Overdosed America (57 page)

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The blood levels of all three kinds of cholesterol (total, LDL, and HDL) are expressed as “mg/dL,” meaning the number of milligrams of cholesterol present in one-tenth of a liter of serum (the clear liquid that remains after the cells have been removed from a blood sample).

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Less than a year after the review article was published, the
NEJM loosened its editorial policy
so that authors of review articles and editorials were allowed to have relationships, but not “significant” relationships, with the companies that could be affected by what they wrote.

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Serious cardiovascular complications include: sudden cardiac death, heart attack, stroke, unstable angina, transient ischemic attack, arterial blood clot, and venous blood clot.

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This much risk may seem hard to believe, but I urge you to check the FDA cardiology reviewer’s report posted on the FDA website.

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The dose for over-the-counter tablets is slightly lower than that for prescription tablets: 440 mg (in two tablets) compared with 500 mg twice daily.

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The United States ranks a lowly 24 among 39 developed countries on infant mortality. There is, however, a problem with international comparisons of infant mortality. Resuscitation is more likely to be attempted on extremely premature babies born in the United States than in many other countries. The extremely premature babies on whom resuscitation is unsuccessful are then counted as infant deaths, whereas they are counted as fetal deaths when resuscitation has not been attempted. A way around this problem is to look at mortality rates only after one day or one week of life. On that measure the
United States’ position improves only from 24 to 20
.

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Includes level of health (25 percent), distribution of health (25 percent), fairness of financial contribution (25 percent), level and distribution of responsiveness of health care system (25 percent).

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Based on health care spending in the United States being 42 percent higher than predicted by the median per-person expenditures in the other OECD countries (corrected for per-person GDP). Even 70 percent is an overstatement, though, because Americans’ health is inferior to the health of the citizens of the other OECD countries.

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Defibrillators for 1000 patients would cost $30 million to $40 million. A total of 308 months of life were saved among the 1000 patients over the last 11 months of the 20-month study. So each month of life extended by defibrillators in heart attack patients with weak hearts costs $100,000 or more, according to the company’s data.

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Sponsored by the National Heart, Lung, and Blood Institute, part of the U.S. National Institutes of Health.

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Brand names are Quinaglute, Norpace, and Pronestyl.

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More than half of adult Americans over the age of 35 have LDL cholesterol levels of 130 mg/dL or higher.

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The men who took Pravachol had 1.1 heart attacks per 100 per year; the men in the control group had 1.6. The relative risk reduction is 31 percent because 1.1 heart attacks per 100 men per year is 31 percent lower than 1.6 heart attacks per 100 men per year.

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LDL cholesterol levels averaged 150 mg/dL. HDL cholesterol levels averaged 36 and 40 mg/dL, respectively, for men and women.

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The cardiovascular death rate in the AFCAPS/TexCAPS study was 1.4 per 1000 people treated with a placebo each year compared with 1.0 per 1000 who were treated with a statin.

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Hormone replacement therapy was found to reduce LDL cholesterol significantly and increase HDL, but did not reduce the risk of heart attacks.

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T scores of lower than - 4, or lower than - 3 with a major risk factor for hip fracture.

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Even though this is a large increase in risk, the number of hip fractures was low, so the difference did not reach statistical significance.

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Though I have been critical of the connection of the AHA and many other organizations to the medical industry, they still may offer important information and advice (free of bias).

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As an unfortunate sign of the times, pregnant women and children must be cautious about mercury and PCB content of oily fish.

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The actual name of this legislation, signed into law by President George W. Bush on December 8, 2003, is the Medicare Prescription Drug Improvement and Modernization Act of 2003.

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The United Kingdom developed an agency to perform this function in 1999, the
National Institute for Clinical Excellence (NICE)
. Its role is defined as providing “patients, health professionals and the public with authoritative, robust, and reliable guidance on current ‘best practice.’” It does this with a budget of less than $30 million per year.