The medical profession would have us believe that medications are important in the effort to prevent diseases. We are advised to take an aspirin a day to ward off heart disease and stroke, and we are prescribed statins and blood pressure meds to lower the risk of heart disease and stroke.
From a wellness viewpoint, taking a drug to prevent a disease doesn’t make much sense. Any drug compromises your health. Does it make sense to harm your health, in order to prevent a disease? I would only use a drug if the risk of disease was very high, the drug was effective, and the benefits outweighed the risks.
Just how effective are drugs at preventing disease? A critical look can be revealing. The FDA reversed its recommendation for using aspirin to prevent heart disease and stroke, except for those patients who already have a condition such as atrial fibrillation.
According to the FDA website, “There are serious risks associated with the use of aspirin, including increased risk of bleeding in the stomach and brain.”
According to the medical evidence website The NNT, it appears that while a daily aspirin does nothing to reduce deaths from heart attack, it increases the likelihood of a bleeding type of stroke, as well as bleeding into the stomach and abdomen. Not a great record.
Let’s take a look at the number one killer of Americans — heart disease. The primary medical approach to prevent it is statin drugs. According to the CDC, 28 percent of adults over 40 were taking a statin in 2012, with the number going to 48 percent among those 75 and older. Drugs to control cholesterol levels (including statins) are the number one category of drugs sold in the US.
But according to the NNT website, statins only slightly reduce nonfatal heart attacks, and do not reduce fatalities at all. And for there to be a reduction of one nonfatal heart attack, over 100 patients have to take the drugs for five years. But the risk of side effects is a problem. Statins cause diabetes in about the same amount that they reduce nonfatal heart attacks — about one in 100 — but cause muscle damage in as many as one in 10.
Blood pressure drugs are only somewhat more effective at prevention. Again from the NNT website, only one in 67 patients who used them for five years benefitted, although one in 10 had side effects.
This translates to about 3 percent of patients who are helped by the drugs, and 10 percent who have some problems with them. Not great odds.
Compare these numbers to the Mediterranean diet. For every 61 people on the diet, there will be one less heart attack, compared to the standard American diet. Also, not one of the patients suffered any harm as a result of the diet (except for the stress of giving up whoopie pies).
This one in 61 compares favorably to one in 100 for statins, and one in 67 for blood pressure meds. In fact, in my experience, patients who eat a Mediterranean diet actually experience “side benefits” rather than side effects- weight loss, more energy, better sleep, etc.
If you are looking to prevent a stroke, there is nothing that comes close to living a healthy lifestyle. A Swedish study of 31,700 women compared the frequency of stroke to five lifestyle factors — a healthy diet, not smoking, limited alcohol use, exercising regularly and not being overweight. The women who had all five of these had a whopping 62 percent reduction in stroke; any one of them alone caused a 28 percent drop. And what side effects would be expected from these lifestyle changes? None that I can think of.
So to me there is just no comparison. Lifestyle changes are more effective, cheaper, and far safer than any drug to prevent the chronic diseases that are so prevalent in older people; and this is especially true of two leading causes of death and disability, heart attacks and stroke.
See you at the farmers market! I hear they are having a special on organic apples.
Dr. Michael Noonan practices chiropractic, chiropractic acupuncture and other wellness therapies in Old Town. He can be reached at firstname.lastname@example.org.