Are Statins for Everyone?

[Northerner]

Statins need no introduction. Although almost unknown 20 years ago, these drugs now are taken by about 1 billion people worldwide. They are popular for good reason: They are easy to take; have minimal side effects; are easy on the wallet; have a measurable biochemical effect; and, importantly, have outstanding clinical benefits for those who take them.

Statins can reduce the risk for cardiovascular (CV) events by 30% or more. They also work across the board—in people with diabetes as well as those without. One question that has remained, however, is whether statin treatment is appropriate in the young diabetes patient or in those at low CV risk.

To address this question, two eminent speakers were invited to debate the issue at the recent annual meeting of the European Association for the Study of Diabetes. The title of the debate was "Statins for All?"[1]

http://www.medscape.com/viewarticle/870803

(free registration)

 

[mikeyB]

I hope your comment that there are minimal side effects doesn't produce a cascade of posts, because it is true- most people who take statins don't suffer significant side effects, but some people do. So please let's take that as said.

What this shows is that there is still an argument in medical circles about whether otherwise healthy younger T2 patients should be put on statins as a routine. I know I have said this before, but there still is no solid evidence that this is of any value, and because there is this question, I don't see any value in prescribing statins as a routine. I couldn't lie to a patient by saying you will live longer if you take this drug.

Clearly, there will be patients who don't exercise, have high blood pressure, high cholesterol and diabetes would benefit, but even that would be only marginal if you didn't correct all the other risk factors.

I suspect this argument will outlive me and thee, Northerner.

 

[grovesy]

I hope your comment that there are minimal side effects doesn't produce a cascade of posts, because it is true- most people who take statins don't suffer significant side effects, but some people do. So please let's take that as said.

What this shows is that there is still an argument in medical circles about whether otherwise healthy younger T2 patients should be put on statins as a routine. I know I have said this before, but there still is no solid evidence that this is of any value, and because there is this question, I don't see any value in prescribing statins as a routine. I couldn't lie to a patient by saying you will live longer if you take this drug.

Clearly, there will be patients who don't exercise, have high blood pressure, high cholesterol and diabetes would benefit, but even that would be only marginal if you didn't correct all the other risk factors.

I suspect this argument will outlive me and thee, Northerner.

I suspect your right!

 

[trophywench]

Yeah - I wouldn't any way any time wish my side effects on anyone else - except quite probably on anyone that swears they're an absolute essential and think that avoiding a heart attack (which I don't believe they do as a general thing anyway) gives you a better QOL than either feeling you have Alzheimer's or having terrible joint pain.

Being born is a death sentence anyway - and no drug on the market or later invented is going to prevent it !

 

[grovesy]

Yeah - I wouldn't any way any time wish my side effects on anyone else - except quite probably on anyone that swears they're an absolute essential and think that avoiding a heart attack (which I don't believe they do as a general thing anyway) gives you a better QOL than either feeling you have Alzheimer's or having terrible joint pain.

Being born is a death sentence anyway - and no drug on the market or later invented is going to prevent it !

It is quality of life that counts as well!

 

[macabee]

I have been taking statins since 1995, I have an inherited condition called FH [familial hypercholesterolaemia] took me ages to remember, even longer to spell. However I digress. In my case it was either the statins or probable premature demise, as I was told that the chances of reaching 60 was 50/50 had I not been diagnosed and treated, I will be 70 next February, so I am thankful for statins.

I am probably fortunate in that I do not have any discernible side effects, aside from those that can be put down to ageing. There may be side effects with all medications to varying degrees, but I do believe that with statins the positives outweigh the negatives.

 

[trophywench]

Can't possibly agree with you macabee - with all the things essential to my life or that of anyone on insulin we have to think about virtually any minute of every day (and if we're not actually thinking of any of it right at that moment, then we have to have it available INSTANTLY we need it - numerous times a day - so with memory failure and obvious cognitive decline - life would VERY soon become impossible to maintain, frankly.

Apart from the personality change these sort of things entail ......

I can't personally relate to muscle damage, but I'm sure those that have suffered that little side effect don't regard it as being positive - how can constant pain be considered positive by anyone?

 

[grovesy]

I have been taking statins since 1995, I have an inherited condition called FH [familial hypercholesterolaemia] took me ages to remember, even longer to spell. However I digress. In my case it was either the statins or probable premature demise, as I was told that the chances of reaching 60 was 50/50 had I not been diagnosed and treated, I will be 70 next February, so I am thankful for statins.

I am probably fortunate in that I do not have any discernible side effects, aside from those that can be put down to ageing. There may be side effects with all medications to varying degrees, but I do believe that with statins the positives outweigh the negatives.

You have a recognised condition that is considered high risk, most of us that have been on them and had problems are not in the same category! Even Malcolm Kendrick who wrote The Cholesterol Con, agrees you are in one of the few groups that may benefit!
I was only in my 50 's and have no family history and only had a borderline Cholesterol because of my Diabetes! I was in pain and felt it impacted on my life both mentally and physically!i stopped them!
13 years on I have not had my Stroke or Heart Attack and I am physically active to enjoy my garden and have been off my antidepressants for a few years!

 

[AlisonM]

I was nagged into taking them for a while having been told all kinds of horror stories about what would happen if I didn't. I had a horrid time with them as the side effects in my case were horrendous. At the same time, and unlike the rest of my family, my cholesterol levels are just fine thank you, always have been. So I stopped taking them, and my cholesterol didn't change much to the amazement of the doctor, but blood tests don't lie... much. I've followed a low sodium diet for many years because my mum had high cholesterol and we all got used to it, so adding salt to stuff is something I do only rarely. I have switched back to butter on my toast and for sauces, I don't fry much and when I do I use a good quality vegetable oil or olive oil depending on the recipe.

IMO, unless there is a clear medical condition, such as high Chol or Macabee's FH, they aren't needed and the NHS should use the money on something that does have real value... Testing strips perhaps.

 

[mikeyB]

Can't possibly agree with you macabee - with all the things essential to my life or that of anyone on insulin we have to think about virtually any minute of every day (and if we're not actually thinking of any of it right at that moment, then we have to have it available INSTANTLY we need it - numerous times a day - so with memory failure and obvious cognitive decline - life would VERY soon become impossible to maintain, frankly.

Apart from the personality change these sort of things entail ......

I can't personally relate to muscle damage, but I'm sure those that have suffered that little side effect don't regard it as being positive - how can constant pain be considered positive by anyone?

Macabee made no claim that muscle pains were a positive, but only pointed out, quite rightly, that he is around now because of the benefits of statins. He says he has had no discernible side effects, and neither have I.

There's no need to quote your own experiences as an example to others to condemn statins out of hand. And your tone came across as a criticism of, or a challenge to Macabee.

My comment right at the top of this thread was an effort to belay the usual parade of statin side effects, because it simply isn't relevant to the topic. As the participants in the discussion stated, these are drugs with minimal reported side effects. They didn't make that up, it's a fact.

 

[Owen]

Maybe its me, but I do not see @trophywench attacking anyone, just having an opposing view?

 

[mikeyB]

Bit vipurative for an opposing view, I thought.

 

[Owen]

Perhaps just a writing style?

 

[trophywench]

Well even if I was macabee, would it be better to be alive but unable to do anything to treat my own diabetes or hold a conversation or understand a damn book - or dead of the possible heart attack?

See - I'd choose the latter - I know I would because I considered suicide on several occasions during this time. However I reminded myself I was such a terrible failure at absolutely everything at that juncture cos every day people kept telling me and rubbing it in every time they found something I'd promised but forgotten to do - and God knows my diabetes was totally out of control and nobody in the NHS was listening when I begged for help) so clearly all that would happen is I'd make a mess of it - and other people would have to sort the mess I'd made out cos I was by now incapable of sorting out a knot in knitting wool.

No way Pedro am I ever going there again as long as I am capable of indicating my preferences.

Do you blame me?

And there's lots of people with FH who don't drop dead as predicted anyway. And they do indeed seem to protect an extra person in every 1,000 is it or 10,000? - but not like 50% or something - the percentage only increases by an absolute gnats whisker. And - any of us could get knocked down by a bus (etc) tomorrow, anyway!

 

[Owen]

Do you blame me?

No, I can relate to this. With and without statins.

 

[FergusC]

participants in the discussion stated, these are drugs with minimal reported side effects

The problem is is that side effects reported to the docs, or side effects passed on by the docs?

 

[Mark Parrott]

My doc wanted to put me on statins as my total cholesterol was high. I asked for the breakdown, & she said it was very good, but as overall total was high, I should consider statins. Saw my DSN, who also looked at my breakdown. She told me I don't need statins.

 

[mikeyB]

Your DSN is right Mark. You're ratios are fine, despite a relatively high cholesterol. You aren't fat, you don't smoke, and I assume your blood pressure is normal. If that is the case, your not at any great risk of popping your clogs anytime soon, or indeed anytime sooner than anybody else.

 

[trophywench]

That's even more confusing than having your own doc extolling their virtues and folk like Malcolm Kendrick and our Zoe saying something different - you have your own nurse saying don't , so whichever you decide to do, Mark - someone will believe you are wrong!

If the GP writes Non Compliant on your records, will the DSN write Oh no he isn't! underneath it? ROFL 😉

 

[Mark Parrott]

Your DSN is right Mark. You're ratios are fine, despite a relatively high cholesterol. You aren't fat, you don't smoke, and I assume your blood pressure is normal. If that is the case, your not at any great risk of popping your clogs anytime soon, or indeed anytime sooner than anybody else.

My BP is 128/78 which i believe is ok.