[rgbgraph]

This conversation is going in circles.

Linked study equivocating on the overstatement of statin side-effects has the first author as a pharmaceutical consultant (you do not see this as a problem, I do).

2% ARR is meager in relation to lifestyle changes that can account for 3x-15x the in ARR compared to statins (you do not see this as a problem, I do).

Those are the facts. How you interpret them is subjective.

All of the money and manpower thrown into statins, could have been thrown into smoking cessation programs or preventing onset of type 2 diabetes. This is an opinion.

Saving 1 life for every 50 patients, at the cost of untold resources, instead of saving 6-30 for every 50 is myopic. This is an opinion.

Medical significance is an opinion. The determination of significance is a subjective interpretation. This is not a "this idea concurs with my sentiments, so I will say it is so. Period." This is math. Statistical interpretation is an opinion. The difference in statin efficacy vs. lifestyle changes is a quantifiable fact. The difference is 3-15x. To take a statistical finding without incorporating it into the larger context is poor practice, bordering on deception (the former is a fact, the latter is an opinion).

Here are 50 people aged 50 y.o. from the general population:

OOOOO_OOOOO | OOOOO_OOOOO | OOOOO_OOOOO | OOOOO_OOOOO | OOOOO_OOOOO

Here is the same group of people after 25 years (14 have died due to CVD-related mortality):

XXXXX_XXXXX | XXXXO_OOOOO | OOOOO_OOOOO | OOOOO_OOOOO | OOOOO_OOOOO

Here is the same group of people after 25 years, but they were on statins:

XXXXX_XXXXX | XXXOO_OOOOO | OOOOO_OOOOO | OOOOO_OOOOO | OOOOO_OOOOO

Here is the same group of people after 25 years, but instead of statins, the smokers ceased smoking:

XXXXX_XXXXX | OOOOO_OOOOO | OOOOO_OOOOO | OOOOO_OOOOO | OOOOO_OOOOO

Here is the same group of people after 25 years, but instead of a treatment, all of them developed diabetes:

XXXXX_XXXXX | XXXXX_XXXXX | XXXXX_XXXXX | XXXOO_OOOOO | OOOOO_OOOOO

[haldujai]

> at the cost of untold resources

Not going to argue the methodology but it seems like a starting point is $22,000-37000/QALY[0-1].

> instead of

This is a false dichotomy, guidelines all start with lifestyle modifications.

[0]https://jamanetwork.com/journals/jamacardiology/fullarticle/...

[1]https://jamanetwork.com/journals/jama/article-abstract/23964...