Statin Wars - British Style!

[aja8888]

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)

Maybe I should tell DW that since she in on 13 meds, a few of which are to keep her breathing?

How do you know which ones to stop taking in my DW's case?

And her brother is a heart transplant recipient and takes more than 5 daily (I don't know how many but I will bet it's more than 5).

 

[Teacher Terry]

Aja, I wasn’t suggesting anyone do that. Just reporting what I read. Plus before I add anything it would need to be for serious problems like you mentioned. Statins for me don’t fall in that category.

 

[HFWR]

This thread has turned into:

But should these horses be prescribed statins?

 

[aja8888]

But should these horses be prescribed statins?

Bandaids...

 

[Chuckanut]

OK, this is Michigan not the UK, but the lesson is a good one. People can overdo supplements in their attempt to avoid a prescription medicine. If one wants to avoid a statin, that is there choice. Keep in mind substituting with a 'suppliment' can be even more dangerous.

https://www.livescience.com/65070-red-yeast-rice-supplements-liver-damage.html

However, many patients and doctors may not be aware that red yeast rice can naturally contain a compound called monacolin K, which is identical to the active ingredient in the statin drug lovastatin, the report said. Red yeast rice supplements with monacolin K come with the same risks as drugs containing lovastatin, which can include liver damage.
<snip>
the woman was diagnosed with "acute drug-induced liver injury," or liver damage due to a drug or supplement. In this case, red yeast rice supplements were the most likely cause of the woman's illness, given the sudden onset of her symptoms and her recent use of the supplement, according to the report, published today (March 25) in the journal BMJ Case Reports.

 

[youbet]

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.

My stats were the same regarding the prognosis for heart attack. But I also noted that going from no statin to low dose statin reduces my stroke risk by 20% per the Mayo tool. (Thanks to tfudtuckerpucker for posting the link to the tools!) Being disabled by stroke seems like it would reduce my FIRE fun....... And a 20% reduction in risk is a BIG number.

I've been on a low dose statin (5 mg) for several years, have good cholesterol numbers and zero side effects. I was going to talk to doc about dropping the low dose statin but the reduction of stroke probability really grabbed my attention. I see him in a few weeks and will discuss.......

This is all very interesting..... and complicated.

 

[Chuckanut]

My stats were the same regarding the prognosis for heart attack. But I also noted that going from no statin to low dose statin reduces my stroke risk by 20% per the Mayo tool. Being disabled by stroke seems like it would reduce my FIRE fun....... And a 20% reduction in risk is a BIG number.

I've been on a low dose statin (5 mg) for several years, have good cholesterol numbers and zero side effects. I was going to talk to doc about dropping the low dose statin but the reduction of stroke probability really grabbed my attention. I see him in a few weeks and will discuss.......

This is all very interesting..... and complicated.

Same here. I take enough of the drug to bring two risk factors we currently know about into a 'normal' level. Then it's a Mediterranean diet as much as possible, and greatly limiting added sugar and highly processed foods.

CVD causes are very complicated. I watched an interview with Dr. Thomas Dayspring - a very competent lipidologist with the lots of creds - and while I did not understand a lot of what he said, it is obvious that this entire area is VERY complicated. What we have believed and currently believe will change so keep tuned in for the rest of your life. And, enjoy your life today.

 

[braumeister]

going from no statin to low dose statin reduces my stroke risk by 20% per the Mayo tool.

I wouldn't doubt your reading of the data, but most of the time, these calculators show relative risk instead of absolute risk.

For example, if 5 people out of 100 are at risk without treatment, and with treatment only 4 people are at risk, that's a 20% improvement (relative risk) caused by the treatment. But the difference in absolute risk is quite small.

At least that's my view.

 

[Chuckanut]

I wouldn't doubt your reading of the data, but most of the time, these calculators show relative risk instead of absolute risk.

For example, if 5 people out of 100 are at risk without treatment, and with treatment only 4 people are at risk, that's a 20% improvement (relative risk) caused by the treatment. But the difference in absolute risk is quite small.

At least that's my view.

A good point. We also see these relative risks in many drug commercials. IMHO, the absolute risk should be mandated, just as credit companies have to tell us the Annual Percentage Interest Rate. It makes comparisons a lot easier.

We should keep in mind that these studies are only for 5 years at the most. Yet CVD takes decades to develop. It's possible that going out 10-20 years or more we may see some very significant improvements in absolute risk. We just don't know since nobody has been able to design a credible study that goes out that far.

Are we having fun yet?

 

[youbet]

I wouldn't doubt your reading of the data, but most of the time, these calculators show relative risk instead of absolute risk.

For example, if 5 people out of 100 are at risk without treatment, and with treatment only 4 people are at risk, that's a 20% improvement (relative risk) caused by the treatment. But the difference in absolute risk is quite small.

At least that's my view.

Good catch braumeister. And I think your interpretation is probably correct. (Since I was looking/hoping for good news, I grabbed the number as absolute. But, sadly, it's probably relative.)

I cut and pasted the info. Don't know how to fix the formatting but maybe it's good enough for you to interpret. It's showing the differences caused by going from no statin to low/standard-dose statin for my inputs. This is the ACC/AHA ASCVD tool from the Mayo site.

Cost

Standard dose statins
about $4/month

Daily Routine

Standard dose statins
One pill once a day

Other Benefits

Standard dose statins
The use of statins reduces your stroke risk by about one fifth.

Side Effects

Standard dose statins

Common side effects
nausea, diarrhea, constipation
(most patients can tolerate);

Muscle aching/stiffness
5 in 100 patients
(some need to stop statins because of this);

Liver blood test goes up
(no pain, no permanent liver damage):
2 in 100 patients
(some need to stop statins because of this);

Muscle and kidney damage
1 in 20,000 patients
(requires patients to stop statins).

 

[youbet]

IMHO, the absolute risk should be mandated, just as credit companies have to tell us the Annual Percentage Interest Rate. It makes comparisons a lot easier.

+1 Completely agree.

 

[braumeister]

The NNT site has good info.

Statins for Heart Disease Prevention (Without Prior Heart Disease) TheNNT

 

[donheff]

Maybe I should tell DW that since she in on 13 meds, a few of which are to keep her breathing?

How do you know which ones to stop taking in my DW's case?

And her brother is a heart transplant recipient and takes more than 5 daily (I don't know how many but I will bet it's more than 5).

I read a book called “Are Your Prescriptions Killing You?” that addressed this. It was written by a pharmacist who consulted nursing homes about drug management. There is no magic number you shouldn’t exceed. It is just that the larger the number the more complicated the interactions and side effects. In addition many drugs become more risky when taken by the elderly. My impression is that the bigger practices that are becoming the rule these days are getting pretty good at weeding out unnecessary drugs. Same with pharmacists if they are aware of all your drugs. The flip side is that uncontrolled and un-monitored prescription drug use is a prescription for disaster.

 

[joeea]

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

It appears we disagree on what "the internet is working" means.
Just like we disagree that "people have become pretty savvy at filtering and checking the information they read online."

 

[joeea]

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?

I use the primary source where my physician sends me. Hint: it's not Facebook.

 

[joeea]

I don’t agree with this.

Do you believe that people have become pretty savvy at filtering and checking the information they read online?

 

[braumeister]

Do you believe that people have become pretty savvy at filtering and checking the information they read online?

Meaningless generalization. Some do, others don't.

 

[joeea]

Meaningless generalization. Some do, others don't.

Then we agree! Except I would have said "most don't".

 

[Teacher Terry]

Yes I think the article I read was just warning people about being careful with the medication you take. I think what happens is people go to different specialists for different issues and maybe all the doctors aren’t aware of everything that the patient is taking.

 

[flintnational]

It appears we disagree on what "the internet is working" means.
Just like we disagree that "people have become pretty savvy at filtering and checking the information they read online."

Book burnings. We need more book burnings!

 

[aja8888]

Yes I think the article I read was just warning people about being careful with the medication you take. I think what happens is people go to different specialists for different issues and maybe all the doctors aren’t aware of everything that the patient is taking.

I'd paste a list of the meds that DW takes, but it would take too long. She is on meds for:

COPD (advanced)
Severe osteoporosis
HBP
High cholesterol
Depression
On O2 100%
Sleep problems (no wonder)

I can't remember what else, but her PCP helps manage the drug regiment in conjunction with her specialists.

Even with Medicare Part D, the OOP cost is high for her drugs. I'm just the opposite, one drug (Tamsulosin).

 

[tfudtuckerpucker]

I recently ran my DNA through an evaluation screen at Promethease, and it flagged this:
- 5x increased myopathy risk for statin users

I'm trying to do the math- does that mean a 25% risk of myopathy for me?

 

[Teacher Terry]

It’s good that one doctor is overseeing the prescriptions. My dad had COPD and it’s tough. Then he had a big stroke and was on a number of medications because he suffered from uncontrollable movements which was caused by the stroke. He wasn’t overweight and didn’t have HBP. Never knew what caused the stroke.

 

[aja8888]

It’s good that one doctor is overseeing the prescriptions. My dad had COPD and it’s tough. Then he had a big stroke and was on a number of medications because he suffered from uncontrollable movements which was caused by the stroke. He wasn’t overweight and didn’t have HBP. Never knew what caused the stroke.

High cholesterol is the least of my DW's worries. She had a Mitral valve replacement a year ago (delicate operation) and her heart and arteries are in great condition (very little plaque build up in arteries, no structural issues).

That valve was leaking, and the cardiologist thought that if it was replaced, she would get more O2 into her lungs to relieve the COPD issues, but it hasn't shown any success.

 

[Teacher Terry]

That’s too bad that it didn’t work.