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Monday, 8 May 2017

Statins

Science News has an article on the contentious issue of statins and their expanding use. I don't take them but at my age the issue is of interest, particularly the idea that statins have a preventative role for people who have not had a heart attack or stroke.

Once the powerful cholesterol-busting drugs appeared, in the 1980s, scientists were able to show that a drop in cholesterol could keep a person who had suffered one heart attack or stroke from having a second. Later studies pointed to protection for even relatively healthy people. Researchers writing in the American Journal of Cardiology in 2010 declared that the drugs were such cardiovascular heroes they could essentially neutralize the health risks from a Quarter Pounder with cheese plus a milkshake.

I can't imagine taking any drug for the rest of my life without good medical reasons. That means reasons which apply to me and are not merely a product of government policy.

Sussman, of Michigan, refers to one of several online calculators that can help determine what that risk number is for any particular person. These kinds of tools take into account each person’s unique set of circumstances. In one online tool, a sedentary 60-year-old white male with a weight of 250 pounds, a total cholesterol of 225, no high blood pressure and no personal or family history of heart disease might have a 9 percent risk of having a heart attack in the next 10 years. A 60-year-old African-American woman with diabetes but all other parameters the same would have a 13 percent risk.

The guiding principle Sussman tells his patients is that the lower your risk of disease in the first place, the less you have to gain from statins. Patients also have to factor in their own sense of how much they fear a heart attack or stroke — all the while knowing there are other means of prevention with almost no risk that can get lost in the statin debate, including weight loss, exercise and a better diet. That theoretical 60-year-old man with a 9 percent risk could drop his risk to about 5 percent with 20 minutes of moderate activity each day and better eating habits.


The comments on the article are generally negative which is not surprising. Apart from being intrinsically suspect, any form of mass medication could result in unforeseen long-term consequences. I'll stick with moderate activity and a fairly healthy diet.

6 comments:

Michael said...

Interesting Mr AK.

I've been on statins for about five years, and the prescription changed to atorvastatin after aches and pains put me off the other sort.

My family had a history of heart probs, so I just said, well let's do it, and forget worrying.

Oddly enough, just this morning on early wireless, there was a snip about statins being beneficial to MS unfortunates. Now that could be a great contribution!

Demetrius said...

Looking at the contents of the trolleys of very many other customers at supermarkets I am not entirely surprised that the quacks hand out statins for all. Like many other things, good for those that really need them and would benefit, not so good for others.

wiggiatlarge said...

I was encouraged to start taking statins as a "preventative" suffered aches and pains in the muscles and came off them , it really doesn't matter said my GP ! sometimes I really do wonder if taking statins or anything else as a preventative is any more valid than a glass of red wine a day.
All are routinely praised or rubbished according to which scientific paper is flavour of the month, anyway I am going with the red wine cure as I suffer from cenosilicaphobia, described accurately thus, the fear of an empty glass - manifests itself in a number of circumstances and the symptoms can be uncomfortable at best, downright terrifying at worst.
I'll go with that.

Roger said...

'Unforeseen long term consequences', I suppose death falls into that category. But then a good number on this blog may well be past the biblical sell-by date and hoping for a bit extra.

Longrider said...

I'll stick with moderate activity and a fairly healthy diet.

Likewise. Mass medication "just in case" is failing to take into account individual medical needs. Also, all medicines carry the risk of side effects, no matter how much they tried to play this one down recently.

A K Haart said...

Scrobs - I'd probably consider statins if my family had a similar history to yours, but I'd be more than uneasy about the side-effects even though they are supposedly the lesser risk where there are known heart issues.

Demetrius - I look at the contents of trolleys too. Surprisingly interesting.

Wiggia - side effects would probably cause me to come off them. I know two people on statins who say they have noticed an impaired memory since taking them. I'd find that alarming.

Roger - with me, the big issue is not so much keeping death at bay, but the prospect of medication leading to a lingering and hopelessly undignified decline.

Longrider - yes, generic tick-box advice is not good enough, especially in such a complex situation.