Friday, 5 October 2012

Beta blockers to statins

Science News reports on a study suggesting that beta blockers fail to protect against heart attacks and strokes.

Commonly prescribed drugs called beta blockers fail to protect against heart attacks and strokes even while helping to control heart rate and blood pressure, researchers report in the Oct. 3 Journal of the American Medical Association. Beta blockers also didn’t lessen the odds of a heart-related death, in heart attack patients or others at risk, over a median follow-up of 44 months.

Beta blockers have been around for decades a treatment for heart attack patients, but if the results of this new study are sound, then two questions spring immediately to mind.
  1. Were beta blockers ever effective?
  2. Are statins also likely to be dismissed as ineffective in a few decades?
Yes there are already plenty of question marks against statins, but taking question 1 first, the Science News report says:-

Early studies had suggested that beta blockers prevented heart attacks, but many of those were short-term analyses, says study coauthor Sripal Bangalore, an interventional cardiologist at the New York University School of Medicine. He and an international team examined a registry of thousands of patients with either a history of heart attack, coronary artery disease or cardiac risk factors. When the researchers compared matching groups of people who differed mainly in whether they got beta blockers or not — nearly 22,000 participants in all — little or no difference emerged in rates of heart attacks, strokes or of dying from a cardiovascular cause.

So beta blockers don't protect against heart attacks, strokes or dying from cardiovascular causes. That of course implies quite strongly that they never did. This isn't necessarily so, because other modern factors could conceivably mitigate the risk that beta blockers previously mitigated. Well it's not impossible, but we are also told:-

In the group with only risk factors but no coronary artery disease, those getting beta blockers actually fared slightly worse than those not getting them, the data show.

I find it difficult to read reports such as this without coming over all cynical. Beta blockers were once supposed to be wonder drugs for those at risk of heart attacks. Now we are told they don't work with a distinct implication that they never did. Not only that, but we are still being nudged towards mass treatment by statins.

The Telegraph Aug 29th 2012
Everyone over 50 should consider taking statins to reduce the risk of a heart attack because the possible side effects have been exaggerated, a leading expert has said.

Strangely enough, statin drug patents have been expiring over the past few years, so mass treatment becomes much cheaper and more feasible because it can be based on generics.

What could possibly go wrong?


Anonymous said...

The trouble with pharma and most of the bio sciences is that one is looking for small statistical biasses. If one can save an additional 1% that is counted as a victory. But 1% is close to the 'noise' and with mass shifts in population susceptibilities over time, diet etc etc I should think that 1% is easily swallowed up - if you forgive the jest.

In need of cheer I looked in WHS for amusement. Spotted a railway mag "Beeching, the inside track" - very droll. Then a magazine for military modellers describing how to paint a model Tank in "50 shades of grey". What purpose a hobby unless to waste time.

I idly thumbed through 'U and non-U' last night and smiled again at 'Phone for the Fish Knives'. The poem is easily found but not so the inestimable Osbert Lancaster's cartoon that goes with it. Anyone know where it can be found on the WEB?

A K Haart said...

Roger - you are right about the pharma stats which many suspect are optimistic to say the least.

I don't know where to find your Lancaster cartoon unfortunately. I have a few P G Wodehouse books where he supplied a cartoon for the dustjacket. Very apt for Wodehouse.

Weekend Yachtsman said...

Half an aspirin a day is the only worthwhile mass medication for heart and vascular problems.

But that's a generic drug widely and cheaply availabe otc, so nobody official is likely to recommend it - no freebies there.

Thud said...

I'm with yachtsman on this.

A K Haart said...

WY and Thud - my father took aspirin for years and lived to 92 in spite of having smoked for decades, drinking like a fish and eating lots of red meat, so you may well be right.

James Higham said...

Shall avoid all of them, especially those officially recommended.

A K Haart said...

James - I do too, mainly because it's all so general - they don't me.

Margaret said...

That means statin drugs are not effective or because statins side effects are scary that's why many people doesn't want to use it.