Does Cholesterol Matter? A Conversation with John Carey of BusinessWeek

Every time I hear the sound of my recorded voice, I am reminded why I write so much.  I am still quite rough at the edges.  Nevertheless, I’ve had the courage to do another podcast, this time with John Carey, senior correspondent at BusinessWeek

J0433218_2Cholesterol and statins have been in the news a good deal lately.  Last week, I wrote about the study release about Vytorin, calling into question whether or not it was effective in preventing heart attacks.  The Forbes article headline was that "Study Shows Vytorin Has No Benefit" even though there are emerging studies that demonstrate or suggest other possibilities. 

The January 28, 2008 cover story of BusinessWeek ran a story the title of which raises the question without having the same conviction as the Forbes article.  It is by John Carey entitled "Do Cholesterol Drugs Do Any Good?"

It is a provocative article that does ask important questions.  In it, John Carey explores the efficacy claims of cholesterol drugs when viewed through the lens of the "Number Needed to Treat" (NNT) – which means how many people actually have to take a drug before there is someone who sees a benefit.

The article suggests that the way we traditionally evaluate and promote efficacy may be by means of  too blunt an instrument.   

On the other hand, also this month, data was released to show that deaths from heart attacks and stroke have plummeted in this country – as well as studies that speculate whether there is a role for statins in cancer prevention.  Coincident with that drop has been an uptake in the long-term use of statins among other things, such as improvements in treatment of heart attack and stroke patients. 

Few public health messages have been pounded into consumers heads more than that which says lower cholesterol lowers your risk for heart attack.  I invite you to listen to Mr. Carey as we discuss his article, the role of blockbuster drugs and what this might mean for the future.

And for communicators, whether you agree with the points raised in the article or not, the discussion raises new questions about how we talk about benefits and efficacy – questions that need to be answered.  Will, for example, NNT capture the role of statins, if any, in the longer term statistics (from 1999-2005) that show a 25% drop in heart attack and stroke deaths?  What should be included in the mix when we define benefit and when we define risk?

I had the opportunity, thanks to colleague Ben Finzel, to sit down with Mr. Carey and discuss just a few of the ramifications of these questions: 

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