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Statins for reducing risk of TIA/Stroke, not for cholesterol

Bluetit1802

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Location
Lancashire
Type of diabetes
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Diet only
I was called in to see my GP with regard to statins because she has just discovered I stopped taking the ones she prescribed for on diagnosis in January. I stopped them a month before my next blood test was due, so I knew I had a safety net, and I told my DN. My next blood test came back with normal cholesterol components for non-diabetics.

A few weeks ago I had a routine CT scan, which was thankfully clear. However, it did show up a low intensity, non-severe thinning or weakness in one area of my brain that was likely due to reduced blood supply. The GP suggests this is a risk factor for future TIA or stroke. She said taking my statins would help reduce this risk (irrespective of what my cholesterol might be and irrespective of my diabetes). She also mentioned a blood thinning agent called Clopidogrel. She sent me away to do my own research on the effect of statins on reducing the risk of TIA and strokes (she knows me too well!!) saying as a doctor she is recommending I take the statins, but is leaving the decision entirely up to me with no pressure.

So, that's me, doing more research for the next few days.

Has anyone any experience of this?
 
No sorry but I am on statins and wondering wether to stop taking them...looks like there is two schools of thought for these drugs but which is the right one??
 
It's going to be a difficult subject to research Bluetit as there is very little impartiality as regards to statins. I do hope that you can find something. If I was you I would ask your G.P. for a more detailed response as to why she thinks that statins are the answer.
As for the blood thinners, have you had any tests as to why your blood is thicker than normal, is there any genetics in the family regarding blood disorders. There is a long history of heart disease in my family and I had blood test to see if I was affected. The results came back as borderline and I was offered an aspirin daily. She may be suggesting this as a precaution?

Take your time in deciding and if taking them in the past did not give you any side effects that may be a plus.
 

Thank you Catherine.

I have discarded the idea of the blood thinners. I've had no blood tests to see if I need them, and my gut feeling is I don't need them. When I bleed, my blood runs freely. On my last blood test it took several minutes to stop the external bleeding, and I am still bruised 3 weeks on. She did say these tablets do the same job as aspirin, but research has shown them to be more effective. She will have offered it as a precaution. She is one of those doctors that offers everything as a precaution!

I must now find out about the statins. I didn't have any side effects when I took them, but I only took them just over 3 months.
 
Hi Bluetit, I'm sure you will do your own research on this (as I would) but in support of that I agree with Catherine - your GP should provide you with justification in the form of links to research documents as to why she is prescribing statins for this specific condition, what the statin is supposed to do to address it, and what other options (drugs or otherwise) might do the same thing. If she can't then I would be a little sceptical. I have books such as Kendrick and Graveline which inform my view on statins, you may well have them also, but they may not help directly here.

Good luck, let us know how you get on.
 
Sorry to hear that you are in this position. It is difficult I think to decide whether a GP is just being extremely proactive over a tiny risk or whether there is a substantial risk and thus benefit to taking the drugs. If you don't want yo take the blood thinner, perhaps you could take the lowest dose of statins possible ? Did you have any issues prior to stopping them? My dad takes them and has had no ill effects but I know many who have had the muscle issues. Could you see another GP at the practice for a second opinion, or get a referral to a specialist? At least then you would know if it is really necessary.
 
I like my GP. She is brilliant at caring. She saw me through my chemo months, came out to see me saying " I was passing so I thought I'd call in", refused to let me near the surgery for fear of infection when my immunity was low, so on and so forth. She spent 30 minutes with me today. She knows how proactive I am when it comes to my health, and I told her the exact reasons why I stopped taking the statins. She was at pains to say she wants me to take them purely for the TIA/stroke risk based on the CT scan, as a precaution. I did ask what statins actually do in this respect, to which she mumbled something about them being little miracles in ways not yet fully understood. I have no heart problems at all, BP normal. I am sure the CT scan has thrown up what maybe a tiny risk, and taken on its own would be insignificant. However, with the diabetes and my current cholesterol levels my CVD risk is at 20% apparently.

I had no issues with the statins when I was taking them before. I was on 40mg. My DN got this changed to 20mg after my last test, but I haven't opened the new packet.
 
Sounds a very caring GP. I don't know enough about the pros and cons of statins to really say anything helpful. What I believe is that what is probably a useful drug in many circumstances has become mired in a lot of controversial debate on both sides, largely I feel because those promoting it seem to be blinded by the big pharma hype so ignore the patient's concerns. Research shows limited benefit for most women but it may be that there is benefit in your specific scenario. Are there any reasons why you are reluctant to try either or both of the meds? I understand that people like to be med free, or worry about side effects but you mention having had chemo which is neither risk nor side effect free. I appreciate that the risk of dying from cancer was measurably higher than the possible 20% risk of a stroke but the latter isn't a negligible risk, and it may be worth trying to reduce it in some way.
 
Thanks CE. I would like to remain med free after a year of being poisoned every 3 weeks last year, and I do like to crow to my friends who take various meds for various things that I don't need any! However, that is pure pride speaking. I am inclined to take the 20mg statins. There does seem to be some scientific research showing the beneficial effects of statins on stroke risk,, but I have further reading to do.
 
Bluetit1802 said:
Idid ask what statins actually do in this respect, to which she mumbled something about them being little miracles in ways not yet fully understood.
Click to expand...

Your GP sounds very nice, but it's statements like that which raise my hackles!

On the risk thing, remember it's not your personal risk that is 20%, it's the average risk to a population meeting those criteria. Within that population there is a wide range, and if your diabetes is controlled then that would bring your personal risk factor down.

According to Graveline, statins are little more than anti-inflammatory agents, but with the down side of inhibiting production of cholesterol, CoQ10 and dolichols that our brain needs. And they can have a negative impact on BG as you have previously surmised when you stopped taking them before.

I don't doubt that you will become a lot more informed about this than me though!
 
Some light reading No I haven't read all of them thoroughly, some may be useful
.
Number Needed to treat : with known heart disease http://www.thennt.com/nnt/statins-for-heart-disease-prevention-with-known-heart-disease/
Number Needed to treat without known heart disease http://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-prior-heart-disease/
(the trouble is deciding which category we fit in . We as people with Diabetes are usually categorised as if we already have CVD, but as stated this may be because a great number of people with diabetes are not well controlled )
Medscape Statins in Stroke prevention (very dense, lots of figures /results of various trials) http://www.medscape.com/viewarticle/576068_8
Cochrane statins for Primary Prevention
http://summaries.cochrane.org/CD004...-primary-prevention-of-cardiovascular-disease
Science based Medicine blog about above with lots of interesting comments http://www.sciencebasedmedicine.org/statins-the-cochrane-review/

Lastly I looked on Bandolier which is unfortunately getting dated now.
http://www.medicine.ox.ac.uk/bandolier/booth/cardiac/cholstroke.html
another NNT set of calculations at different risk levels (not sure how old the data is on this one)
http://www.medicine.ox.ac.uk/bandolier/booth/cardiac/statcalc.html
I also found this review of a study which looked at the differences in outcome on people who suffered strokes according to whether or not they were previously taking a statin http://www.medicine.ox.ac.uk/bandolier/band124/b124-5.html
 
I can understand not wanting to take meds and the pride factor. I was brought up to feel ashamed of illness such as diabetes, high BP etc and to think that taking the meds would mean I was useless or weak willed. Not a very helpful response as something are outside of our control . As you say this has happened irrespective of your diabetes and cholesterol, both of which you are working hard to control. Perhaps the low dose statin is a compromise that you and your GP can live with.
 
You need to know more about the brain thing.

Sure, statins are known to protect against further heart attacks once you have had one, at least in men and it probably has to do with lowering inflammation in some way but so does a low carb diet.
 
Thank you @phoenix I do appreciate it. Whatever would we do with without you on this forum. I will plough through all those, but not today. I'm fed up and have now given myself toothache!

Thank you also @sanguine and @cold ethyl for your supportive comments.
 
Try and relax and take your time to decide. Far better to make an informed decision that you are happy with.
 
Some great advice, I would go along with what Catherine & Cold Ethyl say and ask your gp for more information on why it would be in your best interests to take statins......... or ask for a second opinion from another gp.

Alternatively you could get in touch with the Stroke Association and ask for their advice, I don't know how impartial they would be but I'm sure they will help anyone who is at a heightened risk of a Stroke/TIA.

Whatever your decision I wish you the best of luck.
 
Sounds like you have a good GP. Although there is no good reason for most people to take statins, for those at high circulatory risk they may make sense and I think this is what the GP is saying. If it was me I would take them and see whether you have any side effects. I had no side effects but did decide to stop as I have no family history of heart problems. It's a risk trade-off but you will probably know if you suffer any side-effects
 
PatsyB said:
No sorry but I am on statins and wondering wether to stop taking them...looks like there is two schools of thought for these drugs but which is the right one??
Click to expand...
I take statins have never had any side effects from them so no reason for me to stop them but some others on here have had bad side effects so have stopped them. Yes there are definately two schools of thought on them
 
Seems to be standard protocols for GPs to offer statins to anyone with increased risk of heart or stroke symptoms. Whether you take them or not is your choice. With statins I'd only take them if my cholesterol level was high. The blood thinners are another precautionary measure. You say there's no problem with the texture of your blood, but when your blood sugar is elevated it becomes thicker and stickier. And makes it harder to to get through the arteries especially narrowed ones and can stick to any existing plaques causing narrowing.

So it's all preventative and your choice to weigh up the pros and cons. Have to say despite being put on statins after having an angiogram which showed only minor plaques in a minor coronary artery, I somehow ended up needing a stent to fix a major coronary narrowing just 7 years later. Maybe it would have developed sooner without them , but makes you wonder.
 
Surely does make you wonder so I best take them until I have seen the doc and make sure my levels are ok.
 
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