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[Guest guest]

Drugging Ourselves to Death

The other day, my friend came home from the doctor with a cholesterol

reading of

220 and a prescription for Lipitor. Deborah is 36, exercises like a

demon, is in

great shape, eats a healthful Mediterranean diet, has no heart disease

in her

family and doesn't smoke. But her doctor read her the riot act -- she

left his

office convinced that the only thing standing between her and an

imminent heart

attack was this little pill.

What's wrong with this picture? Why does it seem that so many people

(doctors

and patients alike) believe that drugs are the answer to all our health

problems? The statistics after all are dismal -- health-care spending

has gone

up by 73% over the past five years. We're now spending more than twice

as much

per person as the 21 other industrialized countries, but we are last

in healthy

life expectancy.

What gives? To find out more, I interviewed Harvard professor of

medicine

Abramson, MD, author of Overdosed America: The Broken Promise of American

Medicine (Harper Perennial). Dr. Abramson believes that health care in

America

is going in the wrong direction, and that much of the reason has to do

with the

drug companies.

" FREE " EDUCATION

" The first thing people can do to improve their health and protect

themselves

from distorted health care is to understand that information about

drugs and

health is being brought to them and to the doctors by the drug companies,

because of its commercial value, " Dr. Abramson told me. " The

fundamental purpose

of that information is to improve corporate profits, not to improve

our health. "

Dr. Abramson is hardly saying that all drugs are useless. He simply

believes

that many are way overprescribed and that the focus on specific

measures, such

as high cholesterol, deprives doctors of a real opportunity to

dialogue with

their patients about practices that have been repeatedly shown in

research to

improve health and reduce risk for heart disease and other killers. In

many

cases, such practices are far better and cheaper than drugs.

THE ODD CASE OF STATINS

" Look, " Dr. Abramson told me, " there's not a single randomized

controlled study

that shows that statin drugs (i.e., Lipitor and Zocor) decrease the

risk for

heart disease or improve the health of women that don't already have heart

disease. But consider this -- there are five behaviors that produce an

astonishing 83% reduction in the incidence of cardiovascular disease

in women,

yet only 3% of American women do these five basic things. I think that

concentrating on cholesterol reduction is very misplaced, and is

largely fueled

by drug company marketing. "

The five behaviors that reduce the risk for cardiovascular disease by

83% are...

1. Eat a healthy Mediterranean diet (olive oil, fish, fruits,

vegetables, whole

grains). For more on the Mediterranean diet, see Daily Health News,

January 13,

2005.

2. Exercise regularly.

3. Don't smoke.

4. Consume alcohol only in moderation.

5. Maintain a healthy body weight.

Dr. Abramson continued, " The impression we get from the media is that

we need to

depend on expensive new technologies to be healthy when in fact most

of our

health is determined by how we live our lives. And that is a tremendously

liberating concept. There are things we can control right now that

will dwarf

the health benefits of most of the drugs we're being sold left and right. "

To beat the drums on cholesterol and heart disease a little longer...

a recent

article in the Journal of the American Medical Association on a study that

followed 7,300 women for 31 years showed that the overall contribution

of high

cholesterol to mortality is zero. " It had zero effect on mortality and

it did

not make a significant contribution to heart disease, " Dr. Abramson

told me.

RESEARCH COMPARISONS

Then why are statin drugs pushed so relentlessly? " Let's take a study like

WOSCOP (a famous study used to support the use of statin drugs). They used

high-risk men -- almost half of these men smoked and 8% already had

vascular

disease. Using a statin drug, they got a 31% reduction in heart

disease, which

translates to one death prevented for every 100 men treated over

five-and-a-half

years. Fair enough. But look at what happened in the LYON Diet Heart

Study,

which studied people who had already had a heart attack. Instead of

giving any

drugs, they just gave diet advice: One half was counseled to eat a

Mediterranean

diet, the other half to eat a prudent post-heart attack diet -- one

that is low

in fat and cholesterol. The Mediterranean diet was three times more

effective

than the prudent diet at reducing heart disease, and two times as

effective in

reducing death. And that happened even though cholesterol levels

stayed the

same! " Dietary modification worked far better than the statins.

Dr. Abramson also said that the women in the Nurses Health Study

showed the very

same 31% reduction in heart disease just by eating fish once a week

that the

high-risk men in the WOSCOP study got by going on drugs.

The point isn't that drugs are " bad. " The point is that focusing

exclusively on

cholesterol numbers squanders an important opportunity for doctors to

help their

patients by giving them lifestyle advice that makes far more of a

difference to

their health with no side effects than bringing down cholesterol with

medications.

IT'S NOT JUST CHOLESTEROL

Dr. Abramson and I talked a lot about the use of cholesterol-lowering

medication

since it is such a prominent example of excessive drug use. However,

according

to Dr. Abramson, stroke, heart disease, diabetes, osteoporosis,

depression, lung

disease and breast cancer all respond powerfully to lifestyle

interventions, yet

the cost and frequency of drug usage to treat these issues is also

skyrocketing.

" We know how to prevent about 70% of illness, " Dr. Abramson concluded.

" We ought

to be focusing on the things we can do right now in our lives to

accomplish that

rather than focusing on what expensive drug we've been told we need to

take.

Those drugs don't work nearly as well as the lifestyle choices. "

Plus, the lifestyle choices are free and carry no side effects. Oh,

there's one

possible side effect: Reduced profits at the drug companies. Oh well.

Be well,

Carole

Bottom Line's Daily Health News