In October 2013 the ABC aired the first part of its two-part edition of theCatalyst program titled The Heart of the Matter , criticising the use of statins (cholesterol-lowering drugs) in Australia.
Much has been written about this program, which has now been removed from the web.
The program has been the subject of an internal ABC investigation, a Media Watchprogram and numerous articles.
All have concluded that the program was misleading, biased and ignored the overwhelming evidence of benefit of statins, especially in people with established heart disease or those at high cardiovascular risk.
At the time of the airing of the episodes, the Heart Foundation warned that people would stop taking their medications and that, as a result, people could die.
The Heart Foundation urged people to talk to their doctors before stopping their medication.
It is only now that we have become aware of the full negative impact of these programs.
The conclusions presented in the Catalyst program were not supported by the Heart Foundation or the vast majority of the medical and scientific communities across the country and internationally.
It was with interest, then, that I read the report by A. Schaffer and colleagues published in this week’s Medical Journal of Australia, examining the impact of theCatalyst programs.
The authors used Pharmaceutical Benefits Scheme records to measure changes in weekly statin dispensing and to assess if there was a change in statin dispensing following the program.
The study covered 191,833 people, dispensed, on average, nearly 27,000 statins weekly. The authors found there was a temporary increase in discontinuation and a sustained decrease in overall statin dispensing.
Eight months after the program was aired, more than half a million fewer statins were dispensed, affecting more than 60,000 Australians.
The authors conclude that if the individuals affected remained off statins long-term,
it could result in between 1522 and 2900 preventable, and potentially fatal, major cardiovascular events.
They also write: “The subsequent retraction of the program may counteract some of the apparent negative impact, but this remains to be seen”.
Leon Simons, professor of medicine and director of the lipid research department at the University of NSW, says it directly and most effectively in commenting: “It was unfortunate that while the positive results of research showing the cardiovascular benefits of lipid therapy were often not considered newsworthy, the slightest hint that any medical therapy may have adverse effects leads to sensational headlines.”
The professor is right; we are living in a time when people are questioning the accepted wisdom and are taking a more active role in their health. They also have more information available to them than ever before.
But the science and facts can’t be ignored. Statins are the most commonly prescribed medicines in Australia. More than 27 per cent of people aged 50 and over are taking them.
The simplistic claim that this must be because they are “overprescribed” does not consider the fact that heart disease is Australia’s single biggest killer.
It accounts for the highest numbers of deaths in Australia (19,766 a year), while 600,000 Australians are living with ischaemic heart disease.
Large-scale, randomised trials have consistently shown a significant, beneficial effect of statins in reducing death and disability from cardiovascular disease, particularly in those who already have heart disease.
It is also important to realise that cholesterol is not the only risk factor for heart disease. Other risk factors include high blood pressure, smoking, diabetes, physical inactivity, and obesity.
These risk factors are well known and largely controllable, yet more than 60 per cent of Australians are overweight or obese, two out of three (66.9 per cent) Australians aged 15 years and over are either sedentary or have low levels of physical activity, and while smoking rates continue to fall overall, there is a worrying increase in smoking among young women.
There is a common perception among Australians that heart disease has been “fixed”, or can easily be treated by medications such as statins.
That is not true and much more research is required to guide future treatments for heart disease.
In the meantime it is important for individuals to be aware of their own risk of heart disease and to seek well-informed, balanced advice from their doctors.
This week’s research shows the power of the media in influencing public opinion.
It also clearly shows the consequences when the media get it wrong.
Cardiologist Jennifer Johns is national board president of the Heart Foundation.
