Dr. Aseem Malhotra

And subgroup analysis found, so these are people with statins who either were high risk of a heart attack or had a heart attack.

In the patients in the trials that had normal triglycerides and HDL, no benefit at all from statins.

Think about that.

So if you're triglycerides, urination, we're good.

Even people who've had a heart attack, there was no benefit from the statin at all, which fits with what you just said.

And of course, we haven't even talked about side effects, and that's another issue, right?

So if you look at, to try and explain why there's no reduction in cardiovascular mortality, even if we accept a four-day increase over five years in high-risk patients,

One of my explanations is this.

In the real world, at least 50% of patients prescribed statins, even in high-risk groups, will stop taking it within a couple of years.

And when you do surveys, most of them say they felt they got side effects.

Muscle fatigue, muscle pain, brain fog, erectile dysfunction, and how prevalent... Oh, that's a big one.

Well, how prevalent is that?

And you look at the data and it's mixed, but anything from, in my experience, anything from 20 to 50% of patients at some point, I've had patients who took statins for 20 years and didn't get side effects for 20 years.

And then they got side effects and it gets better when you stop the statin.

So they're very prevalent.

I wouldn't say they were serious or life-threatening, but the question I ask the patient always is,

Does this interfere with your quality of life?

Right.

And it's a very simple, you know, that as a person, it's a very subjective answer.

Yes or no.