Statin Wars - British Style!

[urn2bfree]

Higher LDL is not a disease. I am not aware of any evidence it alone is a risk factor independent of other cardiovascular risks.
This reminds me of the ongoing hysteria about sodium and salt. The anti sodium nuts rage against salt. They claim it is dangerous because it raises blood pressure. And yet it is not at all clear that is an effect for everyone.
These things are complicated. If you have high blood pressure that is sensitive to salt- sure - don't use it. But blanket public policy prescriptions are just stupid.
Same for the statins for all high cholesterol nonsense.
If you do not have any cardiac calcification, no diabetes, no family or personal history of heart disease, no smoking, no high blood pressure...I am not convinced the benefits of statins "fixing" your blood test will be outweighed by the risks and expense of life long medication.

 

[razztazz]

Sorry to hear that.

So statins were listed on the death certificate as the cause of the kidney failure & death? Did she sue the maker? Thanks.

That wot qualify. They will not "declare" statins as a cause of death but it is known that kidney failure is an adverse reaction to statins Also, no law suit will go forward because it is known and prescribed by jillions of doctors. Ergo no malpractice and like, "S***" man the whole world knows these pills can cause this, so, the manufacturer is not sue-able That is exactly how the system works.

My doctors kept saying that even tho all my conditions causing declining health were clearly listed as adverse reactions... in their medical, opinion they were not being caused by the medication and that I needed to keep taking them to "lower my risk". Dr.s have proven themselves to be quite stupid, self-serving, dangerous, and cannot be trusted. I pay for access. If I get their opinion I check it out.

 

[Teacher Terry]

Razz, I totally agree and most people I know don’t sue.

 

[street]

My mother was on statins for many years. She had kidney tests every year to see if there was any damage. Her muscles/bones ached and had pain from the pills but she continued to take them. When she got to mid 80's her Doctor said that she wouldn't need the statin's any more. So she stopped taking them and lived till 92 from other complications but not heart.

 

[eytonxav]

When my GP dr recommended a statin after I failed to get my numbers down through diet(around the age of 50), I didn't hesitate in taking one. My numbers have been great ever since and I have had no side effects whatsoever after 14 years of using the med. My cardiologist and regular doctor are still in the camp of statins. Perhaps they are just old school and closed minded but I doubt it. If I'm not going to follow their advice I might as well quit going to doctors.

Sounds like me. I trust my doctor and tend to agree with his advice vs the internet. I do have risk factors including type 2 D and HPB, although both of those have also been under control for over 10 years with good #s.

 

[Teacher Terry]

You can also read professional medical studies on Pubmed just like the doctors do.

 

[donheff]

Often the initial statin prescription is reasonable but some doctors discount reported symptoms with a dismissive “adverse effects are rare.” DW’s GP and cardiologist kept telling her that her muscle pains and inability to maintain her exercise regimen were very unlikely to be statin related. Dr Google said otherwise. As soon as she quit them ( against medical advice) the problems disappeared. Her new doctors are more open minded and worked with her on alternatives to statins.

 

[Offgrid Organic Farmer]

In 1997 I was transferred to Italy, where we mostly adopted the 'Med diet'. At that time my cholesterol numbers went through the roof. The lab at the US Navy hospital in Naples was not able to get a 'reading' on my numbers they were too high for the lab to get a calibrated reading. I was put on statins. I stayed on statins for ten years.

Then in 2007, I had severe muscle pains in my arms and thighs. I stopped taking statins and within a month the pain went away.

My PCP says that after a decade on statins I had a reaction. Which is not unusual.

I will not take statins again.

 

[eytonxav]

I am not sure it will have quite the same effect as a statin, but I understand phytosterols/plant sterols can reduce LDL about 10% and without any lowering effect on HDL. Aside from those that get side effects from statins, statins will also lower HDL which may be counterproductive depending on your numbers.

 

[flintnational]

Here is a review of the Daily Mail article and an overview of the different positions on statin use. The article is written by Dr. Brett Scher, a cardiologist. IMO, he takes a pretty balanced approach and covers topics such as relative risk vs. absolute risk, statin use for primary vs. secondary prevention, and LDL risk levels in the young vs. risk in the old.

"An important consideration is to whom are we specifically referring? Studies have not shown any mortality benefit for lower risk primary prevention in women, and many haven’t shown any mortality benefit in men either. For secondary prevention (when statins are used to treat people with established cardiovascular disease) the mortality data is better, but even then it is estimated 83 individuals need to take the drug for five years to prevent one death."

 

[Golden Mean]

My (very shallow) understanding of the approach with statins, is that it's akin to thinking you should reduce the oxygen in an environment to reduce the risk of fire instead of trying to stop the cause of the fire.

 

[Lsbcal]

Why go to the Doc when I can get all my medical advice on the internet?

OK, I'm exaggerating. But I'd rather go to my Doc then take alternative advice here. I think I have made the right choice for me (only).

 

[gerntz]

To each their own. I'll believe this, amongst many studies:

"After studying mortality over a 20-year period, researchers led by Professor Kausik Ray at Imperial showed that 40mg daily of pravastatin, a relatively weak type of statin, reduced deaths from heart disease in participants by more than a quarter.

Senior author Professor Ray from Imperial's School of Public Health said: "For the first time, we show that statins reduce the risk of death in this specific group of people who appear largely healthy except for very high LDL levels. This legitimises current guidelines which recommend treating this population with statins.""

"The study, by Imperial College London and University of Glasgow, focused on men with high levels of 'bad' cholesterol and no other risk factors or signs of heart disease."

https://www.sciencedaily.com/releases/2017/09/170906170427.htm

 

[Chuckanut]

I bet the % reduction is relative and not absolute. But, if it is absolute it is powerful.

 

[JAGOTI]

Regardless of how high my cholesterol is it’s one thing I absolutely don’t worry about. I focus on healthy weight,etc. Harming a bunch of people to get one good outcome is ridiculous. I knew someone with a cholesterol level of 300 that lived to 90. I treat my HBP, asthma. It’s a solution to a problem that doesn’t exist and a huge money maker for drug companies.

Well said!

 

[msieweke]

To each their own. I'll believe this, amongst many studies:

"After studying mortality over a 20-year period, researchers led by Professor Kausik Ray at Imperial showed that 40mg daily of pravastatin, a relatively weak type of statin, reduced deaths from heart disease in participants by more than a quarter.

1 - This was not a blinded study.
2 - The effect was statistically significant only for patients with LDL >190.
3 - After treating 2560 patients for 20 years, they delayed 65 deaths, which is a 2.5% absolute risk reduction. In other words they need to treat 39 people for 20 years to save 1 life. Another way to put this is that on average each person got less than 4.6 days of life extension.
4 - All the participants were men around 55 at start of trial. We know statins behave differently in women, and high cholesterol appears to be protective in those over 70, so make of that what you will.

Whenever you look at statin trials, you have to be skeptical for several reasons:
1 - Trials run by drug companies are 5 times as likely to show positive results as trials run by independent groups.
2 - People who show adverse effects early are generally excluded from the trials, which skews the adverse effect reporting.
3 - Statin trials are never fully blinded. The first time you go for a physical and get a cholesterol test, both you and your doctor know whether you're on the placebo.

 

[sengsational]

In other words they need to treat 39 people for 20 years to save 1 life.

Thanks for doing that leg work. I was "this close" to going to the paper to pull back the NNT myself. And that was with people that had LDL-C >190! Quite a few doctors prescribe a statin if they see over 100. Nuts!

 

[threegoofs]

I just have to say, as a trained clinical pharmacist specializing in cardiovascular disease who’s spent 30 years doing statin trials, reading statin trials, interpreting statin trials, teaching students, pharmacists and physicians about statin trials, and committed to high quality care in patients, most of this thread has opinions that are absolute crap.

Statins are ridiculously effective in patients with established CV disease. They are also quite useful in patients who are at risk and qualify for primary prevention. Their safety is very good- literally hundreds of millions of patient years experience.

The people disseminating their ridiculous, half informed opinions on this issue here are putting people at risk...and are probably both unaware of that and don’t care.

Shameful.

 

[Dash man]

I just have to say, as a trained clinical pharmacist specializing in cardiovascular disease who’s spent 30 years doing statin trials, reading statin trials, interpreting statin trials, teaching students, pharmacists and physicians about statin trials, and committed to high quality care in patients, most of this thread has opinions that are absolute crap.

Statins are ridiculously effective in patients with established CV disease. They are also quite useful in patients who are at risk and qualify for primary prevention. Their safety is very good- literally hundreds of millions of patient years experience.

The people disseminating their ridiculous, half informed opinions on this issue here are putting people at risk...and are probably both unaware of that and don’t care.

Shameful.

This is why I listen to my Cardiologist instead of free advice on an internet forum.

 

[razztazz]

This is why I listen to my Cardiologist instead of free advice on an internet forum.

As far as I'm concerned it's just more internet stuff. I have personal experience AND all the OTHER RELEVANT studies. Not just the ones that suit my point.

Any discipline that is defined by "latest studies..." is not a discipline at all

 

[Chuckanut]

I just have to say, as a trained clinical pharmacist specializing in cardiovascular disease who’s spent 30 years doing statin trials, reading statin trials, interpreting statin trials, teaching students, pharmacists and physicians about statin trials, and committed to high quality care in patients, most of this thread has opinions that are absolute crap.

Statins are ridiculously effective in patients with established CV disease. They are also quite useful in patients who are at risk and qualify for primary prevention. Their safety is very good- literally hundreds of millions of patient years experience.

The people disseminating their ridiculous, half informed opinions on this issue here are putting people at risk...and are probably both unaware of that and don’t care.

Shameful.

Perhaps with your expertise you an answer this concern of mine. I do take a low dose of statin after doing lots of research and talking to my PCP. But, to be perfectly honest, I wonder if it does much good. From what I have read literally 100+ people like me need to take the statin for 5 years to avoid one CVD event. OTOH, lowering LDL seems vital to preventing CVD, and statins do that very well.

For person with no CVD history and no CVD diagnosis, how much good does taking a statin do me? In absolute terms (not relative) how much does it decrease my chances of having heart disease? 1%, 10%, 20%?

I ask this not as a wise guy, but as a person who has never been able to get an answer based upon a well done scientific study. People are confused. You posting says "They are also quite useful in patients who are at risk and qualify for primary prevention." For starters what does 'quite useful' mean? What does 'qualify for primary prevention' mean?

Again, I am not trying to put you or anybody else on the hot-seat. I just want to understand.

Signed,
One Very Confused Consumer of Medical Services

 

[Teacher Terry]

I don’t think anyone here is trying to convince people to not take statins. People are stating what they personally do. It’s a individual decision.

 

[ls99]

I just have to say, as a trained clinical pharmacist specializing in cardiovascular disease who’s spent 30 years doing statin trials, reading statin trials, interpreting statin trials, teaching students, pharmacists and physicians about statin trials, and committed to high quality care in patients, most of this thread has opinions that are absolute crap.

Statins are ridiculously effective in patients with established CV disease. They are also quite useful in patients who are at risk and qualify for primary prevention. Their safety is very good- literally hundreds of millions of patient years experience.

The people disseminating their ridiculous, half informed opinions on this issue here are putting people at risk...and are probably both unaware of that and don’t care.

Shameful.

Perhaps an in depth analysis of the NNT as applied to the various forms of statins by expert such as you would enlighten the rest of us.

 

[Rianne]

The people disseminating their ridiculous, half informed opinions on this issue here are putting people at risk...and are probably both unaware of that and don’t care.

Shameful.

Really? I never thought my opinions were 1/2 informed. Nor did I think offering my opinion/personal experience would put anyone at risk. Did anyone ask for your opinion? No, you just gave it.

 

[msieweke]

Suppose you're at a gathering with 99 friends and someone tells you that 3 of you will have a heart attack some time in the next 5 years. "But I have a drug that will prevent 1 of those heart attacks. The problem is that we don't know who is sick or who will benefit." You all decide to take the drug. After 5 years 2 of your friends had heart attacks, and you find out that you are the one who was saved. Pretty good, huh?

But there was a cost. Each person paid $100/month for the drug or $6000 over 5 years. That was a good deal for you, but not for your friends. In total your friends paid $594,000 to prevent your heart attack, and they gained no benefit. Does that still sound good?

But there's another cost. Ten friends developed muscle pain that may or may not have gone away after discontinuing the drug. One developed transient complete amnesia that went away after discontinuing. One developed abnormal liver test results, and is being watched. Two had increased mental confusion, which their doctors ascribed to aging. Six developed type 2 diabetes (who would not have otherwise) and had to go on medication for it. All to prevent your heart attack. Does that still sound good?

You have to ask: Are these numbers realistic? Myalgia (muscle pain) reported rates are from 1-10%, and it is a common reason for discontinuing statins. The mental effects are disputed, but there are a lot of anecdotal and case reports. The adverse event rate is probably higher than 10%. Most doctors tell their patients that muscle pain and mental confusion are normal for their age, so they are not entered in the DAERS. The diabetes number comes from a published study. Transient global amnesia is a known but rare side effect.

How much do these numbers need to change for the risk to be acceptable?