Statin Wars - British Style!

[zedd]

Now I'm wondering if some of the financial advice I've taken from this forum is BS or crap.

BS is crap.

 

[flintnational]

Now I'm wondering if some of the financial advice I've taken from this forum is BS or crap.

Actually I do equate personal finance and health. IMO, both are way too important to outsource completely to others (including experts). That means I spend too much time reading about personal finance and health related topics. Hopefully I come to the right conclusions for me most of time.

 

[JoeWras]

BS is crap.

I'll say this about health related advice on this forum... I learned about kefir here. Good stuff!

Now, do I just drink my kefir and assume it cures all? No. But it is a nice addition. I am on a statin due to family history and my own numbers. I also take vaccines.

 

[Oz investor]

Actually I do equate personal finance and health. IMO, both are way too important to outsource completely to others (including experts). That means I spend too much time reading about personal finance and health related topics. Hopefully I come to the right conclusions for me most of time.

+ 1

 

[tfudtuckerpucker]

Just a reminder...

 

[mamadogmamacat]

I'll say this about health related advice on this forum... I learned about kefir here. Good stuff!

Now, do I just drink my kefir and assume it cures all? No. But it is a nice addition. I am on a statin due to family history and my own numbers. I also take vaccines.

+1 on the kefir, sure did improve things gastrointestinally for me, especially um......the consistency of my well, crap

regarding statins, think we should as a forum put this topic on the list of perennial friendly (I hope) disagreement, like mortgage payoff and when to take SS

 

[zedd]

Too funny!

Not trying to be argumentative. For personal reasons have chosen to abstain from statins. We're all big boys and girls (not PC? No offense intended) here and should be capable of making educated and informed decisions about our health.

Am hopefull that with a little humor a certain contributor,uniquely qualified to engage in this important conversation, will return.

 

[mamadogmamacat]

hope they return too as it sounds like they may have some good reference material

now thanks to this fabulous forum, i have been reminded to go put out some frozen organic blueberries to mix them in my daily plain kefir

 

[threegoofs]

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

It’s not possible to estimate the benefit without lots more info.

A good start is to calculate your ten year CV risk with the CV risk calculator.

http://www.cvriskcalculator.com

You can assume that based on that calculation, a statin will knock off a certain percentage of that risk. How much? Hard to say without knowing details, but it might be 25-33%, depending on your risk and what study you look at.

However, that risk is cumulative- the drug modifies your plaque buildup and stability in your coronaries.

The problem is the downside risk... which pretty much is muscle issues that occur in a few percent of patients. If you get those- you might need to stop.

Cost isn’t really an issue anymore. But if it is for some reason (atorvastatin these days is virtually free!), that’s something.

Overall, they may work for you individually, they very much will work on a population basis, and the downsides are minimal.

 

[threegoofs]

You appear to be in a unique position to provide useful information on this topic. However, in your post you did not provide any data or references. You simply chose to belittle and criticize those that do not agree with you. I suggest there is a better approach. We would appreciate your thoughtful participation in this thread.

I have a day job. This stuff is available on a million reputable health websites and from your physician.

If you don’t believe me, my guess is no reference I provide will be good enough.

If you don’t like me to criticize people who are providing irresponsible information, you probably won’t care about the info I supply.

Frankly, if you don’t take a statin and show up in the Cath Lab, the cardiologists in the lab will be more than happy to make money from a stenting procedure. The rest of the system will be more than happy to collect fees for the heart failure onset, additional complications, etc.

Your failure to take a statin will make medical providers more money. So thanks for that.. I guess?

 

[threegoofs]

First of all no one is telling people not to take statins. People are reporting what they are doing personally. Hopefully, no one would make a personal decision based on a forum.

LOL.

Did you READ the first ten posts or so of this thread?

 

[threegoofs]

In addition to the MD's and researchers mentioned in the OP linked article, there are a number of MD's and medical professionals that believe the benefits of statins are over sold and the side effects minimized. Hence the post title, "Statin Wars".

Like many others on this forum, I have read numerous statin studies. No doctor interpretation needed. The data is conflicting at best. And, the data for all cause mortality vs. cv mortality, men vs. women, young vs. old and primary vs. secondary prevention yields varying results. Then when you factor in that the vast majority of studies are funded by the companies selling statins, many of us rightly doubt the pitch of statins as a wonder drug for everyone with high LDL.

That being said, I have seen no evidence to suggest that anyone is recommending an individual stop their medication. That is a decision for you and your MD. But, those opposing statins for themselves are not being illogical or irresponsible in expressing their views. They are simply reviewing the data (and reading expert opinions on the other side of the issue) and coming to a different conclusion for their situation.

Yeah... this isn’t controversial in the medical community AT ALL.

The anti statin types are widely regarded as kooks.

This ‘both sides’ argument is frankly, absolutely ridiculous.

It’s almost anti-vaxxer territory. And almost as irresponsible.

 

[Teacher Terry]

Yes I read Pubmed and other reputable sites. Everyone is responsible for themselves. We all live with our decisions and I am comfortable with that. We all can be whatever we present ourselves to be on the internet. Enjoy!

 

[flintnational]

Yeah... this isn’t controversial in the medical community AT ALL.

The anti statin types are widely regarded as kooks.

This ‘both sides’ argument is frankly, absolutely ridiculous.

It’s almost anti-vaxxer territory. And almost as irresponsible.

I removed my snarky comment.

ETA: I get your point about population level benefits of statins and I like the calculator you provided. That may be where the conflict arises. You are interested in population outcomes. I am interested in individual outcomes, mine. With a TC of 265, the calculator puts my 10 year risk at 6.9%, or just below the 7.5% recommended threshold for statin use. The DW's TC runs around 295 but her 10 year risk is 2.8% and also below the statin threshold. I think those results will surprise many. Obviously the calculator is giving both of us credit for low BP, high HDL, non-smoker and non-diabetic status.

 

[6miths]

Statins are clearly beneficial to populations with certain risk factors. There is growing concern regarding the veracity of trials that are available with evidence that drug companies are gaming the system and withholding unfavourable results. Even if there was no concern in that area, there would remain concern in the way many drugs are marketed in ways to get doctors to prescribe to individuals in which no benefit has been demonstrated and also in direct to consumer marketing. It is a good idea to be informed and skeptical.

 

[mickj]

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.

 

[flintnational]

..............Frankly, if you don’t take a statin and show up in the Cath Lab, the cardiologists in the lab will be more than happy to make money from a stenting procedure............

Of course. Then there is the recent double blind randomised controlled trial published in the Lancet on the use of stents for angina, the most common use.

"In patients with medically treated angina and severe coronary stenosis, PCI did not increase exercise time by more than the effect of a placebo procedure."

Below is a summary of the stent issue from a Vox article. And. a similar article at the NYT with a pay wall, "Heart Stents Are Useless for Most Stable Patients. They’re Still Widely Used.".

"Over the years, studies have been piling up that suggest stenting stable angina patients may not actually be all that helpful.

A decade ago, researchers published a study in the New England Journal of Medicine showing that stents did not improve patients’ mortality risk or cardiovascular disease outcomes. Since then, meta-analyses of randomized controlled trials on stents in stable angina patients have similarly found the devices don’t outperform more conservative medical therapies (such as medication) when it comes to preventing heart attacks or extending patients’ life expectancy in the long term."

ETA: I get it. Medical research is very difficult. Accordingly, we each need to read, consult with our MD and make our decisions based on the available data. But, to suggest the debate is closed on important medical topics or that critics are "kooks" and "irresponsible", is clearly an impediment to good science. The medical landscape is littered with drugs and procedures that were thoroughly tested by pharmaceutical companies, approved by the FDA, administered to scores of patients and later withdrawn due to negative outcomes.

 

[eytonxav]

A good start is to calculate your ten year CV risk with the CV risk calculator.

ACC/AHA ASCVD Risk Calculator

I have risk factors including type 2 diabetes, HBP, and a family history of heart disease. Due to that my Dr wants my LDL < 70. I do take a low dose bp med and my blood pressure is normal with the medication. My diabetes has remained in pre-diabetic/normal range for about 10 years, and my cholesterol has been low. I tried keying in my numbers and the calculator would not work for total cholesterol lower than 130. Mine is 97. I was curious what the calculator would show my risk factor to be, but I suppose it's intended for folks that are not currently on a statin.

 

[bmcgonig]

It’s not possible to estimate the benefit without lots more info.

A good start is to calculate your ten year CV risk with the CV risk calculator.

http://www.cvriskcalculator.com

You can assume that based on that calculation, a statin will knock off a certain percentage of that risk. How much? Hard to say without knowing details, but it might be 25-33%, depending on your risk and what study you look at.

However, that risk is cumulative- the drug modifies your plaque buildup and stability in your coronaries.

The problem is the downside risk... which pretty much is muscle issues that occur in a few percent of patients. If you get those- you might need to stop.

Cost isn’t really an issue anymore. But if it is for some reason (atorvastatin these days is virtually free!), that’s something.

Overall, they may work for you individually, they very much will work on a population basis, and the downsides are minimal.

Threegoofs,

That calculator is strange.

I'm 63. LDL of 170. HDL 50. BP 120/80. Doctor says those results are great.

Yet, It recommends that I be on a moderate to high statin. Seemingly cos I'm over 60. 8.7% chance.

Can you explain it?

 

[msieweke]

That calculator is strange.

The calculator greatly overstates risk. Here's a study comparing the calculator to actual populations: https://www.statnews.com/2016/05/06/heart-attack-risk-overstated/.

 

[Rustic23]

We have a "preventive cardiologist" in the family. He recommends,
1 Walk an hour a day
2 Cut down on carbs
3 Take a Statin drug. (which he refers to as a miracle drug!)

He says since he started putting patients on this regime he no longer has late night visits to the emergency room.

Good enough for me.

 

[threegoofs]

Of course. Then there is the recent double blind randomised controlled trial published in the Lancet on the use of stents for angina, the most common use.

"In patients with medically treated angina and severe coronary stenosis, PCI did not increase exercise time by more than the effect of a placebo procedure."

Below is a summary of the stent issue from a Vox article. And. a similar article at the NYT with a pay wall, "Heart Stents Are Useless for Most Stable Patients. They’re Still Widely Used.".

"Over the years, studies have been piling up that suggest stenting stable angina patients may not actually be all that helpful.

A decade ago, researchers published a study in the New England Journal of Medicine showing that stents did not improve patients’ mortality risk or cardiovascular disease outcomes. Since then, meta-analyses of randomized controlled trials on stents in stable angina patients have similarly found the devices don’t outperform more conservative medical therapies (such as medication) when it comes to preventing heart attacks or extending patients’ life expectancy in the long term."

ETA: I get it. Medical research is very difficult. Accordingly, we each need to read, consult with our MD and make our decisions based on the available data. But, to suggest the debate is closed on important medical topics or that critics are "kooks" and "irresponsible", is clearly an impediment to good science. The medical landscape is littered with drugs and procedures that were thoroughly tested by pharmaceutical companies, approved by the FDA, administered to scores of patients and later withdrawn due to negative outcomes.

LOL.

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

Because use of statins in that population is absolutely unvontroversial.

 

[threegoofs]

Threegoofs,

That calculator is strange.

I'm 63. LDL of 170. HDL 50. BP 120/80. Doctor says those results are great.

Yet, It recommends that I be on a moderate to high statin. Seemingly cos I'm over 60. 8.7% chance.

Can you explain it?

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.

 

[threegoofs]

The calculator greatly overstates risk. Here's a study comparing the calculator to actual populations: https://www.statnews.com/2016/05/06/heart-attack-risk-overstated/.

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.

But the fact is that statin use has literally changed the course and development in heart disease in the world in a tremendous way.

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

 

[Teacher Terry]

I would be interested in knowing all the doctors and pharmacists that recommend them are you taking the statins?