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Statins -- Underprescribed and Overprescribed

Professor Helen Stokes-Lampard, the chair of the Royal College of GPs, responded to the findings of the BJGP, which is the college’s independent academic journal.

“Patients should be reassured that GPs are highly trained to prescribe statins and base their decisions on the circumstances of the individual patient sitting in front of them,” she said.

My capital letters, what a load of baloney.
 
From my own reading GPs are nowhere near trained to understand the role of all the different cholesterol in the body therefore, how can they possibly prescribe for it? As for assessing the patient in front of them all they do is a qrisk which is just a tick box excercise and no way does it personalise the assessment. To me, it is like a conveyor belt whereby we are treated a little like commodities. If you don't understand the problem how can you, in all faith, advise on treatment? When all said and done statins are a big fat con and if a GP only reason to get me on them is because he is 'incentivised' to do so then sorry, I'm not playing this game.
 
Guzzler said:
When all said and done statins are a big fat con and if a GP only reason to get me on them is because he is 'incentivised' to do so then sorry, I'm not playing this game.
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From what I remember (please correct me if I am wrong), studies have show that statins do not increase life expectancy, however they do reduce the incidence of strokes or other CVD (cardio-vascular disease).

However, and here again I am new to all this, statins seem to wreak a bit of havoc with BG control in diabetics and may even help cause T2 in people who don't have it yet. So it is by no means a slam-dunk decision for a doctor. It is made even more complex by the fact that T2 itself can cause CVD, but statins can help prevent CVD. Rather than a decision tree, it begins to look more like a circular argument.

It's a hard enough decision for non-diabetic patients. Even harder for those with diabetes.
 
When I was diagnosed with diabetes my GP had prescribed statins and aspirin before I walked in the room.!!
CAROL
 
Grateful said:
From what I remember (please correct me if I am wrong), studies have show that statins do not increase life expectancy, however they do reduce the incidence of strokes or other CVD (cardio-vascular disease).

However, and here again I am new to all this, statins seem to wreak a bit of havoc with BG control in diabetics and may even help cause T2 in people who don't have it yet. So it is by no means a slam-dunk decision for a doctor. It is made even more complex by the fact that T2 itself can cause CVD, but statins can help prevent CVD. Rather than a decision tree, it begins to look more like a circular argument.

It's a hard enough decision for non-diabetic patients. Even harder for those with diabetes.
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You are right. Statins have been shown to lower cholesterol but more people die from heart related incidents with low cholesterol than with raised cholesterol. Even after one has suffered a heart attack the benefit of statin use is extremely low. We as Diabetics have a higher risk of CVD/CHD that is why we are almost automatically urged to take a statin. My point is that unless you understand the role of lipids which carry the cholesterol and then apply the logic - the so called logic - it makes no sense at all.
The body manufactures 85% of its own cholesterol, only 15% is dietary. Cholesterol is vital, absolutely vital for life, without it we would be puddles because cholesterol is needed for all but two of the types of cells in the human body i.e cells need cholesterol in the cell wall to maintain structure.
Then there is the way they measure cholesterol. I won't go into it here but it really needs updating.
 
carty said:
When I was diagnosed with diabetes my GP had prescribed statins and aspirin before I walked in the room.!!
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Outrageous, or so it seems to me, unless s/he already had evidence of CVD. (Mind you, baby aspirin, at least, seems almost harmless.)

Thinking about my elderly friends and relatives, many of them are on statins. This has been sold to them as a big "medical revolution" to avoid the strokes and heart attacks of yore, and that particular generation has been raised to believe in Progress and Wonder Drugs so they usually acquiesce without objection.

Trouble is, they are usually taking lots of other drugs too. For hypertension (not just statins), hypotension, sleep deprivation, etc. Then they walk around feeling dizzy and unwell all day, not just from the side effects of the individual drugs but from the interactions of that cocktail. Plus, it's often not clear that the dosage is correct, or that these drug-addled souls are following dosage directions in any case.

I know it will probably happen to me, too, but I'm determined to put off the avalanche of medications for as long as possible. Edited to add: Even more relevant if one has diabetes.
 
Grateful said:
Outrageous, or so it seems to me, unless s/he already had evidence of CVD. (Mind you, baby aspirin, at least, seems almost harmless.)

Thinking about my elderly friends and relatives, many of them are on statins. This has been sold to them as a big "medical revolution" to avoid the strokes and heart attacks of yore, and that particular generation has been raised to believe in Progress and Wonder Drugs so they usually acquiesce without objection.

Trouble is, they are usually taking lots of other drugs too. For hypertension, hypotension, sleep deprivation, etc. Then they walk around feeling dizzy and unwell all day, not just from the side effects of the individual drugs but from the interactions of that cocktail (and that is assuming the dosage is correct, and that these drug-addled souls are following dosage directions).

I know it will probably happen to me, too, but I'm determined to put off the avalanche of medications for as long as possible. Edited to add: Even more relevant if one has diabetes.
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You are giving a very good description of my 87 y/o mother in law. She won't ever question what her GP says as she was raised to believe that doctors can do no wrong yet some of the meds, including statins, that she has been prescribed have turned her at times in to a sobbing zombie. Heartbreaking. Luckily a locum doctor referred her to a specialist who has discontinued five of her meds (much to the disgust of her GP) and she doesn't seem so depressed any more.
 
Chook said:
You are giving a very good description of my 87 y/o mother in law. She won't ever question what her GP says as she was raised to believe that doctors can do no wrong yet some of the meds, including statins, that she has been prescribed have turned her at times in to a sobbing zombie. Heartbreaking. Luckily a locum doctor referred her to a specialist who has discontinued five of her meds (much to the disgust of her GP) and she doesn't seem so depressed any more.
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Someone close to me, who is now 92 years old and was a research scientist by profession, has filled an entire large bathroom cabinet with his medications. He is usually "as sharp as a tack" as they say here in America, but still goes through lengthy periods of wobbliness (constant danger of tripping over and falling) and confusion, and spends much of the day catch-up sleeping because his night-sleep is so disturbed (despite the cocktail of meds he takes for insomnia).

Speaking for myself, I innately trust doctors. However that has been badly shaken both by some personal experiences (a botched elbow operation that required two complex follow-up surgeries to fix) and by seeing what is happening to my elderly friends/relatives. It's not just the mountain of pills that the doctors are prescribing, it's the fact that they are often seeing multiple specialists, who don't seem to talk to each other (this is in USA and France). I wonder whether the NHS does this better.
 
I agree - my husband has something wrong with him that has involved six trips to different discipline specialists in the last six months with each of them requesting blood tests (many of which were duplicates). But, as you say, they don't seem to communicate with each other or even put much thought in to who they are going to refer him to next. it's been like Pass The Parcel. We were both really upset to get a letter to say he had been referred to an Oncologist, especially as no one has mentioned the likelihood of cancer. Thankfully after tests and scans that was ruled out but it's all taking its roll on my husband (and rapidly using up his annual leave entitlement).
 
My parents are both in their mid 80’s. Until recently neither had been on any meds. My father now has stage 4 abdominal cancer so he needs meds.
Before the cancer they were always told to bring their meds to all Dr appointments. When they came without meds the Dr would say, “you are supposed to bring your meds with you to all appointments.” When they stated they weren’t on meds the Dr actually ask, “why aren’t you on meds? You’re old, you should be.” He would try to prescribe some but they refused.
 
I would say it is the same here in UK. There are the highly specialised fields of medicine i.e cardiology, neuro science, oncology etc but they are so separated and 'insular' that they do not cross reference at all. I have had conflicting advice and when I have asked for clarity from a GP the only answer I have got is that the doctors will weigh up the pros and cons before they give treatment but this has not happened in my case, anyway. We shouldn't have to second guess our way through the advice given.
 
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