He showed me a full-page article from The Mail on Sunday, published three weeks ago. This reported that you are three times more likely to die if taking simvastatin than atorvastatin, so naturally William had stopped it. Oh dear! What the newspaper was reporting was a small study in one hospital which showed that the death rate among patients taking simvastatin in one three month period was three times the death rate among those taking atorvastatin in a different three month period.
I explained carefully that this was only one extremely small piece of research that doesn't contradict the large amount of research which shows that simvastatin and atorvastatin are both beneficial. I also explained that it was more dangerous not to take a statin at all. William listened courteously, but replied “it's no use doctor, I can't take them again. Even if I told you that I would, I couldn't bring myself to swallow them”.
So there you have it, the advice of the longstanding family GP counts for nothing against the facts, printed in black and white (and with a colour photograph too) in The Mail on Sunday. This is just a little vexing. I have no problem with journalists reporting facts, but evidence based medicine is a complex beastie and requires careful explanation to the general public. The MoS simply reported that simvastatin patients were more likely to die, and said that the doctors who did the research wanted NICE to reconsider their recommendations. True as far as it went, but extremely misleading out of context. In the case of my patient it has caused a lot of anxiety, and put him at extra risk of a heart attack because he stopped his statin three weeks ago. How many other patients have been similarly affected?
I have asked William to get his cholesterol level checked again and to see me shortly afterwards. We can then look at the figures and I will try to persuade him to restart his simvastatin. But I could end up in the awkward position where I have to offer William the expensive statin he doesn't need because he is too scared to take the cheap statin which would do him just as much good. Which is what The Mail on Sunday wants.
You cannot hope to bribe or twist
(thank God) the British journalist.
But seeing what the man will do
Unbribed, there's no occasion to.