Comments on: The Vytorin Saga Continues: Krumholz Strikes Back

By: Justice in Michigan

Justice in Michigan — Thu, 03 Apr 2008 21:02:09 +0000

One reference, which can perhaps rightfully be considered biased because it comes from Ornish himself. But it has interesting data on compliance with statins.

“Statins and the Soul of Medicine,” The American Journal of Cardiology Vol. 89 June 1, 2002.

As O makes clear, he is not “anti-statin.”

By: Justice in Michigan

Justice in Michigan — Thu, 03 Apr 2008 20:51:05 +0000

Actually, there hqfe been some pretty good studies (sorry I don’t have references) that suggestcompliance with diet/lifestyle about the same as pill-taking, and some about statins in particular. After about a year, well over 50% have stopped medications.

Part of the variation concerns the particular diet/lifestyle program - how integrated and structured it is, for example, as compared with “go out and lose some weight, Sweetie.” Whatever else one says (I have my own questions), programs like Ornish work well for a number of people because they are total “conversion” experiences - a structured immersion - as compared with a bit of this and a bit of that.

By: Abby Normal

Abby Normal — Thu, 03 Apr 2008 19:08:19 +0000

Not to mention that patients are notoriously noncompliant with lifestyle changes, which is why they end up on statins “after diet and exercise don’t work,” as they say in the DTC ads.

By: Paul

Paul — Thu, 03 Apr 2008 18:59:00 +0000

I would rather do both. get benefit from exercise and diet, and get clinical benefit from further lowering my elevated cholesterol.

By: david egilman

david egilman — Thu, 03 Apr 2008 17:40:20 +0000

right answer wrong question

exercise etc. makes you live longer with the numbers you have.

By: BNET Intercom mobile edition

BNET Intercom mobile edition — Thu, 03 Apr 2008 16:52:03 +0000

[...] And now, the backlash to the backlash, as Yale professor and Vytorin critic Harlan Krumholz ably defends himself against snide remarks from Schering CEO Fred Hassan at [...]

By: Paul

Paul — Thu, 03 Apr 2008 15:47:07 +0000

I beg to disagree, John. The best studies of STRICT diet and exercise have showed no more than a 12% reduction in LDL (and even that was not sustainable) which is totally inadequate for someone with a sufficiently elevated LDL. If you have an LDL of 200, bringing it down to 180 does nothing for your risk!

Your recommendation makes perfect sense for those with normal to mildly elevated cholesterol. Which are not the ones taking the statins and other drugs.

Like it or not many of these drugs work. And like it or not, there is study after study that proves they lower risk of disease and death.

By: John Mack

John Mack — Thu, 03 Apr 2008 11:17:39 +0000

What’s getting lost in the debate about Vytorin vs. statins is the fact that a regimen of diet and exercise is probably the best treatment option that physicians can recommend to their patients rather that “turn[ing] back to statins.”