As a fan, prescriber, and consumer of Pfizer’s blockbuster cholesterol-lowering statin drug Lipitor, I’ve long joked that in addition to increasing exercise and improving diet, patients with a high cholesterol should consider eating their hot fudge sundaes with a dose of Lipitor on top. This idea was meant as a joke, but now a London study published in the American Journal of Cardiology has taken the idea seriously. The authors analyzed study data from 42,800 patients and determined that while a 7-oz fast food cheeseburger and a small milkshake increases the risk of developing heart disease by 23%, on the other hand taking most statin drugs decreases the risk by 29%.
So, should fast food chains be handing out Lipitor with the burgers? Should there be an item on McDonald’s menu called a “McStatin”?
Statins are extremely useful. Lipitor is the world’s top selling branded drug, with almost $13 billion per year in sales. The widely publicized 2008 JUPITER trial would seem to confirm this widespread use. This study gave a lot of credence to what we doctors call “primary prevention,” a justification for giving statin drugs to patients before they develop heart disease.
So why not hand out a statin with every double cheeseburger? Well for one thing, these meds are mostly effective when they are taken on a regular basis, not episodically. Your best treatment for high cholesterol is to improve your diet and to exercise regularly, not to take more visits to a fast food joint and pop a pill while you are there.
Marc Siegel, MD, is an internist and professor of medicine at New York University and the author of False Alarm: The Truth About the Epidemic of Fear