Monday, August 16, 2010

DOES TWO WRONGS MAKE IT RIGHT. THE IDEA OF McSTATINS?

The August 15th issue of the American Journal of Cardiology ( the blue journal ), carried an article by the workers from London's Imperial College, entitled, " Can a statin neutralise the cardiovascular risk of unhealthy dietary choices." The authors, Dr Ferenczi et al, did a meta-analysis of 7 large randomised clinical trial of statins from the 80's, involving 42,848 ( even the number is auspices ) patients, to determine the degree by which statins can reduce cardiovascular risk, in terms of LDL-C reduction. They then calculated the cardiovascular risk of a 7 oz McBurger, and found that statins can neutralise the CV risk of a 7oz McBurger. So they concluded that we should encourage McDonalds to include a sachet of statins with every McBurger, so that after eating a McBurger, should our conscience prick us, we can consume the sachet of statins. Does it make sense to you?
This is almost like what some of my patients, and even some of my medical colleagues do. They eat all the fat pork, and crabs, and then pop in a tablet of statins.
It would appear that as a primary prevention strategy, the medical community has tried her best to discourage the consumption of unhealthy diet, exemplified by McDonalds and all the other fast foods, with some success, and they now wish to accept that some will never listen, and perhaps giving them some statins, will still help prevent heart disease. This is almost akin to the strategy of giving condoms to teenagers, or giving clean syringes to drug addicts. But, we are not there. Primary preventive programs have been quite successful. It is true that mortality and morbidity from heart disease in the West, have declined, since the 90's. What we are very concern is that in the 2000's, there is a growing incidence of obesity and diabetes, blamed on lack of exercise and also the fast food culture, or in our Malaysian context, " the hurry, curry, instant " culture. Quick meals ( curry ), to meet a dateline and stress. The instant ( everything now ) culture.
Statins have known side effects and the UK experiment of OTC sale of low dose simvastatin, has proven to be of limited success, not much impact of heart disease. To stretch the idea further, shall we put a small dose of aspirin in drinking water so that we can all have primary prevention with aspirin ( the data here has proven to be weak ). What happens is a kid drinks the water and develops a cerebral hemorrhage, or GIT bleed?
Does two wrongs make it right?


2 comments:

翊翊翊翊張瑜翊翊翊 said...

我們必須先有哭泣,才有歡笑;也必須先感到人生的悲哀,然後才感到人生的快樂。................................................................

文岳仲君 said...

與朋友在一起,分擔的痛苦是減半的痛苦,分享的快樂是加倍的快樂。......................................................................