AHA DAY 1-continued: Physicians Health Study II AND SEARCH

Jason never dies in the Halloween Movie series.  He always raises up from behind the couch or after he jumps out the window, the ground where he landed is mysteriously devoid of a body, so you know that a year or two from now, you are going to have to deal with the masked serial offender again.  Same for Folic Acid, Vitamin E and Vitamin C. 

 I'm not going to give much space to yet another obituary for these entities except to say that at least they are safe because though folic acid isn't in the water, it's in just about everything else we eat in America.   So who really knows how much more a supplement can do on top of how much  we are already supplemented.  However, taking more of any of these "vitamins"  won't save our lives and won't prevent cardiovascular events.  Perhaps next we can spend more money  to see if they might grow hair, make us thinner or make us better looking.  This billion dollar supplement  industry needs to find a real reason to exist  because so far, it's hasn't ( except of course for the possible placebo effect of empowering our patients to go to the local Walmart pharmacy, be able to pick a drug, purchase it and take it with complete control over how much they are going to spend and how long they are going to wait.)  The sad part is that in our prior economy, feeling good from a placebo effect like that was much more affordable.  The bottom line now is that our "bottom line" has changed and Americans on a tight budget can no longer afford such nonsense.

Simvastatin 80 vs. Simvastatin 20 in the SEARCH trial did yield a reduction in events by 6% though NOT statistically significant, however , predictably myopathies increased. So, though we KNOW we can lower LDL MORE with a higher dose, it's worth our patient's time to have a conversation with them about side effects.

Back to vitamins:  If we threw a good billion dollars into smoking cessation classes, exercise equipment, purchased high quality foods instead of junk  and spent that wasted money spent on Vitamin C, E or Folate on  other worthy  primary prevention measures, we would reap tens of billions in reducing the cost of health care in America plus save millions of lives.  Instead, when we finish our next bottle of Vitamin C, all we have is an empty bottle and empty promises to show for it.   

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