But you’re still wrong because she says “Statins are very effective at lowering LDL-C” which is literally something even if that doesn’t translate to less death.
Statin uses translate into less death, without any medical question or doubt. That particular systematic review is notorious for being utterly nonsensical. It's also notable that Maryanne Demasi is of...uh...of dubious professional credibility. Some of her papers have signs of scientific misconduct, including image duplication (yet with new labeling and analysis, indicating willful misconduct rather than simple error) and so on. She has various other questionable claims -- like mobile phones causing brain cancer -- and notably is a low carb advocate, which is something I will touch upon later.
"Our analysis showed that trial participants taking a statin for an average of 4.4 years, showed a 29% RRR in heart attacks, but the ARR was only 1.3%."
Over a 4.4 year average study length, there was already a 29% reduction of heart attack events over the control -- the relative risk. This analysis argues that since only some small subset actual had heart attacks -- again, during the short study period that averaged 4.4 years -- the "absolute" risk was low and therefore, negligible. "Minimal".
There are two enormous problems with this-
1) Most people given statins already have years to decades of CVD progress. Yet even still statins gave them that much of a relative risk reduction. That is an enormous relative risk reduction, clear evidence of the benefits. If you're a 30 year old with high LDL and are looking at the absolute risk reduction of a 55 year old who finally was prescribed statins, note that the possible benefit to you is much, much larger. It's like saying that someone who started brushing their teeth at 40 years old still has a pretty nasty set of chompers so therefore there is no benefit to brushing your teeth.
2) This is an incredibly small window to study the absolute risk.
3) The benefits of lower arterial plaque is much, much greater than just the worst outcomes of heart attack or stroke.
Again, Demasi et al are grifting off of the keto/low carb world, and she is a frequent speaker to this group. The low carb world often has a high saturated fat diet that sees their LDL massively rise, and there's a really desperate need to hope that LDL isn't bad for you. Dave Feldman recently has funded a lot of research on some subset of that group -- a group they call lean mass hyperresponders (LMHR), which are basically fit and active, healthy weight low-carb adherents -- and the premise was that in this subset LDL served a different purpose and wasn't bad. Only their most recent checkpoint was the CAC score of their participants rose disturbingly.
https://www.youtube.com/watch?v=A2hvausg9dg
https://www.youtube.com/watch?v=vRRD8nXEyGM
Better than statins would be changing habits and diets to control cholesterol. But the evidence that lower LDL = a better healthspan and lifespan is absolutely overwhelming. And for some people statins have bad side effects. But anyone believing they do nothing is massively misinformed.