The Movie “Cholesterol: The Great Bluff” Is an Exercise in Denialism

The movie “Cholesterol: The Great Bluff” claims that we have been lied to: cholesterol doesn’t cause heart disease and statins are harmful. It is biased and misleading. The people interviewed in the movie are denialists who don’t accept the clear evidence for the role of blood cholesterol levels and the benefits of statins. A correspondent

Most Patients Get No Benefit from Most Drugs

Some people are reluctant to take statins because they don’t benefit the majority of patients who take them. Actually, most drugs don’t benefit most of the patients who take them. Since we have no way of identifying those who will benefit, we are stuck treating the many to benefit the few. Most of these won’t

Statin Denialism

When Richard Dawkins was asked to justify his belief in the scientific method, he answered, “It works, bitches!”1 When the scientific evidence is compelling, one would have to be willfully perverse to reject it. But some people do; they reject findings that don’t fit with their ideology. We call them denialists. We have climate change

Statistics Done Wrong, And How To Do Better

Statistics is hard, often counterintuitive, and burdened with esoteric mathematical equations. Statistics classes can be boring and demanding; students might be tempted to call it “Sadistics.” Good statistics are essential to good research; unfortunately many scientists and even some statisticians are doing statistics wrong. Statistician Alex Reinhart has written a helpful book, Statistics Done Wrong: The

Statin Side Effects

A recent article in The New England Journal of Medicine by Andrew L. Mammen, MD, PhD, reviewed statin-associated myopathies. Reading his article prompted me to revisit the subject of statin side effects. It can no longer be disputed that statins statistically benefit patients who have cardiovascular disease or who are at high risk of cardiovascular disease. But there

Statins: The Impact of Negative Media Reports and the Risks of Discontinuing Treatment

The evidence is clear: statin drugs are effective in reducing the rate of heart attacks and death in people who have already had a heart attack as well as in people who are at high risk of having one. Some people refuse to believe that evidence; they are statin deniers, similar to the climate change deniers and AIDS deniers (and there are

New Cholesterol Guidelines

On November 15, the American College of Cardiology and the American Heart Association released an updated guideline for the use of statins to prevent and treat atherosclerotic cardiovascular disease (ASCVD). The full report is available online. It has already generated a lot of controversy. The news media have characterized it as a “huge departure” from previous

Red Yeast Rice and Cholesterol

While much of CAM is ridiculous or implausible, herbal remedies are an exception. Plants produce pharmacologically active substances; in fact, the science of pharmacology grew out of herbalism. Some herbal remedies have not been scientifically tested, but others have been tested and are clearly effective. Nevertheless, these are seldom if ever the best choice for treatment. One

An Owner’s Manual for the Heart

In writing about science-based medicine, we give a lot of attention to medicine that is not based on good science. We use bad examples to show why science is important and how it is frequently misapplied, misinterpreted, misreported, or even wholly rejected. It’s a pleasure, for a change, to write about a straightforward example of

Red Yeast Rice to Lower Cholesterol

The Medical Letter,  a highly respected source of reliable independent evaluations of drugs and therapeutics, has just published an evaluation of red yeast rice (Vol 51, Issue 1320, P 71-2, Sept 7, 2009). It has been widely promoted as a “natural” alternative to prescription medications for lowering blood LDL cholesterol levels. Studies have indeed shown