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May 20, 2014

Times Thunderer Column. May 19, 2014
Filed under: Private Eye — Dr. Phil @ 11:46 am

There’s a better way to good health than popping a statin

Should you take medical advice from a surgeon? Much as I admire Sir Magdi Yacoub for his services to heart surgery, I strongly disagree with his paternalistic prescription that everyone over 40 should take a statin to lower their cholesterol. To be fair, Yacoub was trying to rebalance the debate after the British Medical Journal seriously over-egged the side effects of statins, and if those who need to take them stop doing so as a result of this scare it could worsen their heart disease. But we shouldn’t all start blindly popping the pills when we hit 40. A far better approach is to encourage each of us to take responsibility both for our health, and our healthcare. 80% of what can be done to reduce the risk of heart disease, liver disease, kidney disease, strokes and diabetes is down to our behaviour. Health care adds a comparatively modest 20%. Walking wherever and whenever we can, and a modest reduction in portion size are each far more powerful and effective at preventing disease for most of us than statins or blood pressure pills.

If you have established disease or are at high risk, drugs can be life saving but too often we use them as an excuse not to change our behaviour. ‘I’m on a statin or a blood pressure pill so I can eat or drink or smoke what I want.’ A statin may be right for you, but you should be part of that decision and understand the balance of risks and benefits as best you can, and have the right to stop it if you don’t get on with it. For all the heated arguments about side effects in academic journals, you as an individual are the best person to judge if you’re getting any. Many people get none at all, but some get more side effects from blood pressure or statin medication than symptoms from high blood pressure or high cholesterol. It’s your choice if you want to put up with them to reduce the risk to your heart, brain and kidneys.

I in 3 children born today will live to 100, 1 in 3 will develop diabetes and 1 in 3 will develop cancer. The challenge ahead is clear but the evidence for the benefits of mass medicalisation of people with no symptoms and low risk is lacking, and it can make them unhappy, passive, disempowered and dependent. It’s time for patients to be active. When all is said and done, we are each responsible for taking care of our health. And the rewards are huge. Healthy living can give you 20 more years of a healthy life. And it might even save the NHS.

Dr Phil Hammond is a GP turned hospital doctor, and a Vice President of the Patients Association.