Rapid Responses to:

FEATURE:
Malcolm Kendrick
Should women be offered cholesterol lowering drugs to prevent cardiovascular disease? No
BMJ 2007; 334: 983 [Full text]
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Rapid Responses published:

[Read Rapid Response] Informed consent?
Joan McClusky   (17 May 2007)
[Read Rapid Response] Statins decrease lifestyle changes
Sukhbindar S Sibia   (19 May 2007)

Informed consent? 17 May 2007
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Joan McClusky,
Medical writer
New York, NY 10003

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Re: Informed consent?

Malcolm Kendrick's take on the issue of offering statins to women to reduce cardiovascular risk--"no" due to lack of proven effectiveness-- might be supported further by an aspect of preventive medicine that is often overlooked--that of informed consent.

To give women drugs that many studies have shown to be of no benefit in reducing mortality or even coronary heart disease is--at best--a clinical trial. And positions itself in direct opposition to such advice as "don't get a broken leg fixed, you'll have a crook leg."

Before we start putting statins in the the public well, it might be a good idea to develop a simple patient sheet that explains what the overall findings are, the risks of side effects, other treatment alternatives, and let the patient decide. This would make a fascinating study, and could also do something to reduce the demands of the "worried well."

Competing interests: None declared

Statins decrease lifestyle changes 19 May 2007
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Sukhbindar S Sibia,
Consultant Physician
Sibia Medical Centre, B/XIX-568 A, Civil Lines, Ludhiana - 141001 India

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Re: Statins decrease lifestyle changes

It is difficult enough to motivate patients (and non patients) to undergo lifestyle changes for prevention of cardiac and many other diseases. Giving them Statins (to men or women) gives them another excuse to avoid the changes. The side effects of statins and other drugs are better known to the doctors than the patients. Most patients attribute the side effects of statins to decreased cholesterol and dont even report it to the attending physician - a dangerous trend. Like minimal invasive surgery it is time to move towards minimum intake medicines. Dr.Sibia, info@sssibia.com

Competing interests: None declared