Negative media reports on cholesterol-lowering drugs influence people to discontinue their use of these drugs, which in turn can increase deaths by heart attack, a new study has claimed. Even before publication the study has been criticized, however, in part for the lead author's conflicts of interest. Beyond the specific example investigated, the study implies that popular reporting on health matters can be powerful.
Statins, a class of drugs that inhibit the production of cholesterol, include the most profitable drug in the history of medicine. Unsurprisingly, pharmaceutical companies promote them heavily to doctors, although the biggest sellers are no longer under patent. This has led to questions about whether statins are over-prescribed.
Alongside a genuine scientific debate about the appropriate level of statin use sit criticisms from well outside the scientific mainstream. Often these come from people with a financial interest in far less scientifically verified treatments for heart conditions.
When these critics reach mass media, cardiovascular researchers often claim that they were given inadequate opportunities to respond. They fear patients will discontinue their statin intake based on a one-sided TV report, rather than a detailed discussion with their doctors. According to Professor Børge Nordestgaard of Copenhagen University Hospital, these concerns are justified.
In the European Heart Journal, Nordestgaard tracked people discontinuing the use of statins and compared this with news stories about statins. While exposure to positive media made people 8 percent less likely to discontinue their use of the drugs, each nationwide item of negative publicity increased the dropout rate by 9 percent. The findings are consistent with a smaller scale study conducted after an anti-statin report aired on Australian television.
Moreover, Nordestgaard argued, the consequences were serious. "People who stop statins early have a 26 percent increased risk of a heart attack and an 18 percent increased risk of dying from cardiovascular disease when compared to people who continue to use them,” he said in a statement. "We found that exposure to negative news stories about statins was linked to stopping statins early and explained two percent of all heart attacks and one percent of all deaths from cardiovascular disease associated with early discontinuation of statins."
Dr. Kailiash Chand, deputy chairman of the British Medical Association, has argued that consultancy fees and lecture payments from statin-producing pharmaceutical firms cast doubt on Nordestgaard's suitability to conduct the research. Nordestgaard acknowledged these payments in the paper, but his coauthor Dr. Sune Nielson claims to have “no financial or other conflicts of interest.” Chand is an outspoken critic of statin promotion, and told AAP: “In this study the bias is very apparent.”
Even statin proponents acknowledge they cause a wide array of side-effects, frequently including headaches and muscle pain, and less commonly, serious consequences such as pancreatitis. In some cases, such as for people at risk of diabetes, these outweigh the benefits. Other reported dangers are still uncertain.
Unfortunately, many negative reports on statins skip credible concerns to rely on sources without relevant qualifications or peer reviewed research.