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Audio Catalyst presenter defends program questioning heart disease-cholesterol links

Peter Lloyd

Tonight the second part of a Catalyst special program goes to air with the claim that anti-cholesterol medication called statins are massively overprescribed and that can, instead, do serious harm to the health of people taking them. The National Heart Foundation says it has serious concerns about the conclusions in Catalyst and is urging people not to change their diet or medication until they speak to their GP.


PETER LLOYD: As we've been reporting this week, there's been a backlash against the ABC medical science program Catalyst for a two-part special that questions the scientific evidence linking cholesterol to heart disease.

Last week, Catalyst described as one of the biggest myths of medical history the claim that saturated fats and cholesterol causes heart attacks.

Tonight, the second part of that special goes to air with the claim that anti-cholesterol medication called statins is a massively over-prescribed drug that has no guarantee of reducing heart attack and that can, instead, do serious harm to the health of people taking them.

The National Heart Foundation says it has serious concerns about the conclusions in Catalyst. In a statement, the charity is urging people not to change their diet or their medication until they speak to their GP.

The presenter of Catalyst is Dr Maryanne Demasi.

First, let's recap what Catalyst said about cholesterol last week: that the cholesterol theory of heart disease is based on a medical myth.

MARYANNE DEMASI: There's plenty of evidence in the literature to suggest that cholesterol is not the driving factor in heart disease. I felt it was important to highlight a lot of the literature that contradicts this hypothesis.

We know that high cholesterol can correlate with higher risk of heart disease but that doesn't necessarily mean it's a causation of heart disease. I know that there's been a strong emphasis on diet to lower cholesterol, to lower the risk of heart disease by lowering saturated fats, but we can see from the actual studies that have been done that they've been relatively futile.

PETER LLOYD: During our discussion on this program last week, you said these were alternative views. Given the blowback that's happened in the last few days, do you stand by the decision to give them oxygen?

MARYANNE DEMASI: Absolutely. They're not alternative views... if you look at the actual literature they're not alternative views: they're actually expressing the views of what's in the scientific literature.

PETER LLOYD: Your argument, though, is that they're reinterpreting it.

MARYANNE DEMASI: Yes, that's right.

PETER LLOYD: All right. Now, tonight in part two you examine the anti-cholesterol drug statins. What are some of the claims you make tonight?

MARYANNE DEMASI: The claims we make tonight is to really examine who benefits from these drugs and who doesn't. Now, we know that the majority of people that take statins are at low risk of developing heart disease. We acknowledge that there's certainly people that benefit from these drugs but there are quite a few people being prescribed medications unnecessarily and the National Heart Foundation agrees with this.

PETER LLOYD: Why do you say it's unnecessary?

MARYANNE DEMASI: Because when you look at the overall health of the patient, you need to assess not just their cardiovascular system but their overall health. And so if a drug seems to reduce blood vessel disease in some patients, you'd hope that that reduces their risk of dying from that disease.

But in low-risk patients, we don't see a mortality benefit. They don't live any longer by taking statin if they're in the low-risk category.

PETER LLOYD: Indeed, the program goes further than that, though. It says that people who take statins may in fact be doing harm to themselves. What kind of harm are you suggesting?

MARYANNE DEMASI: Well, all drugs have side effects and when you look at the clinical trials, it suggests that the side effect profiles are quite low. But when you look at side effects in the general population, they're a lot higher. And when you speak to doctors who are in clinical practice, they say that sometimes 20, 25, up to 30 per cent of their patients experience these side effects.

So if you're not getting a benefit in having a longer lifespan from these drugs, some patients would want to question whether or not they expose themselves to the risks of these drugs or the side effects of these drugs if they're not going to live any longer.

PETER LLOYD: Now, we're told today that patients with cardiovascular problems are, in fact, going to their doctors and asking questions about whether they should take these drugs. Does that worry you?

MARYANNE DEMASI: Not at all. I think this is a really good thing to happen, that patients need to have these conversations with their doctor. This program is not meant to give patients medical advice. This is to stimulate conversation, to stimulate debate and really reunite doctors with their patients to have healthy discussions and open debates about their health.

PETER LLOYD: All right. Now, I want to give you the opportunity here to directly respond to the criticism of one person in particular. That's Professor Emily Banks, the chair of the Advisory Committee on the Safety of Medicines. This is what Professor Banks told PM on Monday when she called for the ABC not to run tonight's program:

EMILY BANKS (Nov. 28): And if people stop using their statins or if they don't start them when they should be, it's very likely that it will result in deaths.

TOM NIGHTINGALE (Nov. 28): Professor Banks also chairs the National Advisory Committee on the Safety of Medicines. She's written to the ABC to try to stop the Catalyst television program on statins being broadcast on Thursday night.

EMILY BANKS (Nov. 28): So it's likely that if this program goes ahead and it does the unwarranted undermining of statins, that there will be people who didn't have to have a heart attack and didn't have to die from a heart attack who will die through reducing use of statins.

PETER LLOYD: That's Professor Emily Banks. She's the chair of the Advisory Committee on the Safety of Medicines. I should say that she wrote to the ABC in a personal capacity. Maryanne Demasi, what do you say to what she's just said?

MARYANNE DEMASI: Well, I'm rather surprised at her accusation, given that she hasn't seen the program. She doesn't know who's in the program or she doesn't know what the content of the program is.

PETER LLOYD: Well, she saw last week's program.

MARYANNE DEMASI: Yes, but we also have different experts in this program and talking on different topics. I share her concern that patients will stop taking their medication unnecessarily but we also have a responsibility to tell people that the majority of people on these drugs may be on these drugs unnecessarily. So we have a duty of care to those people as well.

PETER LLOYD: You also spoke in the program, both last week and this week, to the National Heart Foundation. Do you have their support?

MARYANNE DEMASI: Can you be more specific?

PETER LLOYD: Well, do they agree with the conclusions of the experts that you present in this program?

MARYANNE DEMASI: The National Heart Foundation agreed that there would be people that are not at high risk of heart disease being medicated for these drugs and they would question whether or not these patients should be on those drugs.

PETER LLOYD: Would it surprise you to learn that the National Heart Foundation's put a press release out today, saying that they are concerned with the program? How do you still say that they support these ideas if they're negating the program in press releases today?

MARYANNE DEMASI: I think they're concerned the same as Emily Banks is concerned: that people will stop taking their medication unnecessarily. But when we actually presented the scientific literature to them then, they were certainly supportive of it.*

PETER LLOYD: Have you made any changes to the program to take account of these criticisms?

MARYANNE DEMASI: No. This program was already finished.

PETER LLOYD: And the program goes to air tonight?

MARYANNE DEMASI: Yes, it does.

PETER LLOYD: That's Dr Maryanne Demasi, presenter of Catalyst. It's on ABC1 at 8 tonight.

*EDITOR'S NOTE: (May 7th, 2014) To clarify, there are in fact clear and significant areas of disagreement between the National Heart Foundation (NHF) and the views presented in the Catalyst programs. It was not accurate to state that the NHF supported all the scientific literature presented to them by the program.