Monday, December 21, 2015

This should kill off the Statin religion (but it won't, of course)

There have been many anecdotal reports of statins adversely affecting mental functioning, to the point where the upsurge of Alzheimer's in recent decades could be nothing more than an effect of widespread statin use.

Scientists, however, rightly pooh-pooh anecdotal reports unless they are backed up by survey or other evidence.  So a recent study (below) is of great interest.  And its findings are striking. Where epidemiological reports in the medical literature characteristically make a big deal out of tiny odds ratios -- with ratios just above one being typical -- the odds ratio for the effect of statins is 4.4!  A very strong result by epidemiological standards.  So statins definitely can and do wreck your memory. The critics of statins are resoundingly vindicated.

The authors below don't want to believe their results, of course, so clutch for comfort their finding that ALL lipid lowering drugs -- not just statins -- wreck your memory. Quite how that is a comfort quite eludes me, however.  I would have thought that the finding shows that we NEED our lipids in our brains and that ANY attempt to lower them is destructive.  And statin critics have often made that point. There is of course a LOT of cholesterol in  our brains. It belongs there.

So we might ask what good is something that protects your heart but wrecks your brain?  But the reality is even worse than that.  A recent very comprehensive study found that statins did not even protect your heart. You were just as likely to die of heart failure with or without them.  Here are the statistics:

Statins reduced the numbers of patients experiencing non-fatal HF hospitalization (1344/66 238 vs. 1498/66 330; RR 0.90, 95% confidence interval, CI 0.84–0.97) and the composite HF outcome (1234/57 734 vs. 1344/57 836; RR 0.92, 95% CI 0.85–0.99) but not HF death (213/57 734 vs. 220/57 836; RR 0.97, 95% CI 0.80–1.17).

And since statins have an acknowledged muscle-weakening effect and the heart is one big muscle, the use of statins to treat the heart was always deeply paradoxical!  Words rarely fail me but that went close.

Clearly, the prescribing of statins to the general public should cease forthwith.

Statin Therapy and Risk of Acute Memory Impairment

Brian L. Strom et al.


Importance:  Reports on the association between statins and memory impairment are inconsistent.

Objective:  To assess whether statin users show acute decline in memory compared with nonusers and with users of nonstatin lipid-lowering drugs (LLDs).

Design, Setting, and Participants:  Using The Health Improvement Network database during January 13, 1987, through December 16, 2013, a retrospective cohort study compared 482 543 statin users with 2 control groups: 482 543 matched nonusers of any LLDs and all 26 484 users of nonstatin LLDs. A case-crossover study of 68 028 patients with incident acute memory loss evaluated exposure to statins during the period immediately before the outcome vs 3 earlier periods. Analysis was conducted from July 7, 2013, through January 15, 2015.

Results:  When compared with matched nonusers of any LLDs (using odds ratio [95% CI]), a strong association was present between first exposure to statins and incident acute memory loss diagnosed within 30 days immediately following exposure (fully adjusted, 4.40; 3.01-6.41). This association was not reproduced in the comparison of statins vs nonstatin LLDs (fully adjusted, 1.03; 0.63-1.66) but was also present when comparing nonstatin LLDs with matched nonuser controls (adjusted, 3.60; 1.34-9.70). The case-crossover analysis showed little association.

Conclusions and Relevance:  Both statin and nonstatin LLDs were strongly associated with acute memory loss in the first 30 days following exposure in users compared with nonusers but not when compared with each other. Thus, either all LLDs cause acute memory loss regardless of drug class or the association is the result of detection bias rather than a causal association.



What, Exactly, Is a Fascist?

I have written on this at some length (e.g. here and here) but the notes below by Stephen Moore are an excellent update -- JR

It’s hard to find a self-respecting liberal these days who doesn’t denounce Donald Trump as “a fascist.” If you Google “fascist,” the first thing that pops up on the screen is a photo of Trump.

University professors, Democratic pundits and members of the media who don’t call him a fascist resort to over-the-top, sneering terms like “racist,” “repellent” and even “Nazi.” After Trump’s call for a moratorium on Muslim immigration, here are a few of the choice words from those tolerant people on the left:

“He is running for President as a fascist demagogue,” said Martin O'Malley, Democratic presidential candidate.

“Trump wants to literally write racism into our law books,” said Huma Abedin, aide to Democratic presidential hopeful Hillary Clinton.

“It is … entirely fair to call him a mendacious racist,” said Ben Smith, editor-in-chief, BuzzFeed.

“America’s modern Mussolini,” said Dana Milbank of The Washington Post.

“Trump is a proto-fascist, rather than an actual fascist. He has many ideas that are fascistic in nature,” wrote Peter Bergen, CNN’s national security analyst.

At the end of this sneering commentary, Bergen launched into a fascinating tutorial on what a fascist is. Here are several key characteristics of a fascist leader according to CNN:

    “The superiority of the leader’s instincts over abstract and universal reason.”

    “The belief of one group that it is the victim, justifying any action.”

    “The need for authority by natural leaders (always male) culminating in a national chief who alone is capable of incarnating the group’s destiny.”

Wait a minute. What modern politician best fits this description? Could it be Barack Obama, the Messiah, the chosen one, the man who holds political rallies with gothic columns in giant amphitheaters, who enters the stage as if he were a Greek god? Obama is the greatest demagogue of modern times, who convinced the vast electorate that they are “victims” and that the key to happiness and prosperity is to take from the rich: people, he says, who have way more wealth than they could possibly need.

Obama’s whole political success rests on identity politics — on persuading blacks, Hispanics, Jews, women, the disabled, gays, students, the poor and immigrants that they are victims of a vast American government conspiracy against them.

As for belief in the “superiority” of the leader’s powers “over reason,” Barack Obama, omnipotent, tells his followers that he has the capability of “healing the planet,” changing the earth’s weather pattern and stopping oceans from rising. He is promising miracles that require people to suspend all reason and believe that he can achieve the equivalent of Moses parting the oceans.

So just who is the “proto-fascist,” really?

“Liberal fascism,” as my friend Jonah Goldberg has aptly pointed out in his book of the same title, is the “collaboration of government, church, unions and interest groups to expand government. It is simply the liberal impulse for controlling the lives of others.” It is the religion of the left.

Ironically, the left intelligentsia that is accusing Trump of fascism are many of the same people in Hollywood who just made a movie celebrating the communists and fascists of the 1950s within their ranks — and portraying them sympathetically as blackballed victims rather than subversive supporters of the butchers who killed millions of Jews, blacks, gays, Christians and dissidents.

Many of the communists in Hollywood, not least of all Trumbo, the new movie’s hero, were avid supporters of Stalin and even remained so after his genocidal purges were well-documented. Even the Russians themselves have repudiated the savagery of Stalin — but not the American left.

So what really is fascism? The left, simplistically, has redefined the term to mean when massive numbers of voters support a conservative cause supported by the right and opposed by the left. If you oppose racial quotas or gun control, you are a fascist. If you support traditional marriage, you are a fascist. If you want to cut welfare benefits, you are a fascist. If you support Donald Trump, you are a fascist. By this definition liberals can’t be fascists because they are on a righteous cause.

But the real definition of a fascist is a leader who wants to use governmental power to suppress rights of individuals. It is the partnership of government and private industry for the “collective good.” Corporate cronyism is a classic form of fascism, which would include programs such as the Export Import Bank.

Fascism, communism, socialism, Nazism, progressivism are all just variations on this same theme. These “isms” all feed on the subjugation of freedom.

The left might want to engage in some introspection and ask why so many millions of Americans — many of whom enthusiastically voted for Obama — now agree with Trump. Are these suddenly terrible people? Have they been duped by a charismatic leader? More likely the answer is that an ever-shrinking number of Americans trust Obama to keep the dangerous Muslims out. People want, above all right now, to keep their families safe, and since Obama has no interest in real and effective terrorist screening, many Americans believe it’s best to keep them all out for now.

If middle-class American voters are so economically marginalized and so afraid, angry and distrustful of Washington that millions would throw their support behind a man routinely denounced as a dangerous Nazi/fascist, maybe the left might want to ask: Who made things so bad that it has come to this? Without Barack Obama’s full slate of failures and his eight years of polarizing politics, there could be no Donald Trump.



What's REALLY bothering Americans?

By Jonah Goldberg

"We have people across this country who are scared to death," New Jersey Gov. Chris Christie declared loudly at this week’s Republican presidential debate in Las Vegas.

Virtually the entire debate was based upon this premise. Which is understandable. Since the bloody Islamist attacks in Paris and San Bernardino, terrorism has shot up as the chief concern for most Americans, particularly Republican voters.

"For most of 2015, the country’s mood, and thus the presidential election, was defined by anger and the unevenness of the economic recovery," pollster Fred Yang of Hart Research Associates explained upon the release of the latest NBC News/Wall Street Journal poll. "Now that has abruptly changed to fear."

Only 34 percent approve of President Obama’s handling of the Islamic State, according to the poll, and more Americans are worried about terrorism than at any time since the aftermath of 9/11.

This abrupt change in the climate explains why Hillary Clinton is suddenly talking much tougher about terrorism and why the president is keen to get some good national security photo ops in before he leaves for vacation.

But I can’t shake the sense that the polls, politicians and my fellow pundits are mistaking a symptom for the disease.

We live in an anxious age. That anxiety runs like a river beneath the political landscape. Different news events tap into that river and release a geyser of outrage and fear. Right now, mostly on the right, it’s terrorism, but before that it was Mexicans illegally sneaking into our country. Sometime before that, there was the freak-out over Ebola and the administration’s aloofness about it.

One common explanation for the anxious age we are in is that the economy is undergoing a profound transformation that is leaving a lot of people on the sidelines. It seems obvious to me there’s a lot of merit to this explanation.

But I don’t think that economics explains everything. Seventy percent of Americans think the country is on the wrong track. Many of those people are doing just fine economically.

No, I think the missing piece of the puzzle is the fact that Americans — on the left and the right — think that the folks running the country have an agenda different from theirs. The left has a much richer vocabulary for such claims, given its ancient obsessions with greed and economic determinism. They see big corporations and the so-called "1 percent" pulling strings behind the scenes. (Watch literally any Bernie Sanders speech on YouTube to learn more.) Paranoia about the influence of big money in politics has inspired the Democratic front-runner to make revising the First Amendment a top priority.

But while there are a great many people on the right who also complain about crony capitalism and special interests, such concerns don’t get to the heart of the anxiety, at least not for conservatives.

Let’s go back to where we started. Christie says, "We have people across this country who are scared to death." No doubt that’s true. But for a great many of them, I suspect, the fear is not so much a fear of the Islamic State but a fear that our own government, starting with the president, just doesn’t take terrorism seriously. We now know he was very late in taking the Islamic State seriously.

I suspect most conservatives think that if America marshaled the sufficient will to defeat the Islamic State, we’d make short work of it. Obama has no interest in such an undertaking. He reserves his passion for attacking Republicans or pushing his other priorities, such as climate change, which persistently remains a very, very low priority for most Americans.

But the president himself is a symptom. The whole system seems to have lost its mind. That there’s even a debate about whether security officials should be allowed to look at the social media posts of immigrants is a sign that our bureaucrats have such open minds their brains have fallen out. We should have seen this coming five years ago, when we learned that Obama told the new head of NASA to make one of his top priorities outreach to the Muslim world.

Terrorism is a big concern, but this sense that the political system is unresponsive, unaccountable and operating on its own self-interested ideological agenda is bigger. It is the ur-complaint that explains everything from enduring outrage over the lies that greased Obamacare’s passage to fury over illegal immigration, disgust over corruption at the IRS and VA, the immortality of the Ex-Im Bank and countless other outrages du jour.

The failure of credible politicians to address this anxiety created an opportunity for Donald Trump. At least he’s willing to say Washington is stupid.



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1 comment:

Anonymous said...

Regarding: What, Exactly, Is a Fascist?

As I see it, Fascism is socialism on the march.

The essence of conservatism is individual freedom and accountability. And because conservatives can see ahead all the possibilities of freedom, including the possibility of losing freedom, so the attitude of conservatives toward change is cautious, for from the conservative perspective freedom can be lost.

The essence of leftism is individual conformity and societal uniformity (which they call equality), in other words, the oppression of individual freedom and accountability. And because leftists see in change the progression towards enforced conformity/equality, so the attitude of the left toward change is eager, for the change the left desires and envisages is towards the equality or levelling of people. And from the leftist perspective no matter how restrictive the legislative change, nothing can go wrong, for equality is the desire.

Fascism is the left rising up to exert itself forcefully towards the change it desires - enforced conformity.