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Statins & high cholesterol

Whereas statins were certainly designed to lower serum cholesterol (as I recall) by enhancing its breakdown in the body, the fact is they don't really know how it reduces the incidence of cardiovascular events. They know people with high cholesterol tend to have more cardiovascular events and statins reduce that, but they also reduce it in people who have cardiovascular disease but "normal" cholesterol levels. FYI the first statin released by our FDA was lovastatin (Mevacor) in 1987. The last one was Crestor (rosuvastatin) which is the only one still under patent.
 
TheBigNewt said:
they don't really know how it reduces the incidence of cardiovascular events.
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Probably because its debatable if it does anyway and the companies that have sponsored the research have never released the raw data.
TheBigNewt said:
They know people with high cholesterol tend to have more cardiovascular events
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Depends on your definition of "high" of course. Looking at the UK parameters for Type 2 diabetics anything over 4.0 is "high" whereas more modern studies seem to think it should be over 10 being classed as "high". The PURE study shows over 8 I think as being less beneficial(i.e. higher overall mortality). What it boils down to is for those who have not had a cardiac event then statins are marginal to say the lease. If cholesterol is a lousy marker for CVD then why look at it unless it is stratospheric. Have a CAC scan and look at the actual calcium build up in the arteries.
 
If you don't think "high" cholesterol isn't a risk factor for coronary events I've got some swamp land I'll send you in Florida! I am pimping statins for people with established disease: stent, heart attack, bypass. No question about statins and them. You mention the "CAC scan, which we call EBCT I think. Now that's controversial. Why? Because the mere presence of coronary calcium doesn't tell if the artery is blocked inside, the flow of blood. And if you have some what do they tell you to do about it? TAKE A STATIN. They are mostly useful if you have NO calcium. Then you're OK. But people I see are usually in their 60s and virtually none of them have zero calcium. I just gives them something more to worry about. Now there are newer imaging techniques that allow you to actually see/estimate % of the artery that is blocked. Those aren't used in a lot of places yet. Old fashioned angiography is still the "gold standard" for coronary blockages. Done my share of those over the years (not anymore though).
 
Art Of Flowers said:
See ...

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OMG by watching this U tube entry I have just realised what my problem is. I was put on Statins over 9 years ago and for 8 of those years I have been suffering with leg and foot pain. Finding also that when driving I start to find it difficult to breath normally. I have been investigating this problem for 8 years now and keep getting fobbed off with "Panic Attack!" when my breathing changes. Yes I have arthritis in my toe joints but get a lot of burning pain in both feet and can't bear anything to touch my legs as the skin and muscles are so painful. Can't wear tights or stockings only lose socks and trousers can't even bear a hem of a skirt touching my skin. I'm getting forgetful, can't sleep at night either. My GP has just changed my statins from Simvastatin to Atorvastatin this week telling me that they would be better for me but won't tell me why. This frightens me now as I struggle in sitting up in bed every morning and sometimes during the night as I feel the muscles around my heart are week. I now feel that trusting the NHS is killing me. I'm only 65 and have had to look after a husband that is a quadriplegic for over 20 years so haven't had time to enjoy my life yet. I came off Metformin 2 years ago as it was giving me stomach cramp pain when it was releasing itself. Probably was that mixed with the statins that didn't agree with each other. I love the Low Carb diet and in all fairness I don't eat processed foods any more so I do believe that I could keep the carbs down and the cholesterol at the same time. But what really frightens me is if i gave up the statins is it going to make me feel worse first before I get better and will I be writing my own death certificate if i stop them straight away.
 
I had only five weeks or so of taking Metformin and Atorvastatin, and I got all the side effects - and how!!
When I stopped taking them I was a total mental and physical mess.
I am getting some ability to remember things back but a lot of it is energetic relearning and going through my diaries - but after a few weeks I managed to get about more and in a little while after that I managed without the walking poles and the heart pounding whenever I exerted myself gradually reduced. Thank goodness I wrote down a lot of my songs for posterity - it turns out that is me.
No matter what the tablets protected me from, sitting staring at the TV or out the window wishing I could go outside is not what I want to be doing. It is not a life.
 
Lorraine Cannell said:
My GP has just changed my statins from Simvastatin to Atorvastatin this week telling me that they would be better for me but won't tell me why.
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The reason is because Atorvastatin is a cheaper drug, and because of this is now the one recommended by NICE. It has nothing to do with being better. I think they both do the same thing.
 
Bluetit1802 said:
The reason is because Atorvastatin is a cheaper drug, and because of this is now the one recommended by NICE. It has nothing to do with being better. I think they both do the same thing.
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Both statins are generic and cheap. Atorvastatin was known as Lipitor. The reason cardiologists use it for CAD patients is because it's the one that's been studied the most in those people. In one landmark randomized trial, the group randomized to take Lipitor 80mg/d who had definite angiographically proven coronary blockage(s) and who were referred for either balloon angioplasty or stent (and did not have it done) only needed the procedure about 15% of the time within the next 3 years. As opposed to the other group who all had the procedure and got whatever lipid lowering therapy their doctors prescribed. In short, the high dose Lipitor group did better in the long run. And the side effects of low dose are about the same as high dose Lipitor.
 

I bow to your superior knowledge.
 
What is the difference between Atorvastatin and Simvastatin. I have been taking Simvastatin for years and have a huge muscle problem that no one has ever got to the bottom of. My GP retired before Christmas and on her last day she changed my prescription to Atorvastatin and would say why other than she thought it would be better for me.
 
Someone having "definite angiographically proven coronary blockage(s)" would clearly change my views on them taking statins. The issue I have is that I no longer trust the research results about statins usage in people where the only risks factors are "age", "high cholesterol" and "Type2 that is well controlled with diet and/or Metformin".
 
Simvistatin (aka Zocor) came out before atorvastatin (Lipitor) and at the time was more potent than the original statin (lovastatin) and the 2nd one (pravastatin). Muscle pain from statins is the most common side effect and stops when the drug is stopped (within a few weeks usually). The statin that is the most chemically different is pravastatin, which is also the least potent. Lipitor is the most potent generic, max dose is 80mg, and by far the best studied in patients with CAD. Crestor (rosuvastatin) is newest and now the most potent at 40mg, not yet generic.
You're talking about primary prevention of CAD which is much harder to prove than secondary prevention. If you have established CAD, usually after an "event" (heart attack, stent, bypass) then it's like having cancer, your future cause of death has most likely been established and you'd be wise to take the only drug class proven to alter that course other than aspirin. I'm not talking about someone found to have a minor 50% blockage in one vessel. A lot of Type 2's have not so great lipids as well, which is why may are prescribed statins in addition to hypoglycemics (metformin, insulin, etc.). That combination not infrequently lead to a CAD event. Type 1 diabetics are a different animal, tend to get "microvascular" disease (eyes, kidneys) and I don't think have been studied with statins probably because they tend to be much younger and there are far fewer of them around.
 
Correct me if I am wrong here, cholesterol is needed by every cell bar two types in the body. Without it we would be puddles of goo. It is used for repair, though this is by far not its only role. The full story on its roles is not known, yet. More people die of a heart attack having had lower levels of cholesterol than higher levels. Collins is withholding the latest research (funded by Big Pharma) into statin use and ignoring calls to publish.
Science does not have the answers and yet guidelines are set for 'safe levels', these numbers have been pulled from the air. Elderly people, I am speaking of those in their eighties and nineties are being put on a drug to extend life, the obvious point here is that these elders havn't done too badly without statins.
Why, with these drugs having been around for a while is the death rate from CHD/CVD still rising.
Why is it that top notch cardiologists are saying in no uncertain terms that cholesterol is not the enemy. And why medicate, or plan to medicate, whole populations on flimsy evidence that bears no scrutiny. If the evidence, the proof, was clear that lowering cholesterol extends life then why is it so very difficult to find.
 
TheBigNewt said:
Crestor (rosuvastatin) is newest and now the most potent at 40mg, not yet generic.
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I have taken this one for nearly four years, but not the 40mg size dose only the 10mg size. I have had no side effects with it.
 
Guzzler said:
Elderly people, I am speaking of those in their eighties and nineties are being put on a drug to extend life, the obvious point here is that these elders havn't done too badly without statins.
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Yep had a massive argument with my Aunt's GP who tried putting her on statins in her late 80's she has enough medical issues with taking other medications and their side effects. The GP who came out agreed with me saying it was a total waste of time.

Read Dr Malcolm Kendrick views on Cholesterol and statins
 

Kendrick's book is excellent. You don't have to be a HCP to read/understand it. His writing really states what should be obvious to us all.
 
[QUOTE="Guzzler, post: 1664234, member: 408573
Why is it that top notch cardiologists are saying in no uncertain terms that cholesterol is not the enemy. And why medicate, or plan to medicate, whole populations on flimsy evidence that bears no scrutiny. If the evidence, the proof, was clear that lowering cholesterol extends life then why is it so very difficult to find.[/QUOTE]
No reputable cardiologist ever said lowering cholesterol with statins extends life in "whole populations". What we use statins for is to treat ESTABLISHED CORONARY DISEASE (in case you didn't read things that I've posted). In fact if a cardiologist implants a coronary stent into a 60 year old patient who's suffering a heart attack and fails to prescribe a statin it is clearly against the standard of care IMO. Right then and there you know what that guy's probably going to die of. He has a clear disease process established. Statins are proven to lower his risk of another coronary event NO MATTER WHAT HIS CHOLESTEROL IS. Go ahead and eat more avocado and forego the dreaded statins if you want, I'm not selling you any life insurance lol.
 
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