80% of Heart Attack Victims Have High Cholesterol
-Lipitor Television Ad
If you had high cholesterol, would you start feeling worried? Lipitor is lying. Not in a factual sense, but in an emotional one. This is an example of a great statistical lie. One that we have a hard time understanding on the surface, but which demands to be clarified. The world has too much fear already and we don’t need pharmaceutical companies abusing our understanding of statistics to create more fear driven consumption. So lets walk through this.
This quote causes our fear center goes off because we start thinking that 80% of those with high cholesterol have heart attacks. But that’s not what this statistic says. What does this statistic tell you if you have high cholesterol?
There is not enough information about the rest of data. The one critical piece of information that is missing is the number of people with high cholesterol who never have a heart attack. To help explain why, lets convert this from statistics into real people and figure out what the true risk of heart attack is if you have high cholesterol.
Suppose the following (these are not hyper accurate, but are reasonable approximations based on a quick survey):
- 30% of the population has high cholesterol
- .2% of the population have heart attacks every year (765,000/300,000,000)
- 80% of heart attack victims have high cholesterol
So if we have a sample of 10,000 people:
- 3000 have high cholesterol
- 7000 have normal cholesterol
- 20 have heart attacks
- 16 of these have high cholesterol
- 4 of these have normal cholesterol
The overall risk of having a heart attack if you have high cholesterol is 16/3000 or 0.5%!!! Imagine if they had used the real statistic in their advertisement:
0.5% of High Cholesterol Sufferers have heart attacks
Not nearly as compelling.
So besides inane advertising that is simply fear mongering, why does this matter? It matters because this fallacy comes up in many other settings as well. The formal name of this fallacy is the Base Rate Fallacy or the Prosecutors Fallacy. The latter because similar statistical lies are used to convict people based on “what are the chances that…” type of arguments.
Moreover, as I’ve stated before, our knowledge is becoming increasingly fragmented. We have no way to run our own study about a particular medical diagnosis or how often a car breaks down. We are at the mercy of whoever provides us with the information. Being aware of how statistics are used can help us be more vigilant in thinking about what is true.
[Personal Note: I don’t have high cholesterol, nor am I a doctor, but I play one on TV 🙂 (reference to yet another frailty in our ability to discern truth)]
I thoroughly enjoyed you last well written post on Lipitor. It really provides an opportunity to think about some of the material we “ingest” while watching t.v. or reading a magazine. I think the fears from marketing styles such as this tend to “brew” in our mind. You provide a good insight into something that can easily be misinterpreted. Big pharma half-truths can be very misleading. Thanks for bringing this to light, Matt!
What do Lipitor ads and the medical/pharmaceutical industry consider High Cholesterol. The standard keeps getting lowered. When testing first began (80’s?) anything over 240 total was considered high and ratios were not taken into account. I continue to have “high” cholesterol with acceptable ratio between LDL and HDL. I have refused to go on statins or other meds to lower my chol. I have found a physician who does not prescribe, I suspect he doesn’t believe the garbage the pharmaceutical co’s and medical industry promolgate. Thank you for the article.
These ads are disgraceful. Besides being completely misleading. The placebo effect is well known, but how does it work on the negative side? How many heart attacks and deaths are the suggestions in the ad responsible for?
Thank you for your insights. I have seen the Lipitor commercials and wondered how the statistics were compiled and how they define “high cholesterol” since I have also read that half of all people who have heart attacks have normal or low cholesterol. I am attending a lecture this evening (hence my googling and finding your blog) at Scripps Integrative Medicine in La Jolla, CA where Dr. Guarneri a top cardiologist will be giving a lecture and hoping I can get further clarification. My mother, nearly 80, has had high cholesterol (over 300) since they began testing twenty or so years ago and she has never had a heart attack or stroke. Her triglycerides are 60 and this for women is a better indicator of heart attack risk. Risk factors are more complicated than total cholesterol, one must consider many other factors, CRP, type of LDL, fibrinogen, etc.. Thanks again for your post. If I come back with additional information I’ll let you know.
I just read here-> http://www.spacedoc.com/statin_scam
that only 25% of heart attack victims have high cholesterol!
We need a factchecker site for medicine!
Actually, to be truthful, you should also note that there are 4 out of 7000 normal cholesterol people who also die of heart attacks (0.0571%). You could draw the conclusion that having high cholesterol (0.533%) will in fact raise your chances of a heart attack by over 9 times! Or let’s say 933%.
That’s good enough for me to listen to my GP, as it’s also true that high cholesterol can cause other medical ailments as well, such as: angina and pain in the calves, atherosclerosis, stroke,
dizziness and impairment of balance, aphasia, and more. Had you also included those conditions, well, just do the math.
High cholesterol is a symptom of another problem. High cholesterol doesn’t cause other problems as another reader below who trusts his GP. You have to treat the root cause and not the symptoms. Cholesterol is made in the liver, do look at the liver. My mom went to a Functional Medicine Doctor and along with a few other problems she was copper deficient. Copper is needed for a health liver. So, after taking a copper supplement, her total cholesterol went from 310 to 215 in less than a year. Guess what, no Lipitor. Doctors also should offer a CRP and Homocystene test along with triglycerides. The moral of the story is treat the root cause and not the symptoms.