Colesterol and statins

[mjr]

And that his quack's a liar.

Certainly, I would have made a formal complaint if it hadn't taken about a decade for me to recover, during which that doctor had retired anyway.

 

[joeegg]

Has anybody read any research on the actual effectiveness of preventing a stroke/heart attack rather than just reducing cholesterol ?
According to my medical professor friend lowered cholesterol "may" prevent a heart attack/stroke in 1 in 300 people who are taking statins.He stopped taking statins due to muscle aches and pains.
I know numerous people who have been offered statins but with no real medical reason.Not high cholesterol or poor family history.
I spoke to my doctor about feeling pressurised to take statins even though my blood test readings were good.He said instructions come from above with regard to advising people about the advantages of statins.

 

[raleighnut]

Has anybody read any research on the actual effectiveness of preventing a stroke/heart attack rather than just reducing cholesterol ?
According to my medical professor friend lowered cholesterol "may" prevent a heart attack/stroke in 1 in 300 people who are taking statins.He stopped taking statins due to muscle aches and pains.
I know numerous people who have been offered statins but with no real medical reason.Not high cholesterol or poor family history.
I spoke to my doctor about feeling pressurised to take statins even though my blood test readings were good.He said instructions come from above with regard to advising people about the advantages of statins.

I too have refused statins for years, mind at one point I was type 2 diabetic and on tablets for high blood pressure which made me feel chuffing awful..................bit of research and I lost over 4 stone in weight (Half Hundredweight) and am now tablet free.

 

[kingrollo]

Has anybody read any research on the actual effectiveness of preventing a stroke/heart attack rather than just reducing cholesterol ?
According to my medical professor friend lowered cholesterol "may" prevent a heart attack/stroke in 1 in 300 people who are taking statins.He stopped taking statins due to muscle aches and pains.
I know numerous people who have been offered statins but with no real medical reason.Not high cholesterol or poor family history.
I spoke to my doctor about feeling pressurised to take statins even though my blood test readings were good.He said instructions come from above with regard to advising people about the advantages of statins.

Statins don't only lower cholesterol though. They alter the make up of plaque in the arteries making such plaques less likely to rupture.

Also not all heart attacks are caused by chlostrel or blockages. So I would be intrigued to know how the 1 in 300 figure is arrived at.

 

[Punkawallah]

I was told . . . must have been over ten years ago . . . that my cholesterol was ‘high’, and I would have a one in six chance of ‘heart problems’ in later life. While NICE gives figures for ‘heart failure’, they do not for ‘heart problems’. So, having turned down statins, I continue into my 60’s with a five in six chance of -not- getting ‘heart problems’. And avoid a list of two dozen or so adverse side effects.

https://cks.nice.org.uk/topics/heart-failure-chronic/background-information/prevalence/

 

[mjr]

Has anybody read any research on the actual effectiveness of preventing a stroke/heart attack rather than just reducing cholesterol ?

Yes, years ago. The best starting point is probably the National Institute for Health and Clinical Excellence (NICE) Clinical Guideline evidence reviews, which you can find at https://www.nice.org.uk/guidance/ng238/evidence (general heart attacks) and https://www.nice.org.uk/guidance/cg71/evidence (heriditary high cholesterol). I'd start with the statin efficacy evidence summary from the general one.

According to my medical professor friend lowered cholesterol "may" prevent a heart attack/stroke in 1 in 300 people who are taking statins.He stopped taking statins due to muscle aches and pains.

The "may" there might just reflect the usual uncertainty of most medical evidence. It's pretty rare for medics to be certain that doing A will cause B, as there always seems to be some freaks that do the opposite of any theory, like the anecdotes about 120-year-old 20-a-day smokers.

I know numerous people who have been offered statins but with no real medical reason.Not high cholesterol or poor family history.

Were you in the room with any of them? There's normally a medical reason, even if it's just a high QRISK assessment, as prescribing without reason is an ethical offence, but it doesn't seem to be communicated very well much of the time. Medics qualify through medical ability more than ongoing communication skills.

The current assessment seems to be that statins would benefit most older people who have even slightly-above-normal cholesterol. Personally, I suspect that the drawbacks and adverse events are being underestimated in various ways, including deliberate exclusion of those most likely to suffer adverse events from some studies of adverse events, but I don't have any funding to get involved in the research and my experiences clearly make me biased anyway, or rather my continuing anger about them does.

I spoke to my doctor about feeling pressurised to take statins even though my blood test readings were good.He said instructions come from above with regard to advising people about the advantages of statins.

Yeah, I think that loops back to the current assessment being that some percentage of people over each age would benefit, so there seems to be an attempt to find and medicate that percentage. The disadvantages are fairly well-known and even mentioned on pages like https://www.bhf.org.uk/informationsupport/treatments/statins with the qualifier "more research is needed to find if statins cause these side effects" (but not mentioning that nobody seems to be doing that research) so I guess it's not surprising if most of the advice is about the advantages. Surely by now most potential statin-takers know someone in their family or friends who's been unable to sleep, floored by screaming pain, or started losing their marbles soon after taking them?

Interestingly, I see that the NICE Patient Decision Aid contains 2 pages (out of 12) on the side-effects, but it's mostly making claims about how rare they are (2% of takers get muscle pain as a result? Yeah, right(!)) without mentioning any limitations of the research, such as the excluded patients I mentioned earlier.

 

[kingrollo]

Yes, years ago. The best starting point is probably the National Institute for Health and Clinical Excellence (NICE) Clinical Guideline evidence reviews, which you can find at https://www.nice.org.uk/guidance/ng238/evidence (general heart attacks) and https://www.nice.org.uk/guidance/cg71/evidence (heriditary high cholesterol). I'd start with the statin efficacy evidence summary from the general one.


The "may" there might just reflect the usual uncertainty of most medical evidence. It's pretty rare for medics to be certain that doing A will cause B, as there always seems to be some freaks that do the opposite of any theory, like the anecdotes about 120-year-old 20-a-day smokers.


Were you in the room with any of them? There's normally a medical reason, even if it's just a high QRISK assessment, as prescribing without reason is an ethical offence, but it doesn't seem to be communicated very well much of the time. Medics qualify through medical ability more than ongoing communication skills.

The current assessment seems to be that statins would benefit most older people who have even slightly-above-normal cholesterol. Personally, I suspect that the drawbacks and adverse events are being underestimated in various ways, including deliberate exclusion of those most likely to suffer adverse events from some studies of adverse events, but I don't have any funding to get involved in the research and my experiences clearly make me biased anyway, or rather my continuing anger about them does.


Yeah, I think that loops back to the current assessment being that some percentage of people over each age would benefit, so there seems to be an attempt to find and medicate that percentage. The disadvantages are fairly well-known and even mentioned on pages like https://www.bhf.org.uk/informationsupport/treatments/statins with the qualifier "more research is needed to find if statins cause these side effects" (but not mentioning that nobody seems to be doing that research) so I guess it's not surprising if most of the advice is about the advantages. Surely by now most potential statin-takers know someone in their family or friends who's been unable to sleep, floored by screaming pain, or started losing their marbles soon after taking them?

Interestingly, I see that the NICE Patient Decision Aid contains 2 pages (out of 12) on the side-effects, but it's mostly making claims about how rare they are (2% of takers get muscle pain as a result? Yeah, right(!)) without mentioning any limitations of the research, such as the excluded patients I mentioned earlier.

Interesting post.

I can't remember where - but the muscular pains are much higher in active people. It goes up to 20% I believe.

 

[richardfm]

What makes you think that there is deliberate exclusion of those most likely to suffer adverse events from some studies of adverse events?

 

[mjr]

What makes you think that there is deliberate exclusion of those most likely to suffer adverse events from some studies of adverse events?

It was literally written in the test subject recruitment criteria. Someone like a younger me, who had "failed off" one statin at that point with blood test evidence backing up patient testimony, would not have been allowed to take part in some such clinical trials, even though they wouldn't know whether they were taking another statin or a placebo.

I know there is an arguable ethical reason to exclude them, as there's a theory that someone who suffers an adverse event on one statin is more likely to suffer one on another statin, so it would be cruel to deliberately inflict that unknown elevated risk on them, but it does mean that there is this weakness in the evidence, as we have far more people failing off than taking part in trials without ever having taken statins before. Also, we're also a long way from proving or disproving that theory because it's at least as unethical to test it deliberately!

 

[roubaixtuesday]

What makes you think that there is deliberate exclusion of those most likely to suffer adverse events from some studies of adverse events?

Would advise against going down this rabbit hole.

Previous discussion on the topic.

https://forum.cyclinguk.org/viewtopic.php?p=1781932#p1781932

 

[fossyant]

Do what you want. Mine is genetics. Same diet as my wife, loads more exercise, mine is a little high. Low dose statin sorts it. Was also very low for heart attack on the calculations. Both my parents take them I found out. Doc said no diet will lower it after I tried.

Absolutely no side effects here.

 

[fossyant]

There is alot of dodgy advice on the Internet these days, take advice from a neutral professional.

 

[mjr]

Would advise against going down this rabbit hole.

Previous discussion on the topic.

https://forum.cyclinguk.org/viewtopic.php?p=1781932#p1781932

That's not a discussion. It's just someone misdescribing my posts and getting no reply. It's not even about a study of adverse events, but a general efficacy and safety study.

 

[mjr]

There is alot of dodgy advice on the Internet these days, take advice from a neutral professional.

Excellent advice. As I've posted before, if you doubt your usual medics about cholesterol and statins, the excellent HeartUK charity has an email helpline on ask@heartuk.org.uk https://www.heartuk.org.uk/about-us/helpline and I think the British Heart Foundation have some similar services.

 

[mjr]

Do what you want. Mine is genetics. Same diet as my wife, loads more exercise, mine is a little high. Low dose statin sorts it. Was also very low for heart attack on the calculations. Both my parents take them I found out. Doc said no diet will lower it after I tried.

Absolutely no side effects here.

Good for you, but I think it's rare for no diet to lower it. I can't lower it enough, but diet still does something, so I do as much as I reasonably can anyway (oat bran, stanols, brazil nuts, olive oil, ...), in the hope of lower doses meaning lower risk of side-effects from the drugs that I have yet to exhaust. Exercise seems to have about the same effect as diet, which is a reason why I cycle.