One in 5 refuse statins

A big study — we’re talking more than 24,000 people over almost eight years — found that “roughly 20% of high-risk patients don’t take statins, even when their doctor recommends them.”

Yep, they refuse them, even when their lives are at risk. Women are more likely than men to skip statins — 20% more likely at first, but as men tend to change their minds, eventually women are 50% more likely to refuse to take statins. Not surprisingly, their cholesterol levels went up.

The big question: Why?

“I can only speculate,” said one of the co-authors (out of Brigham and Women’s Hospital), but the answer seems to be — wait for it — misinformation.

“So, for example, if you go to Amazon and you put the word ‘statins’ in the search box, the first things that come back are books with titles like: A Statin-Free Life, The Dark Side of Statins, The Truth About Statins: Risks and Alternatives to Cholesterol Lowering Drugs. I’m not picking these out. These are the top things that come back in my search.

“Then you go to Facebook — and, of course, everyone gets slightly different results — but what I get when I put the word ‘statins’ in the search box is lists of groups with titles like: Stopped Our Statins or No More Statins.”

Why pharma’s rep matters

We sometimes run stories about which pharmaceutical companies have the best reputation. It turns out that’s more than newsletter filler: When it comes to prescribers, reputation matters. (If you can’t read that online, click here to view a PDF copy.)

“Corporate brand matters — a lot,” wrote the folks at We, a branding consultancy, based on their survey of 1,000+ prescribers in six countries.

Two-thirds of HCPs are reluctant to prescribe or recommend a medication from a biotech/pharmaceutical company that does not have a good reputation.

Verapamil vs diabetes?

Patients given the calcium channel blocker within a month of being diagnosed with type 1 diabetes saw their insulin-producing pancreatic beta cells survive longer for up to a year.

To put it another way, verapamil delayed the expected decline in C-peptide production from 3 months after diagnosis of type 1 diabetes to 6 months after diagnosis.

Said one endocrinologist, considering its low cost and high safety, “verapamil should be a consideration for newly diagnosed patients with type 1 diabetes.”

Lawmakers know how to fight drug shortages

Six House Democrats have written a Strongly Worded Letter to the chair of the FDA asking him “to further its efforts to address the shortage of over-the-counter flu and cold medicines.”

Of course, the FDA doesn’t have the power to compel manufacturers to make products or speed up the pipeline. But the reps did have some, er … helpful suggestions:

1. Provide pharmacists with guidance on alternatives to pediatric ibuprofen and acetaminophen^*.
2. Encourage “heightened transparency from manufacturers regarding supply locations and demand”.
3. Proactively communicate with healthcare providers about the shortages.

Well those should solve the global manufacturing and distribution problem in days^†. Get on it, FDA!

^* “Temporarily loosen restrictions on pharmacy compounding” might actually have been a good suggestion.
^† This is sarcasm.

D is for “Don’t get dementia”

People who aren’t at high risk for dementia might reduce their risk even more by taking a vitamin D supplement.

Canadian and British researchers, looking at data on more than 12,000 US patients, found that those without dementia had a better chance of holding it off by taking vitamin D supplements.

It worked better for some people than others. Women, people not (yet) cognitively impaired, and those without the APOEe4 gene (which indicates a higher risk of Alzheimer’s) had the greatest benefit.

Don’t cut salt too much

There’s enough evidence out there to suggest that too much salt might be bad for your heart, so cutting down isn’t the worst idea.

Unless it is. It seems that heart failure patients who lower their salt intake too much can be risking death in a big way, as Creighton University researchers found.

Those who had a target of less than 2.5 grams of salt a day were 80% more likely to die during the study than those whose target was 2.5 grams a day or higher.

They did a meta-analysis of nine randomized, controlled trials from 2008–2022 totalling about 3,500 people with heart failure, in case you were wondering.

The Buddha was right: All things in moderation.

Short Takes

Elsewhere: Rocky Mountains edition

Colorado put a cap on insulin four years ago, and now it’s looking to make sure epinephrine is also affordable. “A proposed state law would cap out-of-pocket copays at $60 for a two-pack of epinephrine autoinjectors.”

Sour sweetener

Check your protein bars, lo-cal baking mixes, and anything sweet and sugar-free. If it’s got erythritol as an ingredient, you might want to think twice. According to the good folks at the Cleveland Clinic, too much in your blood leads to “an increased chance of cardiovascular events, like heart attack or stroke.”

All right, maybe worry a little

Granted, the Atlantic is the World’s Most Depressing Magazine™, but it does have a point. With bird flu spreading to mammals, it could be only a matter of time before it picks up a mutation that makes humans susceptible. In other words, “We Have a Mink Problem.”