Statin Wars - British Style!

[flintnational]

In the internet age, people have become pretty savvy at filtering and checking the information they read online. IMO, more information is always better. We have to have faith that our fellow citizens are smart enough to read, ask questions and make their own decisions. I do not accept that we are living dangerously if we expose them to differing opinions. In my case, this thread has challenged me to go back and reread many of the larger statin studies. Accordingly my knowledge has been enhanced not restricted.

I love you guys, but I don't blindly believe everything that gets posted here. I doubt I am alone. That being said, I am smarter because of this forum and the challenges it poses to my beliefs. I routinely rethink and investigate topics raised here.

 

[Oz investor]

*** No... statins are incredibly UNcontroversial in medicine. ***

that is NOT what the hospital registrar who prescribed them ( and made sure i left with a box of them in my hand ) she took nearly 10 minutes explaining the risks of taking them v. not taking them before the medical intervention ( stent )... 4 months later .

https://www.rxlist.com/crestor-side-effects-drug-center.htm

since i have been on 40 mg a day since November 2016 the GP has been watching the liver and kidney functions very closely .

 

[Oz investor]

I agree with that. But it's really not that simple. How about diabetes?

https://www.diabetes.co.uk/news/201...creased-risk-of-type-2-diabetes-97343893.html

the latest blood tests showed a rise in ( fasting ) blood glucose so am now on annual GTT ( glucose tolerance testing ) ( the results are still to come back )

so yes my GP is alert for that as well

 

[bmcgonig]

No... statins are incredibly UNcontroversial in medicine.

Yes, lots of websites and an occasional editorial in the published literature will be critical, but the general consensus as codified in guidelines around the world is pretty solid.

Statins for primary prevention IS controversial. Even the USPSTF doesn't recommend it. Again this isn't some antivax silliness.

https://www.jwatch.org/na48090/2019/01/29/another-model-statins-primary-prevention

https://jamanetwork.com/journals/jama/article-abstract/2584032

".... Thus, the task force recommended “initiating use of low- to moderate-dose statins in adults aged 40 to 75 years without a history of CVD who have 1 or more CVD risk factors and a calculated 10-year CVD event risk of 10% or greater (B recommendation)” or “7.5% to 10% (C recommendation).”1* Although the task force did their usual careful job of reviewing the evidence, the evidence for treating asymptomatic persons with statins does not appear to merit a grade B or even a grade C recommendation."

Even jwatch admits there is "substantial disagreement".

https://www.jwatch.org/na48090/2019/01/29/another-model-statins-primary-prevention


"...There is substantial disagreement on which patients without known cardiovascular disease (CVD) should take statins."

 

[Rianne]

Physician here and feel obliged to say that this thread does one thing, and one thing only, for sure: it demonstrates that permitting medical advice to be given on an open forum is an appallingly bad idea.

lt is honestly shocking to read the falsehoods and bad medical advice blithely dispensed in this otherwise great forum.

Moderators, please please reconsider whether it is responsible policy to allow medical advice to be given here.

That's interesting. My nephrologist encourages research and discussion found in forums and articles and studies found on the internet. As a matter of fact, the discussion regarding this very topic on this forum brought up an excellent discussion during my appt. last Weds. My personal conclusion, any physician that discourages a patients own research on their medical condition is a physician that prefers their patients' ignorance. How do you feel about 2nd opinions? Some physicians discourage that too.
And BTW, our discussion made our appt. longer. After approx. 40 minutes, he encouraged me to call him if I had more questions.

 

[Chuckanut]

I love you guys, but I don't blindly believe everything that gets posted here. I doubt I am alone. That being said, I am smarter because of this forum and the challenges it poses to my beliefs. I routinely rethink and investigate topics raised here.

I love you too, Bro!

+1

Well said.

 

[Chuckanut]

Physician here and feel obliged to say that this thread does one thing, and one thing only, for sure: it demonstrates that permitting medical advice to be given on an open forum is an appallingly bad idea.

lt is honestly shocking to read the falsehoods and bad medical advice blithely dispensed in this otherwise great forum.

Moderators, please please reconsider whether it is responsible policy to allow medical advice to be given here.

I agree with you to a certain extent, but then I also have to temper that agreement with a few things that, IMHO, really cause confusion in the general public as well make the public suspicious of the medical establishment. Among them:

1. Drug advertising. Need I say more?

2. Bad and tainted advice in the past. Examples: Swine flu shots, substitute high-trans-fat margarine for real butter, sugar bomb cereals getting the healthy heart mark, providing sugary non-fat chocolate milk to kids in school but forbidding plain whole milk, the whole non-fat-low-fat craze, Nutritionist and Dietician gatherings sponsored by Coca Cola, and various Big Food companies, and I could go on and on.

3. The media (bless their little hearts) have few if any reporters who can accurately report on the 'latest medical studies' about anything. I doubt if more than a handful of them can read the statistics of a medical study and understand them. It's pathetic.

4. The cost of medical care. 19% of our GNP in the USA. Really? The next highest country is 12%. At least some people in medicine are worshiping at the foot of the Almighty Dollar.

5. In the case of statins in particular, that calculator that recommends a low to moderate dose of a statin for men with absolutely wonderful lipid numbers just because they are male and above a certain age.

In other words, many in the medical establishment have shot themselves in the foot in terms of credibility.

That said, I take my low-dose statin, exercise regularly, and try to eat a more Mediterranean diet. That seems to be the best I can do to add quality years to my life. And, I also watch for the inevitable changes to what we currently believe to be true.

 

[mpeirce]

No... statins are incredibly UNcontroversial in medicine.

Settled science, eh?

DW had a long talk with her doctor when he suggested statins. He was supportive of her declining to go on statins. So you're suggesting that he's practicing malpractice?

 

[threegoofs]

*** No... statins are incredibly UNcontroversial in medicine. ***

that is NOT what the hospital registrar who prescribed them ( and made sure i left with a box of them in my hand ) she took nearly 10 minutes explaining the risks of taking them v. not taking them before the medical intervention ( stent )... 4 months later .

https://www.rxlist.com/crestor-side-effects-drug-center.htm

since i have been on 40 mg a day since November 2016 the GP has been watching the liver and kidney functions very closely .

Right. Thorough explanations of the well understood and well defined risk and benefits of a drug is good evidence that they are uncontroversial. We know these drugs, have for decades, and have a lot of evidence for their benefit and risks.

The various medical societies guidelines are quite consistent with each other and clear. That’s what I mean by uncontroversial.

 

[threegoofs]

Statins for primary prevention IS controversial. Even the USPSTF doesn't recommend it. Again this isn't some antivax silliness.

https://www.jwatch.org/na48090/2019/01/29/another-model-statins-primary-prevention

https://jamanetwork.com/journals/jama/article-abstract/2584032

".... Thus, the task force recommended “initiating use of low- to moderate-dose statins in adults aged 40 to 75 years without a history of CVD who have 1 or more CVD risk factors and a calculated 10-year CVD event risk of 10% or greater (B recommendation)” or “7.5% to 10% (C recommendation).”1* Although the task force did their usual careful job of reviewing the evidence, the evidence for treating asymptomatic persons with statins does not appear to merit a grade B or even a grade C recommendation."

Even jwatch admits there is "substantial disagreement".

https://www.jwatch.org/na48090/2019/01/29/another-model-statins-primary-prevention


"...There is substantial disagreement on which patients without known cardiovascular disease (CVD) should take statins."

For low risk patients.

 

[threegoofs]

Settled science, eh?



DW had a long talk with her doctor when he suggested statins. He was supportive of her declining to go on statins. So you're suggesting that he's practicing malpractice?

It’s all risk benefit. The benefit may be low, but the risk is too. He made the suggestion. Patients can always refuse. That’s not malpractice.

Malpractice would be not bothering to discuss statins at all in an appropriate patient at high risk.

 

[joeea]

In the internet age, people have become pretty savvy at filtering and checking the information they read online.

I completely disagree.

People seem to believe all sorts of wild conspiracy theories. And in the internet age, web sites and search engines are happy to feed whatever fevered imagination you might have.

Recently, Pew Research conducted a survey. It found that 45 percent of US adults get at least some of their news from Facebook. That survey also found that of the 45 percent turning to Facebook for news content, half claim it is the only social platform they are using for news.

Sad.

I wish most people were skeptical readers. But that's just not what happens these days.

 

[joeea]

Settled science, eh?

DW had a long talk with her doctor when he suggested statins. He was supportive of her declining to go on statins. So you're suggesting that he's practicing malpractice?

Supportive of her declining = malpractice?

Don't you think that's a bit of a leap?

 

[JoeWras]

Somewhere up the way there was a link or two to scholarly sites. Good stuff.

I read beyond the linked article to another referenced article at that stie about the "nocebo effect" of statins. It was a study where patients were given statins or a placebo, and instead of checking for effectiveness, they were looking for side effects, specifically muscle pain.

So, using my savvy filtering brain, I have decided to continue taking statins after reading that article.

 

[tfudtuckerpucker]

JoeWras, your approach is exactly what I like to see happen. Patients educate themselves, and consult with their physician, and decide for themselves. I think some (most?) physicians find it frustrating to compete with "Dr Google", and find themselves spending too much time justifying their recommendations to patients. But I think including patient education can yield better results than simply following "doctor's orders". In the case of statins, there is no consensus for prescribing statins for primary prevention treatment (here, here, and here), and patients need to understand the risk/reward tradeoff.

There's an interesting decision aid tree here , that helps visualize the results of the statin choice.

 

[bmcgonig]

For low risk patients.

Good Lord that is the entire point.

High risk patients should be on statins. There's no controversy there. The controversy is all about low risk.

 

[flintnational]

I completely disagree.

People seem to believe all sorts of wild conspiracy theories. And in the internet age, web sites and search engines are happy to feed whatever fevered imagination you might have.

Recently, Pew Research conducted a survey. It found that 45 percent of US adults get at least some of their news from Facebook. That survey also found that of the 45 percent turning to Facebook for news content, half claim it is the only social platform they are using for news.

Sad.

I wish most people were skeptical readers. But that's just not what happens these days.

So, you disagree and everyone is aware of your position. It appears the internet is working.

 

[MichaelB]

I completely disagree.

People seem to believe all sorts of wild conspiracy theories. And in the internet age, web sites and search engines are happy to feed whatever fevered imagination you might have.

Recently, Pew Research conducted a survey. It found that 45 percent of US adults get at least some of their news from Facebook. That survey also found that of the 45 percent turning to Facebook for news content, half claim it is the only social platform they are using for news.

Sad.

I wish most people were skeptical readers. But that's just not what happens these days.

I don’t agree with this.

 

[bmcgonig]

I completely disagree.

People seem to believe all sorts of wild conspiracy theories. And in the internet age, web sites and search engines are happy to feed whatever fevered imagination you might have.

Recently, Pew Research conducted a survey. It found that 45 percent of US adults get at least some of their news from Facebook. That survey also found that of the 45 percent turning to Facebook for news content, half claim it is the only social platform they are using for news.

Sad.

I wish most people were skeptical readers. But that's just not what happens these days.

If you're looking for information on studies for "statins for primary prevention", you can go to Facebook and get whatever, or you can go to Google Scholar and get studies with several thousand citations.

Which one do you use?

 

[eytonxav]

This thread has turned into:

 

[mountainsoft]

There's an interesting decision aid tree here , that helps visualize the results of the statin choice.

My doctor showed me something similar on my last visit. With my BP and cholesterol readings, statins only prevented heart attack for 2 people out of 100. That means 98 people got no benefit from taking a statin, in fact 7 people still had a heart attack.

Granted, if you're one of those two it helped you'll be glad you took it. Otherwise, I'm more likely to be in the larger percentage taking it for no reason. Any medication has side effects, so I try to minimize the medications I take unless absolutely necessary.

My doctor recommended I take a statin. I told my doctor thank you, but I declined at this time. Hopefully I'm not one of those two.

 

[flintnational]

This thread has turned into:

So true. But, I am just hanging on hoping a thread I started gets to 10,000 views!! Then the royalties really kick in.

 

[zedd]

This thread has turned into:

It just so happens that we have three horses. None of them seem to be worried about CVD.

 

[Teacher Terry]

I read you should never take more than 5 medications since it’s bad for you and they start to contradict each other. So no statins since I am at my maximum)

 

[Winemaker]

I read you should never take more than 5 medications since it’s bad for you and they start to contradict each other. So no statins since I am at my maximum)

That's probably a different thread.