Statin Wars - British Style!

[flintnational]

LOL.

One of the things it was compared to was... intensive statin treatment.

Because use of statins in that population is absolutely unvontroversial.

I have not indicated the high risk group should avoid statins. In fact, the data strongly supports their use in this population. I am more concerned about the lack of nuance for other groups and the trend to expand statins into otherwise healthy populations. Regarding stents, I am well aware the study indicates statins/medication provide a better benefit. You were the one that mentioned a stent procedure would be used. I simply pointed out the current data does not support that position for most.

You and I are in agreement that in higher risk populations the study data supports that the benefits of statins outweigh the risks. If you have compelling data for the primary prevention group, I would be interested. I think many of us would like to see the NNT and the net life extension (total mortality) for the primary group . The studies tend to only include soft end points not total mortality. Many of us in the primary group are aware of the side effects but are unclear about any potential benefits and their magnitude. And in the lower risk population, we also wonder about the unknown. For my situation, in the primary group, I am about 40/60 for/against statins. I constantly reevaluate their use.

You and I got off on the wrong foot not because I am against statins, I am not. But, I was opposed to your apparent attempts to not discuss the issue with data and simply shut down debate.

 

[donheff]

.

You and I got off on the wrong foot not because I am against statins, I am not. But, I was opposed to your apparent attempts to not discuss the issue with data and simply shut down debate.

+100. Calling people dangerous idiots is a questionable means of persuasion. I too am not anti-statin but was offended that you would call me a fool if I so much as questioned the risks of statins. You essentially made an angry argument from authority and closed the door.

 

[bmcgonig]

Look. You’re 63. What’s the chances of you living 10 more years? What’s the chance that the thing that affects you is heart disease? What’s the chances that you get heart disease but do not die?

All of those things increase with age. If you were 90 with the same numbers, those numbers are great. But I guarantee your risk of heart disease will be much higher.

Statins are not drugs that are treating abnormal disease these days. They’re drugs that are treating normal aging processes, like atherosclerosis. You are just lucky to live in an age where we have this knowledge to help extend your healthy lifespan.

You saying that anyone over 60, even if their cholesterol and bp numbers are excellent should take statins? Just in case?

 

[gerntz]

Count me as one who has chosen to not take a statin

I have high LDL cholesterol

I have had a coronory heart scan with a score of 0 out of 100 for plaque

I have had a ultrasound of my carotid artery which also showed that I don't have any plaque or hardening.

I also don't drink or smoke and I am not overweight.

I don't put 'statin deniers' at the same level as anti-vaxxers.

The results of the pharmacological industry funding their own studies and publishing those results doesn't impress me as a great way to get the best healthcare either.

If your HDL is high enough, 60, maybe 70, you're pretty close to bullet-proof & your LDL doesn't much matter. Very very low density is worse also than run of the mill LDL.

If the pharma industry doesn't fund studies, who will?

 

[gerntz]

I haven't run the numbers on this thread, but it appears there are more con than pro for statins.

When a thread starts with a built in, against-the-grain POV, you're going to get an outsized response from those that agree with it - not using statins - because they fall into the small percent with side effects or because they don't trust medical research in general, particularly by those who financially benefit from the research.

 

[JoeWras]

If your HDL is high enough, 60, maybe 70, you're pretty close to bullet-proof & your LDL doesn't much matter. Very very low density is worse also than run of the mill LDL.

If the pharma industry doesn't fund studies, who will?

But there are recent studies that refute this. It is so damn frustrating!

The problem with medicine is there are always exceptions. Hell, DISEASE is an exception which we begrudgingly accept.

What I'm saying is that statins sure look to be helpful, but without a doubt, there can be severe side effects. These are exceptions. They are serious enough to cause high push back.

Same can be said for vaccines. Example: it is well known that the influenza vaccine can trigger Guillain-Barre syndrome. This is an accepted fact. It is a rare exception, and a serious one. I choose to take the risk. Other people base a whole premise and even conspiracy on it.

Life sucks. Nothing is perfect. Non-smokers get lung cancer. People get hit by a bus. Living causes death.

It is all about balancing the risks. I choose to take a statin and get vaccinated based my assessment of these risks.

 

[6miths]

If the pharma industry doesn't fund studies, who will?

Well let's see, there's governments, universities, NGO's, philanthropists...

It's not that drug companies shouldn't fund studies, it is that they should not have exclusive control of the data and have investigators sign non-disclosure agreements or attempt to discredit or threaten those who bring issues to light.

 

[Chuckanut]

I used a different calculator to see how my lipid ratios worked out:

Cholesterol HDL/LDL/Triglycerides Ratios Calculator

Before statin usage

Your Total Cholesterol of 257 is HIGH RISK
Your LDL of 169 is HIGH RISK
Your HDL of 73 is OPTIMAL
Your Triglyceride level of 75 is NORMAL

RATIOS:

Your Total Cholesterol/HDL ratio is: 3.52 - (preferably under 5.0, ideally under 3.5) GOOD
Your HDL/LDL ratio is: 0.432 - (preferably over 0.3, ideally over 0.4) IDEAL
Your triglycerides/HDL ratio is: 1.027 - (preferably under 4, ideally under 2) IDEAL

After one month on 20mg of Atorvastatin

Your Total Cholesterol of 179 is DESIRABLE
Your LDL of 91 is OPTIMAL
Your HDL of 75 is OPTIMAL
Your Triglyceride level of 65 is NORMAL


RATIOS:

Your Total Cholesterol/HDL ratio is: 2.39 - (preferably under 5.0, ideally under 3.5) IDEAL
Your HDL/LDL ratio is: 0.824 - (preferably over 0.3, ideally over 0.4) IDEAL
Your triglycerides/HDL ratio is: 0.867 - (preferably under 4, ideally under 2) IDEAL

Before After
Total C 267 high risk 179 desirable
LDL 169 high risk 91 optimal
HDL 73 optimal 71 optimal
Trigs 75 normal 65 normal
Chol/HDL good ideal
HDL/LDL ideal ideal
Trigs/HDL ideal ideal

Other than total cholesterol and LDL my numbers are pretty good.
However, a month on Avrostatin makes them all good or great.

This is my interpretation of what is, I believe, a confusing issue. LDL is still key to lowering overall CVD risk, though good ratios are certainly protective even with high LDL. It's not simple, and I don't think the medical profession knows for certain how to evaluate all of this.

I can't tell others what do to. But, for me, a low-dose of the statin eliminates my only two risk factors, and so far I don't seem to be suffering any bad effects. But, I will be watching. Hopefully, medical science will come up with better guidelines in the near future.

 

[sengsational]

Still looking for the study that compares a baby aspirin to statins in a low risk cohort. My theory is that it's not the LDL-C reduction effect of statins but rather the anti inflammation effect that is making statins effective in the higher risk cohorts, or at least partially responsible.


As to the previous post and the hope that medical science will improve, the first thing I'd do is use what's out there today: find out as much as you can about the size and number of LDL particles. The calculated LDL-C is crap. And measure LP(a) to make sure that isn't throwing you into a different space.

 

[travelover]

+100. Calling people dangerous idiots is a questionable means of persuasion. I too am not anti-statin but was offended that you would call me a fool if I so much as questioned the risks of statins. You essentially made an angry argument from authority and closed the door.

+1. I'd appreciate an intelligent discussion, as I struggle with this. I've taken two statins and one left my legs aching, the second one made me totally fuzzy headed. Both my parents has strokes at about my age, but they did not eat well, nor exercise. Other relatives on both sides lived into their 90's. My cholesterol numbers are good, but docs have this new formula that sweeps me into the "take statins" category.

 

[mamadogmamacat]

Well, I got both fuzzy headed and muscle soreness from my six weeks of statin experience. As I've posted before, subsequent research (sorry i did not do it before accepting the statin prescription, but live and learn the hard way) led me to conclude statins are both relatively useless and dangerous for post menopausal women. For men, there does appear to be a definite benefit, independent of age, to statin use.

If you stay on the statins, watch for actual muscle wastage, which for me at least has not been reversible. There may be some benefit to CoQ10 supplements to prevent muscle wastage, or at least mitigate it. I just started taking CoQ10, now 2 yrs after stopping the statins. Energy level is up, too early to tell if my muscles get any better from it.

 

[msieweke]

You know why it might overstate risk? Because it was developed on epidemiologic data from the 90s, and most of those people were NOT TAKING STATINS.

Other factors probably play a role too- better BP control, better lifestyles, etc.

And now everyone can take these highly effective, well tolerated agents virtually for free.

Did you read the study? They didn't include patients prescribed statins. But just for grins let's say they did that wrong and 100% of the control subjects were on statins. Factoring in the benefits of statins, the calculator overstated the risk by 3x (Yes, that's right - 3x).

Other factors do play a role, but you'll have to explain how those other factors account for a .67x reduction in risk. That's a lot better than the 0.3x reduction in risk you get from statins. We need to explore those other factors.

We also need to factor in that somewhere between 30 and 60% of patients discontinue their statins, and "as many as 20%" complain of side effects. https://www.latimes.com/science/sciencenow/la-sci-sn-statin-denial-20170724-story.html Apparently these "well tolerated agents" are not so well tolerated.

I personally know 4 people on statins, and I was unable to convince any of them to discontinue them. If you think it's easy to get someone to go against doctor's orders, you should give it a try. Now 2 of those people have discontinued the drugs due to muscle pain. Another complains of pain, but he won't go against the doctor's orders.

The benefit of statins depends entirely on your heart disease risk. If your risk is 30%, then statins lower your risk 10%. That's pretty good, even if there is (for example) a 10% risk of side effects. But if your risk is 3%, then statins lower your risk only 1%. That's not a very good tradeoff against 10% side effect rate. This is why it's so important to know your real risk and the real side effect rate.

The risk calculators don't take into account hsCRP or triglycerides, both of which are important risk factors. They don't take into account exercise or diet, which are also important, even though the evidence is mostly epidemiological.

 

[JoeWras]

I personally know 4 people on statins, and I was unable to convince any of them to discontinue them.

So why is that so important to you?

 

[msieweke]

So why is that so important to you?

Not sure I understand the question. I don't like to see friends or family suffer needlessly. Is this not enough? Since 2 are my parents, I'll eventually have to take care of them - which will be harder if they suffer mentally or physically. If they take an ineffective drug, that distracts from addressing the underlying issue.

Also, in my experience the side effect rate is closer to 75%. It may be anecdotal, but I have no patience for those who claim statins are "well tolerated".

 

[Teacher Terry]

I tell people what information I have and why I won’t take them but I don’t try to convince anyone else as it’s their decision.

 

[Winemaker]

In the end, we are all dead. 70 or 76 or 80 or 86. If there is something that one suggests to help extend your life expectancy, so be it. If you don't accept it, then don't. If you think the side effects are worse than the bite, then don't use it. Same as religion, if you think there is a God, then believe, and don't pass judgement. If you think God is malarky, then carry on, and don't pass judgement. This is an internet forum, not a court of law or tribunal. Argue over something real, like is Merlot a washed up varietal, or why does Chardonnay have to be so oakey sometimes. Those are life true questions......

 

[JoeWras]

Not sure I understand the question... but I have no patience for those who claim statins are "well tolerated".

Got my answer. Thanks.

 

[msieweke]

Winemaker: Thank you. That is just what I needed to hear. Goodbye.

 

[sengsational]

So why is that so important to you?

We humans are fairness machines; it's hard for some of us to sit back and watch someone suffer at the hands of another. In fact not being bothered by a clear case of inflicting suffering is probably a sign of a less healthy mental state. Of course the statin debate is far from clear, but if one takes the position that statins have been oversold and those that are undertaking that activity are in part duplicitous, then it would be strange to stay silent.

 

[PatrickA5]

Also, in my experience the side effect rate is closer to 75%. It may be anecdotal, but I have no patience for those who claim statins are "well tolerated".

What if the four people you know didn't have any side effects? Would you still try to convince them to quit?

Some people have serious side effects and should talk to their doctor about alternatives. Millions of others tolerate the drug just fine. The fact that you have "no patience" for these types of people seems kind of odd to me. Or, maybe I'm misreading what you're trying to say?

I'm not going to try and convince anybody to go against their doctors suggestions. Everybody should do their own research and talk to their Doctor if they have questions or concerns.

 

[Rianne]

I used a different calculator to see how my lipid ratios worked out:

Cholesterol HDL/LDL/Triglycerides Ratios Calculator

Before statin usage


After one month on 20mg of Atorvastatin


Before After
Total C 267 high risk 179 desirable
LDL 169 high risk 91 optimal
HDL 73 optimal 71 optimal
Trigs 75 normal 65 normal
Chol/HDL good ideal
HDL/LDL ideal ideal
Trigs/HDL ideal ideal

Other than total cholesterol and LDL my numbers are pretty good.
However, a month on Avrostatin makes them all good or great.

This is my interpretation of what is, I believe, a confusing issue. LDL is still key to lowering overall CVD risk, though good ratios are certainly protective even with high LDL. It's not simple, and I don't think the medical profession knows for certain how to evaluate all of this.

I can't tell others what do to. But, for me, a low-dose of the statin eliminates my only two risk factors, and so far I don't seem to be suffering any bad effects. But, I will be watching. Hopefully, medical science will come up with better guidelines in the near future.

Best calculator!! The ratios are what matter, not the actual numbers. My ratios came out ideal, even though cholesterol slightly high and trigs high

 

[msieweke]

What if the four people you know didn't have any side effects? Would you still try to convince them to quit?

Some people have serious side effects and should talk to their doctor about alternatives. Millions of others tolerate the drug just fine. The fact that you have "no patience" for these types of people seems kind of odd to me. Or, maybe I'm misreading what you're trying to say?

None of my friends/family had side effects before I advised them to quit. They were all on statins for primary prevention, where the risk/reward ratio is poor. I learned later that 2 quit due to muscle pain. DM had muscle pain on 2 statins. Not sure how many DBiL tried before giving up on statins.

So, yes I would advise them to quit despite no visible side effects. The full explanation involves statin effects on CoQ10 production, but that's a red pill topic.

 

[Oz investor]

What if the four people you know didn't have any side effects? Would you still try to convince them to quit?

Some people have serious side effects and should talk to their doctor about alternatives. Millions of others tolerate the drug just fine. The fact that you have "no patience" for these types of people seems kind of odd to me. Or, maybe I'm misreading what you're trying to say?

I'm not going to try and convince anybody to go against their doctors suggestions. Everybody should do their own research and talk to their Doctor if they have questions or concerns.

i would strongly suggest , research and careful thought when using these , there might be a better alternative for you .

especially when this is used long term

 

[threegoofs]

If your HDL is high enough, 60, maybe 70, you're pretty close to bullet-proof & your LDL doesn't much matter. Very very low density is worse also than run of the mill LDL.



If the pharma industry doesn't fund studies, who will?

The data doesn’t support that.

But my guess is that realistically, it might not be a bad idea, if one tolerates them as the vast majority of users do.

Cholesterol numbers are nice as a guide, but statins probably are working independent of the effect upon LDL levels. They seem to stabilize plaque... and if you’re 60, I can almost guarantee you have coronary plaque.

 

[threegoofs]

Did you read the study? They didn't include patients prescribed statins. But just for grins let's say they did that wrong and 100% of the control subjects were on statins. Factoring in the benefits of statins, the calculator overstated the risk by 3x (Yes, that's right - 3x).



Other factors do play a role, but you'll have to explain how those other factors account for a .67x reduction in risk. That's a lot better than the 0.3x reduction in risk you get from statins. We need to explore those other factors.



We also need to factor in that somewhere between 30 and 60% of patients discontinue their statins, and "as many as 20%" complain of side effects. https://www.latimes.com/science/sciencenow/la-sci-sn-statin-denial-20170724-story.html Apparently these "well tolerated agents" are not so well tolerated.



I personally know 4 people on statins, and I was unable to convince any of them to discontinue them. If you think it's easy to get someone to go against doctor's orders, you should give it a try. Now 2 of those people have discontinued the drugs due to muscle pain. Another complains of pain, but he won't go against the doctor's orders.



The benefit of statins depends entirely on your heart disease risk. If your risk is 30%, then statins lower your risk 10%. That's pretty good, even if there is (for example) a 10% risk of side effects. But if your risk is 3%, then statins lower your risk only 1%. That's not a very good tradeoff against 10% side effect rate. This is why it's so important to know your real risk and the real side effect rate.



The risk calculators don't take into account hsCRP or triglycerides, both of which are important risk factors. They don't take into account exercise or diet, which are also important, even though the evidence is mostly epidemiological.

You didn’t understand my point.

The risk calculators are off because they are based upon population risk of patients who were not getting the optimal care we enjoy today, especially statin use.

If you don’t understand the simple basics of epidemiology, you really shouldn’t be putting people’s health at risk trying to convince them they shouldn’t be taking the medicine that they have been prescribed.

Google is not a substitute for a medical degree.