Statins?

[smittykitty]

Just wondering what you ladies think about Statins. My husband and I have been on them since about age 49 (now 55). Zocor 20 mg/day.

We both saw our numbers climbing for the 2 or 3 years prior to starting on the statins. We immediately changed to a heart healthy diet and lost a few pounds when first diagnosed with increasing cholestrol #s. But the #s kept going up.

Both of my parents had heart attacks, but they smoked, ate high sat. fat diets and were totally inactive.

In the last 5 to 6 years I've gone from a total couch potatoe to moderately active. (Biking addiction, joined gym) My DH has always been very active.
Our weight is very good (I'm size 2 to 4 Petite). BP low.

While I never wanted to go on the drugs, I didn't want to die of heart disease either. I tried going off of them a couple of years ago and my numbers shot right back up. For the last year I've been hit and miss taking them, probably 3 or 4 doses per week.

This summer I felt my legs never really got as strong as they should. Granted, I totally neglected the gym, cuz why go there when you can ride a bike! I'm wondering if the Statins could be playing into the sore/weak leg thing. Or, am I just a wimp who needs to also be hitting the gym in the summer? My quads and calf muscles just always seem to working so hard ie. tired, pain. Hills are really tough. It seems recovery from gym workouts and long rides (50-60 miles) takes longer than years past.

Any thoughts? Also, reading an old post that mentioned Metamucil. I thought maybe that would help in more than one way! I'll pick some up.

Gotta go, looks like the rain is gonna hold off. We're gonna get a ride in today after all:)

[KnottedYet]

High cholesterol is not a disease, and there are several studies that point out we are making perfectly healthy people take statins for no reason than "bad" numbers. Why take a medication for a lifestyle problem?

The breakdown is more important than the total. Exercise raises the "good" cholesterol. Fiber in the diet lowers the bad cholesterol.

For women, in particular, Metamucil appears to have better effect on survival rates than statins. (Statins will lower a woman's cholesterol number, but have no effect on survival rates... useless. Fiber in the diet improves survival rates. The only time statins influence survival rates is if a woman has already had a heart attack or stroke. They do nothing for first CVA or MI.)

If you are already shocking your liver with hit-or-miss dosages 3 or 4 times a week, I would suggest discussing the issue with your doctor. It sounds like you don't want to take it, to the point that you are forgetting to take it. You're just hurting yourself now.

And yes, statins are notorious for messing up muscle.

[KnottedYet]

I just gotta rant.

We've been trained to think of cholesterol as this sticky poisonous goo flowing through our pipes, creating clogs everywhere it goes.

That's not what it does.

It's like little packages of spackle. When the wall of a blood vessel is damaged (often from stress, smoking, etc) the little package of spackle opens itself and spreads itself over the damaged area. Just like spackling a cracked pipe. Yes, now the pipe is a bit narrower, but it isn't leaking anymore.

The issue isn't that we have to many spackle packages (we NEED them!) the issue is we have too much damage to our pipes.

Stop damaging the pipes, and they stop narrowing every time they have to get repaired.

Cholesterol isn't the problem. It's what we're forcing our bodies to do with the cholesterol over and over again that is the problem.

Ever wonder why a stressed out person has their cholesterol levels climb? It's because stress is damaging their circulatory system and the body is throwing extra cholesterol in to patch the damage.

There have been some very interesting studies in baboons on social ranking/stress and arteriosclerosis and cholesterol levels.

Stress is the baddie.

[AppleTree]

Just wondering what you ladies think about Statins. My husband and I have been on them since about age 49 (now 55). Zocor 20 mg/day.

We both saw our numbers climbing for the 2 or 3 years prior to starting on the statins. We immediately changed to a heart healthy diet and lost a few pounds when first diagnosed with increasing cholestrol #s. But the #s kept going up.

Both of my parents had heart attacks, but they smoked, ate high sat. fat diets and were totally inactive.

In the last 5 to 6 years I've gone from a total couch potatoe to moderately active. (Biking addiction, joined gym) My DH has always been very active.
Our weight is very good (I'm size 2 to 4 Petite). BP low.

While I never wanted to go on the drugs, I didn't want to die of heart disease either. I tried going off of them a couple of years ago and my numbers shot right back up. For the last year I've been hit and miss taking them, probably 3 or 4 doses per week.

This summer I felt my legs never really got as strong as they should. Granted, I totally neglected the gym, cuz why go there when you can ride a bike! I'm wondering if the Statins could be playing into the sore/weak leg thing. Or, am I just a wimp who needs to also be hitting the gym in the summer? My quads and calf muscles just always seem to working so hard ie. tired, pain. Hills are really tough. It seems recovery from gym workouts and long rides (50-60 miles) takes longer than years past.

Any thoughts? Also, reading an old post that mentioned Metamucil. I thought maybe that would help in more than one way! I'll pick some up.

Gotta go, looks like the rain is gonna hold off. We're gonna get a ride in today after all:)

My mother (although in her 70's) has had a terrible time with statins making her feel tired and achy all over. She just quit her 2nd round of them and swears she will never take another statin. I guess it affects people in different ways. I have heard a LOT of home remedies for high cholesterol. Pom juice, fish oil, cinnamon, turmeric, and of course, excercise.

SmittyKitty, hope you get your ride in today! We are headed out to the Centennial Trial, looks like the rain is going to give us an unexpected break today, hooray! :D

[Thorn]

Thanks Knotted for your rant....spot on.

I am thorougly convinced that statins killed my mother. She went on the drugs early in their usage when the muscle damage was poo-poo'd. They left her on the drugs for several years claiming it was an auto-immune disorder related to arthritis. No heart disease in the family, she was very fit when she started taking the drugs, and she spiraled into heart failure. She died 5 years later of heart failure, 20 years younger than her parents at their deaths.

Now I realize that that is extreme, I'm biased based on an unscientific statistical sample space of one, but there is some evidence that statins mess with muscle tissue even in asymptomatic patients. I wish I could find the source. My guess is that it was on NutritionFacts.org (all video so very hard to skim, but an interesting source). Search for statins -- he has 5 videos on the subject.

As Knotted says, healthy lifestyle that includes keeping the stress low (and lovin' the oatmeal doesn't hurt, either).

[Crankin]

Well, I am going to give the other point of view. I don't disagree that statins have horrible side effects for some, and I hate to see people who lead very unhealthy lifestyles think that taking a pill will make their risks for heart disease go away, but...
My DH has a family hx just like the OP. He was very thin until he was in his mid forties and then started gaining weight, despite a fairly good diet. He had been moderately active, but no real aerobic exercise (tennis, golf, walking). He started cycling at age 43-44? When he was 48, he started having the classic pain in his jaw/neck, when he and I were running in the winter. He went to the doctor, got put on a high blood pressure med. and Lipitor, as his numbers were bad. He had a stress test with the dye and nothing showed up. At this time, he was cycling 3-4,000 miles a year and he is strong. A year later, the pain was getting worse, to the point where I could ride faster than him up hills. Nothing showed up on later stress tests with the dye, so he pushed for an angiogram. Tah-dah, he had two 80% blockages. Stents went in and he was riding 5 days later. This was in 2005.
He has been on an aggressive regimen of Zetia and Crestor since 2006, along with aspirin and a tiny dose of a blood pressure medication. His numbers are great and there are no side effects. He doesn't think twice about taking these drugs. Both of his parents died horrible deaths from cholesterol related illnesses. Yes, they didn't have the healthy lifestyle we have, but they were not overweight. 3/4 of his grandparents had more than 2 heart attacks. While I think that if he had started riding and eating a bit better in his twenties or thirties, this may have been averted, I am not sure. Family history is a powerful risk factor. We have to fight the insurance company every couple of years to pay for the Zetia, as they think Lipitor, or its generic will work this well. It didn't. It's quite likely he would have been one of those guys that dropped dead shoveling snow, if he hadn't been a cyclist and noticed the increasing pain from angina as his intensity increased. This is not stuff to fool around with.

[tangentgirl]

What about niacin?

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000700/

[KnottedYet]

People who actually have heart disease DO benefit from statins. There's no disputing that fact. So Crankin's DH is the perfect example of someone who should be on them.

A healthy person who has no signs of heart disease and whose only reason for taking statins is "numbers" is not going to benefit, as studies have shown repeatedly.

If someone comes in with heart palpitations, is the doctor immediately going to burn out her AV node and hook her up with a pacemaker? Or is the doctor going to look at her lifestyle and tell her to stop drinking her customary 3 pots of coffee a day? If she has a malfunctioning AV node, surgery and an implanted pacemaker would be appropriate. If someone has heart disease, statins are appropriate.

But just as the numbers of someone's heart rate don't tell the whole story, nor do the numbers of someone's cholesterol. We are told over and over again to treat the patient, not the test result. IMHO statins are over-prescribed because doctors know their patients aren't going to change their lifestyle and they are afraid of being sued when the patient gets ill if they haven't done SOMETHING to treat the "problem."

Irresponsible patients and terrified doctors in a profit-driven system are a bad combination.

[Jolt]

People who actually have heart disease DO benefit from statins. There's no disputing that fact. So Crankin's DH is the perfect example of someone who should be on them.

A healthy person who has no signs of heart disease and whose only reason for taking statins is "numbers" is not going to benefit, as studies have shown repeatedly.

If someone comes in with heart palpitations, is the doctor immediately going to burn out her AV node and hook her up with a pacemaker? Or is the doctor going to look at her lifestyle and tell her to stop drinking her customary 3 pots of coffee a day? If she has a malfunctioning AV node, surgery and an implanted pacemaker would be appropriate. If someone has heart disease, statins are appropriate.

But just as the numbers of someone's heart rate don't tell the whole story, nor do the numbers of someone's cholesterol. We are told over and over again to treat the patient, not the test result. IMHO statins are over-prescribed because doctors know their patients aren't going to change their lifestyle and they are afraid of being sued when the patient gets ill if they haven't done SOMETHING to treat the "problem."

Irresponsible patients and terrified doctors in a profit-driven system are a bad combination.

I would tend to agree with this. For people who already have heart disease, or who have a genetic problem with very high cholesterol levels, statins are helpful. For others, I would really prefer to see lifestyle changes tried first...but unfortunately too many patients aren't willing to cut down on the junk food, eat more fruits, veggies, whole grains, healthy fats and fish, exercise more, and stop smoking. Instead they would rather look for the "quick fix" and take a pill, even though that pill has side effects as do all medications whereas eating better and exercising will only have positive effects--not only on cardiovascular health but on other aspects of health as well. You're also right about the "cover your butt" aspect playing into it in some cases.

[Crankin]

I guess my cautionary tale is, how does the OP know she does NOT have heart disease, given her family hx? Up until my DH was on the table for the angioplasty, no one believed him (you ride 4,000 miles a year and you are thin). I am sure the blockages were there long before the symptoms. I am not advocating she get surgery, but if she wants to stop the drugs and try something like niacin or Metamucil, I would get a stress test with IV contrast dye, to rule out anything. I tend to want aggressive treatment for anything, and heart disease scares the crap out of me. Enough to keep me on the straight and narrow in terms of my eating and activity.
I totally agree that people want a pill to fix everything. It is difficult to believe the amount of non-compliance I see as a therapist, and not just with psychotropic drugs. I mean compliance with all medication.

[goldfinch]

For a discussion on using statins for primary prevention of cardiac events: http://www.sciencebasedmedicine.org/index.php/statins-the-cochrane-review/

My read of this evidence is that there is solid evidence that statins have a real benefit for primary prevention. This benefit is small, which is exactly what I would predict for a preventive measure in a low-risk population. The data also show that statins are safe. The major risk is for the development of an inflammatory muscle disease, but that is very rare. For interventions that prevent death – that lower mortality – I think even small benefits are worthwhile. Further, having a heart attack or stroke, even if it is not a fatal event, has a very negative effect on quality of life. Taken together, one person per year out of several hundred taking statins for primary prevention will avoid a heart attack, stroke, or death. From a purely medical point of view, that sound pretty good to me.

What seems reasonable is to use statins for primary prevention in those who have some risk factors for vascular disease, in patients with genetically high cholesterol, and in those with high cholesterol or significant risk factors in whom lifestyle counseling has not yielded adequate results. Try diet and exercise first – and always in conjunction with medication, but statins are a reasonable choice in selected patients, even for primary prevention. We could use more studies to better delineate where to draw that line, but that will be difficult as any difference in outcome is likely to be slight and therefore massive trials will be needed to get statistically significant results.

[pll]

@goldfinch: That is very nicely written article you linked to. Very interesting site, altogether. Thank you!

[smittykitty]

Thanks ladies. Lots of good info pro and con for Statins. Tough to know what to do. Would love to not take them, but what if I'm the one who really needs them:confused: I will seriously continue to give it more thought. In the mean time I will put some real effort into more exercise and no ice cream:( Sure wish I could see into the future!

And yes, I think my MD tends to over prescribe, but then again, I've seen my numbers!!!

And yes, we did get in a nice ride! Rode yesterday too! Always a bonus this time of year. My FX is on loan (up near the wonderful Centennial Trail!) and Ruby is made of Sugar, so she can't get wet! (She's so Sweeeet!)

Thanks again for everyone's insight.

[OakLeaf]

Here's a review of a book talking about medical consumer decisionmaking in general. I haven't read the book yet, but it's a subject I take a great interest in both personally and intellectually. https://www.nytimes.com/2011/10/09/books/review/your-medical-mind-by-jerome-groopman-and-pamela-hartzband-book-review.html?ref=health I think it's always important not only to be fully informed before making important decisions, but also to understand what your ultimate goals are, and this is what the book is supposed to address.

[Dogmama]

Crestor was approved for people without CHD to help prevent heart attack & stroke. http://www.ajpblive.com/media/pdf/AJPB_10aug_Theodorou_279-285.pdf

[Peanut03]

I have had a tough time with a couple statin drugs. My LDLs are high and HDLs are a little low even when on a really good diet. My father died from a massive heart attack while running at age 62. He was in great health and was quite competitive in his age group. He had controlled high BP, and slightly elevated cholesterol (this was 1995, so statins were not available to him). We are not sure about his family history; he was adopted. My mother's side of the family has some heart issues - all smokers too. I went on Crestor and reacted when the dose went from 5mg to 10mg. Next up, simvistatin...I suffered for almost two years when I decided to stop taking it. I had no idea the aches, pains and muscle weakness I was feeling was from the simvistatin. It crept up slowly and I kept thinking that I'm getting older and this was normal. It was not! I am so cautious now, and they want me back on a small dose 2x a week...not sure about that. I added flax seed, fish oil, and ubiquinol to my diet which seems to have helped my cholesterol numbers. IF you choose to go on a statin, listen to your body - also add ubiquinol, it's supposed to help.