Telegraph: Statins for all over-50s to reduce heart deaths

[borofergie]

Re: Telegraph: Statins for all over-50s to reduce heart deat

If it is proved to help save coronary problems, yes, i will take the advice of my cardiologist.

That's the key point - I don't think it has been proved to save coronary problems, at least not when applied to women or those without a cholesterol problem.

Let me ask you a question, if there had been a pill around when you were growing up that was proved to help stop people develop diabetes, would you or your parents have considered it? Were you immunised as a child against the usual diseases? Have or will your children be given the same help? Do you think that the NHS should have stopped giving the TB inoculation?

My parents probably would have, but unfortunately they didn't have the benefit of my education or the information resources available to them. Unfortunately they both died in their early sixties after failing to challenge doctors who missed obvious diagnoses of cancer. So blindly taking doctor's at their word is a sore point.

But vacinations is a good point. My son was one of those that received the MMR vaccine when one "dubious maverick" was saying that it caused autism. I did my own research, listened to both sides of the argument and made what I thought was the best decision for my kid. There is much better data on the efficacy of vaccinations then there is on the benefits of statins.

I think that preventative medicine can be very useful and should not be discounted just because a few dubious mavericks say something is useless, thats not to say I wouldnt consider things on an individual basis if offered preventative drugs but I like the idea of having a choice.

But it's not a few dubious mavericks. If they are suggesting that everyone takes statins, they need to demonstrate that the average benefit outweighs the typical risk by enough to make the exercise worthwhile. If they could do that, I'd take them, but if they can't I won't. To misquote Jerry MacQuire: "SHOW ME THE EVIDENCE!"

But then I'll always be alright, because I can think for myself. I speak here for all the hundreds of thousands that lack my critical ability, and will simply do exactly what their doctor's tell them to do.

 

[Dillinger]

Re: Telegraph: Statins for all over-50s to reduce heart deat

Are you saying that preventative medicine is a bad idea? I seem to remember you posting a few months ago that 'everyone' should take a vitamin D supplement, double standards or just that some things fit in with your view of things and others dont?

No, Sid. Vitamin D supplementation seems sensible because a large number of people (up to around 70%) are deficient. There are no side effects to Vitamin D supplementation until you get about 50,000 iu a day. Here the study is saying even though you do not have 'low' cholesterol take a statin. For the vitamin d point to be equivalent I'd have to say even if you have good levels of vitamin d take vitamin d supplements. Which is not what I'm saying. What follows from the advice of the study is how does this 'preventative medicine' work if the point of statins is to reduce cholesterol and your cholesterol levels are already low? That's the point I'm making.

Many people take statins without problems and have found a big difference in their cholesterol so to say they dont work is nonsense, you may not want to take them but they are a lifeline to many others.

That's not what I'm saying though is it Sid? Let's try it again; I think I said "I believe that Statins reduce cholesterol. I believe that they have some benefit for preventing CVD (not much but some)." What I'm saying is that if your cholesterol level is not the issue, (and how can it be if the advice is take statins irrespective of your cholesterol level?) then what is the cause of CVD?

How much benefit do statins give? Well, as Julie1471 pointed out for Lipitor Pfizer's own results show that 3% of patients taking a sugar pill/placebo had a heart attack compared to 2% of patients taking the statin Lipitor (over a 3 year period). Those are rubbish results and yet statins are 'the magic bullet'. That drop in absolute risk fits with many other reports on the benefits of statins too.

I am fortunate that my cholesterol has always been around the 4 mark every time I have been tested but if it had been 6 or 7 I think I would have accepted a statin if advised to do so.

By all means take your doctor's advice but let's not forget the advice we have all had about our diabetes and how to control it; surely that must stimulate an inquiring mind with all our standard advice? It seems to me that what you are really saying is 'don't question the advice - take the pills'. That is especially perverse as you don't even take the bloody things...

It's important to be able to distinguish between discussion on websites and being told what to do; no one anywhere is telling anyone what to do.

Dillinger

 

[noblehead]

Re: Telegraph: Statins for all over-50s to reduce heart deat

That's not what I'm saying though is it Sid? I think I said "I believe that they have some benefit for preventing CVD (not much but some)." What I'm saying is that if your cholesterol level is not the issue, (and how can it be if the advice is take statins irrespective of your cholesterol level?) then what is the cause of CVD?

Dillinger if I'm not mistaken but you recently said you'd stopped taking a daily statin, was it because your cholesterol levels have now fallen below the recommended guidelines or for other reasons?

The reason why I ask is I remember you saying on the defunct lowcarbdiabetes forum that your total cholesterol was high (6+ if I remember right) as was your LDL and it was causing you concern, don't feel you need to answer this if it's something that you would rather not talk about.

Thanks!

 

[alaska]

Re: Telegraph: Statins for all over-50s to reduce heart deat

There's a good comment from GP Peter Windross on this article:
(scroll to comments beneath the article)

I note - as none of the press coverage does that the conflict of interests openly discuss that nearly all the trials and authors are subsided by the pharmaceutical industry

the 95 confidence interval quoted for those without prior cardiovascular Hx (ie the people the press are claiming should be treated without Ix) is RR per 1.0 mmol/L LDL cholesterol reduction 0.85, 95% CI 0.77—0.95.

Does this not mean that by reducing the LDL by a point they are claiming there is a 15% reduction in risk but is might be as small as 0.05 reduction in the risk

http://www.pulsetoday.co.uk/newsart.../gps-should-prescribe-statins-to-all-over-50s

 

[chris lowe]

Re: Telegraph: Statins for all over-50s to reduce heart deat

I always take these so called studies with a pinch of salt (well I would if salt wasn't bad for my blood pressure according to studies). All medication has advantages and disadvantages. I can't see how they can tell if it does or doesn't prevent heart attacks - how do they know if someone would or wouldn't have a heart attack or stroke unless it actually happens. As for medicating the whole population, it's already being done by some water companies putting fluoride in water supplies with no choice by the consumer unless you use bottled water. Luckily my water company doesn't add fluoride.

 

[borofergie]

Re: Telegraph: Statins for all over-50s to reduce heart deat

There's a good comment from GP Peter Windross on this article:

How do you know that Peter Windross is not a "dubious maverick".
What happens if he is both a "dubious maverick" and your GP? Are you still obliged to blindly follow his advice?
Is there some sort of NHS postcode lottery for "dubious mavericks"? How do I apply?

 

[alaska]

Re: Telegraph: Statins for all over-50s to reduce heart deat

His post is rated 5 stars by 5 other health professionals so there must be at least 6 dubious mavericks roaming...

 

[borofergie]

Re: Telegraph: Statins for all over-50s to reduce heart deat

Didn't the Cochrane Review conclude for low-risk groups (ie all over 50s not already on statins) that you'd have to treat 1000 people to save a single life?

21,000,000 people in the UK are 50 or over.
So this treatment would potentially save 21,000 lives while exposing 20,979,000 to potentially harmful side effects with no benefit.
That's 99.9% of the over-50 population essentially "taking one for the team" at a cost of £357,000,000 per year to the tax-payer.

Cochrane Review author Dr. Shah Ebrahim is quoted as saying:

If you look at the hard end points of all deaths and coronary deaths, the effects are consistent with both benefit and with the play of chance. But importantly, the absolute benefits are really rather small—1000 people have to be treated for one year to prevent one death. It is probably a real effect, but it means a lot of people have to be treated to gain this small benefit. As we don’t know the harms, it seems wrong-minded to me to treat everyone with a statin. In these circumstances, lifestyle changes and stopping smoking would be far preferable.

http://www.theheart.org/article/1174743.do

Which set of dubious mavericks are you going to believe? The ones whose salaries are paid for by "Big Pharma" or the ones on the Cochrane Review?

 

[Dillinger]

Re: Telegraph: Statins for all over-50s to reduce heart deat

Dillinger if I'm not mistaken but you recently said you'd stopped taking a daily statin, was it because your cholesterol levels have now fallen below the recommended guidelines or for other reasons?

The reason why I ask is I remember you saying on the defunct lowcarbdiabetes forum that your total cholesterol was high (6+ if I remember right) as was your LDL and it was causing you concern, don't feel you need to answer this if it's something that you would rather not talk about.

Thanks!

Well, I've wandered into the public domain with this so I don't mind discussing my levels; as of December 2011 my total cholesterol is 6.1, triglycerides 0.7, HDL 2.3 and LDL 3.6.

I'm not sure really how much any of that has actually got to do with CVD probability. But if it does the only element that might concern me is the LDL but as had been addressed elsewhere there is evidence that the way that this element is measured can be skewed by having low triglyceride levels (which I do) http://www.ams.ac.ir/AIM/08113/0014.pdf

So, the LDL doesn't really bother me.

Also the CVD risk is apparently related to total cholesterol to HDL ratio this is what a site called medicine.net says about that "with an average ratio of about 4.5. Ideally we want to be better than average if we can. Thus the best ratio would be 2 or 3, or less than 4."

My ratio is 2.7

My total cholesterol levels were about 4.0 when I was on statins, but I felt very unconvinced by the science, was getting muscle cramp side effects and possibly digestive side effects (on the luxury statin Atorvastatin) and thought enough is enough. My cholesterol levels have been at about 6.0 ever since.

According to the Framingham risk equation I have a 1-2% risk of CVD in the next 10 years. Acceptable risk I think.

My consultant gets a bit upset at the 6.1 and the LDL but then gets happy about the rest of it and so isn't being very vociferous in his suggestions to take statins; we just review the position at each meeting and I say 'I'm not taking them' and so he says 'let's review that at our next meeting' rinse, repeat.

Best

Dillinger

 

[kentish maid]

Re: Telegraph: Statins for all over-50s to reduce heart deat

my diabetologist said he would like all diabetics to be on a statin to prevent heart attacts he was on a statin and wasn't having any side effects .One year on that perhaps not all patients neened them because he had ,had a bad reaction and at last understude what we had been telling him.Perhaps all hcp over 50 should take them see how they get on ,

 

[noblehead]

Re: Telegraph: Statins for all over-50s to reduce heart deat

Well, I've wandered into the public domain with this so I don't mind discussing my levels; as of December 2011 my total cholesterol is 6.1, triglycerides 0.7, HDL 2.3 and LDL 3.6.

Thanks Dillinger, it was interesting seeing your readings before on statins and now since you have stopped taking them. I can appreciate your consultants concern but as long as you are happy and convinced your doing the right thing then that's all what matters, I've put off statins myself for the last year or two but after having a scare last year (which thankfully turned out fine) I'm seriously thinking of asking to be started on a low-dose statin.

Can I ask what dose you were taking the Artovastatin as this is the one I'm wanting to start on?

Thanks again!

 

[Dillinger]

Re: Telegraph: Statins for all over-50s to reduce heart deat

Can I ask what dose you were taking the Artovastatin as this is the one I'm wanting to start on?

Thanks again!

Hi Noblehead,

I think it was 20mg a day (?) does that sound about right? I can't really remember to be honest - I seem to remember that I started on 10mg and went up, I really think I'd have remembered if I'd gone up to 40mg so that kind of leaves 20mg(!). See, look what those statins have done to my memory...

Best

Dillinger

 

[noblehead]

Re: Telegraph: Statins for all over-50s to reduce heart deat

20mg sounds about right Dillinger, if and when I do start Arto I'll let you know if I get any side-effects.

Thanks!

 

[viviennem]

Re: Telegraph: Statins for all over-50s to reduce heart deat

I wouldn't recommend anyone either to take or to refuse statins; each individual should make up his or her own mind.

I had side-effects from 10mg of Simvastatin a day; mostly joint and muscle pains but I'm beginning to wonder about my memory as well. That's my experience. Now I don't take statins. Everyone should get as much information as possible before they decide either way.

Please, however, Google 'Stephanie Seneff' and 'Duane Graveline' and read what they have to say.

She is a professor of bio-engineering; he is a retired doctor who worked for the USAF and was on the NASA space programme, and has also worked as a family doctor. That doesn't stop either of them being maverick cranks, but at least they're well-qualified and should have some critical faculties!

Viv 8)

PS I know at least 3 HCPs who won't take statins, and I know one doctor who won't prescribe them except as a very last resort.

 

[Unbeliever]

Re: Telegraph: Statins for all over-50s to reduce heart deat

Not so many years ago here was a similar suggestion but it concerned over-40s being given statims. of course prescribing hem and getting patients to take them are no one and the same hing.

When i was disnosed T" all newly-diagnosed were issued with bg meters and test srips. Issuing paitents with these things did not ensure their effective use of xourse. That didnt matter however, Based on the poor results of this policy strips were largely with drawn. Will "they " decide that statins are not working if there appears o be no great improvement in outcomes as a result of medicating everyone?
And how would such a thing be adminsitered i wonder? Would perfectly healthy people find themselves terroridsed by "the cholesterol nurse"?
I was prescribed stains on diagnosis. Everyone was at he time. It is the only one of my meds I regularly forget o take because it must be taken at night. I have recenly asked the Dr to change hem as I was suffering muscle pain and cramps. I never had high colesterol but was prescribed 40mg of simvasain from the start. Now the Dr is starting me on 10mg of another statin.
I found myself able to return several boxes unopened to he pharmacist because i tend o ry to order all my neds at once and my pracice issues 2 month prescriptions.

I can see all his money going in the bin or down the oilet. Then those who may have benefited from their use will find hem seves deprived of them on he grounds that they dont work.. O Brave new world!

 

[borofergie]

Re: Telegraph: Statins for all over-50s to reduce heart deat

20mg sounds about right Dillinger, if and when I do start Arto I'll let you know if I get any side-effects.

Have you thought about trying a ketogenic diet?

 

[noblehead]

Re: Telegraph: Statins for all over-50s to reduce heart deat

20mg sounds about right Dillinger, if and when I do start Arto I'll let you know if I get any side-effects.

Have you thought about trying a ketogenic diet?

It was suggested to me when I first joined the forum but after my own research and speaking to my Endo I considered it would be detrimental to my health to do so. One of life's pleasures to me is to enjoy food and the variety it presents, I have and I could low-carb if I wanted to do but as as long as I'm well controlled and have no problems with insulin resistance I don't see the need to at present, I don't eat a lot of carbs anyway and it is typically around 130-150g of carbs a day.

My cholesterol levels are fine and ECG's, Echocardiogram and Coronary Angiogram last year confirmed that my Arteries and heart are all clear and working fine, the cardio team were impressed with my diet and lifestyle but thought that a low-dose statin would be beneficial in the long-term to protect myself from CVD 10-15 years down the line, like Dillinger I'm unsure what the reasoning is behind this but anything that will keep me alive for a few more years has to be looked at in a positive light.

 

[IanD]

Re: Telegraph: Statins for all over-50s to reduce heart deat

Dr Briffa comments:
Statins for healthy people? Hang on a minute…

I wasn't warned against the muscle pains side effects - apart from the small print in the leaflet. I had to sleep with a pillow under my legs to minimise the pain. That was on 10mg.

It was several months before I read letters in "Balance" relating their adverse experience. I stopped immediately, & the pains disappeared in a week. Then my Dr said it was a known side effect. The pharmacist said they didn't warn people because we would attribute problems to the drug....

 

[Maundown]

Re: Telegraph: Statins for all over-50s to reduce heart deat

Not all drugs are safe and not eveyone can take all drugs. Assuming you can take a drug and do not have any intollerable side effects from it and assuming you take it as prescribed (ie time of day, etc) then most diabetics (over 50 - over 40 I would say) should take a statin, 75mg aspirin and an ACE inhibitor, as well as their anti-diabetic medications. Again, only if it is safe to take, there are no side effects or reasons not to take them and as long as you take them as prescribed, eg take aspirin AFTER A MEAL and never on an empty stomach. There are good data out there supporting this approach, even if you have no symptoms. The effects are microscopic so don't expect to feel a change. You may just live longer!

 

[Merluza]

Re: Telegraph: Statins for all over-50s to reduce heart deat

I took statins for 2-3 years. I can confirm that they work to reduce cholesterol but the side effects became so pronounced that I prefer to run the presumed risk.

I took Simvastatin for about 1.5-2 years and was switched to Simvastatin as part of the cost cutting exercise. After a time I began to feel fatigue which got worse and I started to have a kind of shambling gait. I began to get extreme pins and needle all the way down both arms and noticed my reflexes were slower, it felt as if a limiter had been put on my response time. I particularly noticed this because I play the saxophone and could easily tell that I was getting slower.

I was also getting clumsy and generally felt dull. The final thing was sharp shooting pains in my legs. I decided to quit the statins. Within 3 days my fatigue was lifting and I was walking properly. The pins and needles declined and eventually stopped although this took several weeks, my reflexes returned and the shooting pains never returned.

Whether my reactions were caused by statins in general or Simvastation particularly I don't know and I'm not moved to test this out. My doctors regularly and repeatedly try to get me to take a statin, any statin but I'm afraid I was bitten too hard and won't take them again unless my cholesterol starts to rocket, I don't recall my last test but I think it was 5.4 which is a bit high but within normal levels. A life lived feeling tired, slow and with nerve pains, and who knows what else, but with immaculate cholesterol is not one worth living in my opinion. I felt 20 years older.

The trouble with describing these symptoms to anyone, especially doctors it seems, is that they haven't got any way of judging or imagining how it feels and think you are exaggerating. They also tend to subscribe to the way of thinking of researcher Colin Baigent quoted above.

I've checked out any number of clinical trials and even the results that find in favour seem to bring such slight benefit. I think statins have wide-ranging effects and it would be interesting to see results investigating instances of side-effects. In research you go looking for something particular and either find it or not. With statins you will always find they reduce cholesterol, it's the other stuff they do, especially the potential damage they cause, that isn't being looked at.

I'm not advocating that everyone should stop taking statins, it should be a personal choice, I'd like to be left to make that choice and the reasons outlined above are why I choose not to take them.