Interestingly, I have found that it is easy to obtain and understand one's risk for heart disease through all sorts of genetic tests. For me, it has helped guide therapy, and also understand why holistic medicine is helpful, but not enough to prevent disease. Yes, I suffer from statins, yes I have had a cardiac stent, and yes to diet, exercise, etc. Predicting the future is quite difficult for most of us, and refusing a statin if determined beneficial is somewhat like going without a vaccine, not a lot of medical evidence to support going without.
1
Jane's personal decision about statins may have been right in her case -- familial high cholesterol that can't be controlled by diet and exercise -- but it would be wrong to extend it to others. My own exhaustive personal review of the pros and cons of the same therapy led to a different decision (published as a chapter in my book Ten Drugs). Statins can be very useful in many cases. But they are also, in my opinion, vastly over-hyped, oversold, and overused. They might be right for Jane. But they're not for me.
6
To make a long story short, after several years of taking statins, Vytorin, (which was taken off the market), Lipitor, red rice yeast. I was having left knee pain and generally increasing overall body aches. I finally realized that if I stopped taking the med, all these pains (after 2-3 days) disappeared completely. After all this trial and error, I was finally put on Crestor, which I tolerate without any obvious aches and pains. Point is that if I just went didn't monitor my symptoms with my cardiologist I would probably be physically unable to function at this point.
2
Statins are often said to provide a 30-ish percent RELATIVE reduction in risk, for people who have not already experienced a cardiac event (primary prevention).
The recommended risk calculator provides an estimate of the 10 year risk for a “cardiovascular event”, including stroke, heart attack, but also new onset of angina (and perhaps other categories).
For an individual who has a predicted 15% risk of an event, that means his/her “risk” of NOT having an event is 85% over the next 10 years, without adding a statin. If a statin is added, his “risk” of NOT having an event increases to 90%. To me this represents a RELATIVE benefit of 5/85 or 6%.
5
I am writing this because a new column by Ms. Brody on statin use does not allow comments (yet)? She refers in the 3/18 article to a single digit increase in diabetes risk but a more recent and larger study found a 38% increased risk of diabetes from statin use. Given that 25% of those over 65 have diabetes, that translates to one in nine or ten older patients facing diabetes with statin use while one in 100-150 healthy people (no previous coronary history) need to take statins to prevent a heart attack. Is my math wrong? I agree that individual decisions should be made in consultation with a doctor, but for general advice, the balance of risks seems worse than she has indicated.
2
Where was the reference to "The Truth About Statins" - by Dr. Barbara Roberts - former president of the AHA New England - before you consider statins, read the book! https://www.amazon.com/Truth-About-Statins-Alternatives-Cholesterol-Lowering/dp/1451656394
2
I have tried 2 different statins and both have caused me severe muscle and joint pain in my legs. I have chosen to not take them because any benefit does not away my ability to walk.
1
The level that this drug is pushed is amazing.
The pain to my hip I endured each time, from three different brands, was so savage I thought I'd prefer a heart attack.
I've never been so angry at a product.
2
@Robert same here my friend have tried 2 different statins both made it almost unbearable to walk and to sleep at night.
Eat your nuts and legumes -- humans have been doing that for 10's of thousands of years and those are rich in stanols (or natural statins).
It helps a lot if you don't eat a western junk diet humans were never designed to have. Some may have genetic issues but you can still give yourself a long headstart by starting to eat natural & health early on in life.
(and, of course, exercise)
4
@crwtom:
Eat you meat, fish, and eggs. Humans have been doing that for millions of years, and these foods are packed with essential nutrients.
Thank you, Jane Brody. Now I would like to see your research and analysis of Dermatological procedures. Specifically, are biopsies being overdone, at what age 70?. 89?, 90!? can a person quit worrying about, or at least quit dwadling in waiting rooms before being sprayed with that cold mist . . . again. And all the time its more Ka Ching in the coffers of of providers (USA and insurance) and doctors with borders and debt.
3
Thanks to Cuomo and his good-government clap-trap, even if I wanted to remain on a statin, he makes them hard to prescribe for Physicians. They must be electronic or he fears someone will snort them or make a salad out of them. In essence, we must all be punished due to the opiate addicts that populate our land. My dogs and feral cats, heck, even the neighborhood raccoon and opossum can get a prescription on paper but not I. Thank you Governor, another reason you wont get my vote in November. Bad public policy.
I regret that Ms. Brody has bought into the Big Pharm plan to have the entire popultion on statins. Statins damage you mitochondria. They do this to everyone at some level. Some people may suffer muscle pain, other may suffer from Rhabdomyolysis. Ms Brody thought perhaps she was just getting old - if course everyone is getting older - but with statins you're going to "old" faster. And so the dilemma - every one just thinks they are getting older and may not consider what the statins are doing to them. Pretty perfect scenario for an industry that needs everyone to have a reason to be taking drugs.
7
@DILLON
I agree with you, even more, statin drugs when reduce the amount of cholesterol that the liver makes, it is breaking up the chain that produces the testosterone than men need to have a healthy prostate, and soon have and inflamed prostate that causes BPH (Benign prostate hiperplexia) and having to urinate many times do to be unable to empty the bladder completely. Producing insomnia and consequently having a terrible subsequent day.
Thanks
My numbers were always in the 180-190s and I had no risk factors. And yet, my doctor prescribed 1 a day at night 40 mg simivastatin as a preventative measure while in my mid 40s. for over 15 years, I've never incurred any of the side effects and am still quite fit. I am really realistic, though, what works for me may not work for others -- one size doesn't fit all. Arguably. every individual's metabolism is unique. Equally then, statin therapy needs to be customized to the individual. I've often wondered if 20 mgs taken 3x per week -- or some other combination of lower dosages and variable timing -- would have the same efficacy. Surely, it must be. And think of the number of folks how would benefit from the positive effects of statins without all the side effects.
2
"I've often wondered if 20 mgs taken 3x per week -- or some other combination of lower dosages and variable timing -- would have the same efficacy."
Why do you assume that there's any "efficacy"? How would you measure this? Not, I hope, through the surrogate marker of lower LDL. Lowering LDL isn't of any value if we don't get less heart disease, live longer, feel better, or something.
For primary prevention, it's still being argued in the major medical journals is statins are of any benefit at all. (On the other hand, for those who've already had a heart attack or stroke, there does seem to be benefit.)
Some researchers have concluded that statins invariably decrease skeletal muscle function, so it's possible that everyone suffers an adverse effect. Most people wouldn't notice that, since most people don't challenge themselves physically. See https://well.blogs.nytimes.com/2013/05/22/can-statins-curb-the-benefits-...
Or see StatinVictims.com for photos of some worst cases.
2
I would like to take statins for their properties of resolving inflammation. Statins and asprin are pro- resolution friendly drugs. My LDL has never been high.
However, I have memory loss and confusion after two days of taking them. I also get this weird shortness of breath as well. It isn't my preconception because I didn't know these were symptoms statin related. I knew about the muscle fatigue, which was non-existent.
I've tried 3 different statins at different strengths. Even turmeric, which also gives me statin-head.
What I can do is take it every 10 days or so. It isn't the first dose, it's the second that gets me. I tried once a week and that was too much. If arthritis flairs up I take it. It "seems" as if it helps resolve the inflammation, but it also could be placebo.
If your goal is to reduce inflammation, you should change your diet to a Whole Foods, plant based diet. That is the biggest and most effective way to lower inflammation, not through any drugs which can have serious side effects. Read books by T. Colin Campbell, Michael Greger MD, and Caldwell Esselstyn MD for more information.
4
There is another potential benefit of statins. Taking a statin could reduce the progression of atherosclerotic plaque formation in small vessels in the brain, which could result in less loss of cognitive function as one ages.
6
This article is so stridently in favor of putting most of the population on Statins that it isn't persuasive in at all. As to the years that they are allegedly going to add to life just look at the complaints made about them everywhere. As Shakespeare wrote: “Of all the wonders that I have heard,
It seems to me most strange that men should fear;
Seeing death, a necessary end,
Will come when it will come.
(Act II, Scene 2)”
― William Shakespeare, Julius Caesar
If you want to address the cures for high blood pressure, etc., look to lifestyle change. Eat different foods; move around more; relax yourself; lose excess weight, and don't read the internet. If doctors want to make more money let them see more patients instead of catering to the drug companies.
13
Joel, your comment is sensible, but isn't necessarily applicable for all of us. I eat a healthy diet, I exercise intensely (ran a 3:48 marathon last fall), and I'm at a healthy weight. I'm also 47 and have been on statins and blood pressure drugs for nearly a decade. My father had a heart attack at 63, and his father had several heart attacks. Also, elevated blood pressure runs in our family and I'm fighting to lower it. All of my healthy habits aren't enough to keep my blood pressure levels in a healthy range. Sometimes drugs are necessary. Lifestyle changes can't accomplish everything.
12
I agree. I was looking for the disclaimer that the author is a drug company lobbyist.
3
The first thing you learn at Pharmacy Marketing School is that healthy people are bad customers. How great to invent reasons for healthy people to be on as many drugs as possible!
3
What in the world is this supposed to mean?
"Furthermore, people correctly regard 'risk'as a possibility, not a probability, and vary in the degree of risk they are willing to tolerate. One chance in 100 may be acceptable to one person, while another may regard one chance in 1,000 as too risky."
Those numbers are probabilities. And most of life's predictions are based on quantitative probabilities; you're better off knowing what actual the numbers are in making decisions.
1
Although a statin would be good for me, I cannot take them. After three days I am incapacitated and non-functioning. As the docs tell me, there should be a statin that I can take and still be able to walk, talk and go to work.
2
@PBç
Dear PB, according Medical Doctors, that specialize in no man made drugs treatments, one of each of three fruits consumed daily will lower your LDC (bad cholesterol) by 50 %.
One red delicious apple.
One plum.
One carrot.
Eat it fresh and uncooked. Good luck.
Thanks
2
My doctor prescribed Lipitor with no discussion of side effects and I took that statin for several years, with gradually increasing muscle pain. My doctor ignored my complaints. It got to the point where the pain was so severe I stopped taking the drug. The doctor prescribed a new statin; after two months the muscle pain was so bad I could barely walk. I stopped taking it. Now I am on a third, and final, statin. If the pain gets too bad, I'll stop taking it and ask if there are any alternatives to statins to control my cholesterol. I don't know how rare this side effect is, but my doctor at least didn't want to hear about it. He was focused only on the benefits of the med, and it did control my cholesterol. My numbers were good. But there is a quality of life issue here that doctors must contend with.
10
I have had the same expience when prescribed Lipator several years ago. When I complained of muscle and joint pain, it was chalked up to arthritis. The muscle pain and weakness have become so severe that I can hardly walk. Only yesterday, a new doctor had me stop the statin for a week to see if there are any changes. I certainly am hoping for some relief
I lost the genetic lottery, 3 out of 4 grandparents had heart attacks in their 50s, and I have chronically low HDL, even though my LDL is not unreasonable. I also have coronary artery calcium scores that are terrible for my age. Statins have enabled me to get the increase in the calcium score essentially halted and my HDL/LDL ration under control (which is more important than overall cholesterol score, or LDL score).
My feeling is that the primary benefits of statins are related to their anti-inflammatory action, which is what seals off the lesions in the arteries and reduces the risk of a heart attack. I think this needs to be touted more as more than ever people are aware of the problems associated with inflammation (heart disease is ultimately a disease of inflammation). I had to try a few statins as I did have muscular reactions to a few of them, but my current statin has no side effects and my blood work, calcium score, etc., are all normal for the first time in a long time. They are not a big pharma scam, they are a valuable tool for people like me (my cardiologist predicted an 80% chance of a major event 12 years if I was untreated) to stay alive. Even if I ate extremely well and exercised all the time, I would still have these risks. It's genetic. I'm the first generation in my family who can really take advantage of it. I'd be an idiot not to.
11
@EH Congratulations! I am kind of confused. To my knowledge circulatory lesions are sealed by CHOLESTEROL and not by statins. To me, statins reduce the liver production of cholesterol. Sorry.
Thanks
Why doesn't the medical community focus on what a patient eats instead of filling them with dangerous drugs? This madness is killing Americans and the world now too. I stopped eating sugar, flour, starch, and everything else that raises my glycemic index. I need no statins, nor would I take it under any circumstances. Try changing what you eat before you submit to mad scientists who work for Big Pharma.
6
Mark - I eat healthier than 90% of the people I know and I exercise daily and maintain a healthy weight. My numbers still weren't good enough and heart problems run in my family. Therefore I take medications. So will you if you ever need them, I'm sure.
6
I'm 60, an avid mountain biker and nordic skier, very healthy eater and good weight. So when my LDL soared Doc said to go on these. I've never been on any drug, so I said "lets give it 7 months of even more intense exercise and even more aggressive exercise". I did so -- and the results came back that LDL had soared even more. I was shocked. So now what? Seems like time to go on them, if it gives me a better chance of seeing my granddaughter into their teen years no?
4
@Dan You are right. The key here is if you need them. For what I gather thorough experience, studies and commentaries is that statins are not as aspirins, it should not be taken as prevention by anyone, EXCEPT by people that already had brain and/or heart infarcts.
Thanks
1
This article is just another promotion for a class of drugs that has made the pharma industry unimaginably rich and powerful. Like the telling history of hypertension medications. The simple approach is this: EVERYONE should be on a statin and/or high blood pressure medicine, whether healthy or not. Period. Never mind if the drug turns you into a zombie, saps all your energy, gives you a rash, destroys your liver, ruins your kidneys, you need it to insure you don't die of a heart attack. Better die or go through life at half speed, or depressed, and die from cancer. And remember the drugs are assigned under the assumption that the assignment is for life. You may change your statin, but never never go off of all. You may change one hypertension drug for another, but never give up all. And each drug's prevalence is dependent on the advertising--read pressure--on doctors to prescribe it.
6
Nonsense. If your cardiologist is telling every patient to get on a statin with no basis in current pathology or risks, get a new cardiologist. For people like me with intractable genetic issues, it's a life saver. My liver, kidneys, blood sugar, etc., are fine.
I did go off my hypertension drug a long time ago. I lost 30 lbs. My doctors were overjoyed.
Consider yourself lucky if your genetic inheritance is clean.
3
I have been on a statin drug for about 8 years. My cholesterol levels had always been well under 200. However, an x-ray of my lower back revealed plaques in the descending aorta, and a subsequent coronary calcium scan showed major blockage of the descending aorta. My cardiologist prescribed a statin and a baby aspirin. A nuclear stress test was negative. All this time, I was asymptomatic. I have had no adverse effects from the statin.
I can only attribute my lack of symptoms to my running over the years. Perhaps corollary circulation due to exercise made up for the blocked artery. Nevertheless, I know that I have coronary artery disease, and I am glad there is preventive treatment available.
6
Incidentally I was found to have evidence of an ischemic stroke in an MRI. I asked when it appeared to have happened. The doctor said "who knows, maybe in utro". That stroke put me into the statin category despite all other signs other than age being negative. There does not seem to be more granular information on how to evaluate my risks since Type II diabetes is in my family history, have osteoporosis, and I am currently have ligament and muscular issues. At the same time I really, really do not want to have a stroke and already live a healthy life style (weight, exercise, near vegetarian, etc.). In the short term I have put off taking the statin while investigating. This article might have added additional tests for those with issues that want additional clinical information.
There needs to be a very real investigation of statins' triggering of Type II diabetes. There is a very strong link. This issue was not discussed in this article at all. And onset of diabetes can be as nearly a strong threat to longevity as chronic coronary build up.
The article put "family history" as the least important factor in their lineup of precipitating risk factors for coronary events. It should be the highest risk factor. In fact, current guidelines suggest taking statins when LDL reaches over 190 and there is a "history of coronary disease in the family." Absent other co-morbid issues.
1
Articles such as this never talk about dosage. My long time doctor, who was a medicine minimalist, had me on 10 mg of a statin. I was hospitalized for a coronary event and sent home with a prescription for 80mg. Following discussion with my new cardiologist I reduced it to 20mg. I imagine side effects of medication varies with the dose, but that is never mentioned.
7
Maybe it’s just me, but I didn’t get any pros and cons from this article. I just read that I shouldn’t be afraid of statins and all those nasty scare stories.
All this talk of statins starts with recommendations from screening charts that put anyone over 60 on statins. No talk of diet, exercise, sleep, lower stress, and the whole list of actions a person can take to achieve a much better result than comes from statins, except for the few who have genetic problems.
These articles are just more pharma marketing, with reassuring pats on the fanny about how you really can take these drugs and the side effects aren’t so bad.
7
Having read many of the comments, I'm so heartened to see how well educated people are becoming about the risks and needlessness of statin drugs. For the vast majority of people diet and lifestyle changes will lower "bad" cholesterol, and so many more benefits.
4
That's why this article and so much understanding of statins is off the mark. The main benefit isn't lowering cholesterol, it's combatting inflammation. Heart disease is one of inflammation, which causes lesions in the arteries, plaque builds up around the lesions, eventually breaks off and you have a heart attack and die. Statins, reduce inflammation, seal off the lesions, smooth the surface of the arteries, nothing breaks off and you don't die. My calcium score was increasing at a ferocious rate every year until I started statins, and afterwards it essentially stopped. I exercise, eat well, etc., but nothing was helping because it was genetic. Statins are saving my life.
Not everyone has the same situation as I do, I lost the genetic lottery, but for those it helps, it's a life saver.
5
Been taking 5 mg of a generic statin for 10 years. I have never experienced any of the negative symptoms.
4
I took statins for 8 years and experienced nothing but negative symptoms. I had "night terrors" where I woke up in the middle of the night with my heart pounding out of my chest and breathing my way into hyperventilation. It would take me half an hour to calm down and another hour to get back to sleep. The greatest day of my life was when I quit taking them. All symptoms stopped immediately. That was 8 years ago. Better off ever since.
3
Wait, "reversible" side effects. Well, if you're supposed to be on them indefinitely, there's nothing that's reversible. Like "... confusion and memory loss, liver problems, increases in blood sugar and muscle weakness, as well as interactions with certain other medications." No, thanks.
5
Cindy: Right!
Who tests to determine if the side effects are actually reversible? No one, of course. There is no financial incentive to study this, only the possibility of financial loss. People may say that muscle pain and weakness go away, but only real studies would prove or disprove this.
The fact is that the US has no system, other than self-reporting, for even tracking side effects. And no one does testing to determine if recovery from adverse effects is complete.
The norm is to exaggerate benefit and ignore risk--thus maximizing profit. In fact, the Supreme Court decisions of 2011 and 2013, leave generic drug companies not liable for not staying current on their warning labels, and not liable for faulty drug design either.
Knowing all this, please support those suffering from statin damage. The fault is not with the victims. Statinvictims.com.
5
Its not big pharma pushing statins, its doctors. Statins are all generic now, there are no billion dollar brand name statins anymore. Just like over prescribing ssri's, statins keep drs offices in business. Do you really think drs would advocate there use if they were OTC.
2
Yes, just like aspirin.
1
I think they are prescribed so often because statins and asprin are the best documented preventative medicines for heart disease.
5
I am surprised in reading the comments that people fault their doctors for not telling them more about the side effects. When I want to know about side effects, I read the enclosure that comes with the prescribed drug and I ask my pharmacist since that is where the bulk of their training resides. If I am still not satisfied that I have enough information, I research the drug on reputable internet sites. When you consider the incredible amount of information that doctors and nurses have to know, you realize that researching your medications and regimens is essential to improving your own chances for survival.
11
How about trying something really Radical-Like switching to a plant based diet and moderate exercise. What we are finding out about gene expression is that just because you have potential harmful mutations doesn't mean the expression of those mutations will happen. Studies also show that life style changes can "manipulate" gene expression. I know that's complete Not the American Way of "Lets try this drug" as first line of treatment. That's got to change!
6
I did that lifestyle and was shocked to discover a coronary artery score in the 99th percentile at age 40. It was getting worse every year. Statins halted it in its tracks. For those with a genetic predisposition to heart disease, it's a life saver. I've almost made it through my 50s and no heart attack. I can't say the same for 3 out of 4 of my grandparents.
6
Studies show that side effects appear to be over reported. However, two statements in this article minimize some actual side effects because they are reversible. But, once prescribed people are expected to stay on statins.
2
I read that statins inhibit the production of not only cholesterols. Statins inhibit the production of ALL STEROLS.
I wonder what other sterols play a part in our chemistry.
Every drug has side effects and some of them are catastrophic.
Care for Thalidomide anyone?
3
At 55, my cholesterol level was quite high. There's a history of heart attack in my family. When my doctor suggested a statin drug, I went along.
Within a month my personality changed from easygoing guy to argumentative and difficult. After six months my wife told me I had become "impossible" and suggested that my personality had changed not long after I got on statins.
I angrily accused her of wanting to me to die in order to claim life insurance. She said, "Just listen to how crazy you sound! This is nuts." I replied, "I'll show you how crazy I'm not" and went off the statins to prove my case. Within three weeks I was back to normal.
When I described this to my doctor, he said, "Nonsense. That side effect is extremely rare." So I went back on the statins. A few weeks later, my son asked me, "Dad, have you gone back on the get-angry drug? You're shouting at me for no reason! I don't even want to start a conversation with you anymore."
I began to cut the pills in half. It helped. Then I stopped completely. My personality again returned to normal. Then I tried a sequence of different types of statins. Always with the same result: in the space of a few weeks I'd go from friendly Dr. Jekyll to mean old Mr. Hyde.
I'll never take them again. I'd rather die of a heart attack than be the person I became while on statins.
18
This was one of the effects of every statin I have ever taken, along with confusion and pain. Like you, I'll take my chances dying from heart attack over alienating everybody I know, losing my job because I can't concentrate anymore, losing my health insurance, losing my wife and family, and dying alone in poverty.
I haven't been scared off by the stories about side effects as the condescending writer suggests, I've experienced them and decided that the effects were ruining my life. If the side effects weren't so horrible, I'd be popping statins Tic Tacs.
Why do these articles pushing statins keep coming up in the Times? Has the Grey Lady starting to become a little OCD about statins?
7
Does it happen with the first dose or with several doses? Try going for a longer time in-between doses. It might be worth a try. Maybe some of us are just hyper-sensitive.
I think the trouble is that we can be prescribed a statin with no warning of its possible effects. A friend of mine was assured that it was well-tolerated, and it was only six months later that a shoulder specialist in a big hospital center revealed that it was the statin that had made him unable to get his coat on unassisted for six months! Anyone on a statin should be monitored for the side effects, not just sent away without followup.
6
Anyone on any medication should be closely monitored. Statins are definitely no different, if not more so.
1
For those of us who tried two different statins and the first gave terrible muscle pain and the second gave high liver enzymes, I am back to my regular prescription, lose weight, eat lots of fiber, avoid saturated fat, exercise every day and hope for the best. Some people wish they could take statins but one's body disagrees.
5
My cholesterol was 279 at one point. My doctor wanted to put me on statins, I chose to change my lifestyle. I started exercising daily and avoiding cheese and most dairy products and red meat. It took me a couple years, but I went from 240 to 217 to 195. I have been able to maintain 195 and I have never taken any statins.
7
As a patient educator, I have recommended a low glycemic index diet (one that does not raise blood sugar quickly) for those who are adamant about avoiding statins. I have seen many people who do no more than eliminate soda (diet and regular) and replace it with water lower their cholesterol significantly.
One patient told me that his doctor forgot that he was not taking the statin. His doctor told him at his annual appointment to keep up with the drug regimen because it was working. When the patient reminded him that he had just changed his diet, the doctor just nodded. However, the doctor dropped the push for statins.
2
Once again, the NYT has allowed big pharma a platform to push unnecessary drugs - and a dangerous one to boot.
"Reports of side effects" on statins "are largely exaggerated".
No, the reports of terrible, debilitating side effects - even death - from statins are not exaggerated. They are, in fact, grossly under reported. And when they are reported, they are dismissed by big pharma as the "noceba" effect. A term created by drug manufacturers, for drug manufacturers.
Shame on the NYT. This is the fourth article in the last month I have read pressuring people to take more drugs, ignoring the withdrawal symptoms (anti-depressants),and playing down the side effects (statins and Hormone Replacement Therapy) of drugs that possibly do more harm than good.
8
Since Statins are for the most part generic, the first part of your argument is incorrect - it's not pharmaceutical companies pushing statins. Statins have had many large clinical trials showing that they lower the rate of heart attacks. My mother and father died in their 50's of heart disease, and I have taken a statin for over ten years to control my cholesterol. I've had no side effects that I'm aware of from taking statins. Telling the public that statins are dangerous to their health may well result in more heart attacks and deaths - so unless you can cite a meaningful large study, please don't dismiss how important this class of drugs has been to reduce deaths from heart attacks for the last 30 years.
7
How do generic drugs get manufactured? By drug manufacturers aka pharmaceutical manufacturers / aka big pharma. Most big pharma companies have a wholly owned generic division. Generic drugs and brand name drugs are all manufactured by drug manufacturers - sometimes the same one.
To put another way, generic drugs are still prescription drugs that need to be manufactured and are a very profitable part of big pharma.
The meaningful large studies that should exist, do not, in large part due to suppression by big pharma. Research is undertaken to ultimately make money for pharma, and little or no funding goes into the after market side effects of a huge money making drug. Take a look at the Cox II inhibitors that were on the market for a while and and what it took to get them taken off the market after years of big pharma hiding the debilitating side effects.
And if someone is getting their medical advice from someone commenting on an on line newspaper article, (on statins or any other subject) they get the treatment they deserve.
5
The clinical studies show benefits for those who've already had heart attacks/strokes. Not for those who have not. And the benefits are seen for men and for premenopausal women. The biggest study apparently showed no benefit in taking statins for menopausal women. The information isn't complete yet. It's too easy for doctors to hand you a pill - we as patients need to try to be informed. Our doctors, sadly, don't always bother.
2
Diet - eat less meat and processed foods; eat fresh and natural.
Exercise - get up and move
Don't smoke
Reduce stress (reduce ....from what ever it is to something less)
These three things will easily reduce your risk of cardiovascular events by 1/3. Only they cost no money and make no profit. They are your god given right to do. So do it !!
5
Those are excellent life tips for anyone, but some people are genetically predisposed to high cholesterol. I'm not overweight, I've never smoked, I eat a (mostly) vegan diet and I exercise regularly. I'm also 64. I'm on a statin to lower my cholesterol.
Not everyone is the same. Yes, we all have a God-given right to our own health, and that includes statin drugs, if necessary. I don't want to be the guy who has a heart attack or stroke and wonders why because I ate right.
8
@Louis J:
Good quality meat _is_ fresh, natural, nutrient-dense, and relatively unprocessed. Don't lump all meats together with processed junk food.
4
Don't forget the importance of finding the correct dose for each individual! Too much can cause discomfort and many doctors seem to feel that a higher dose is always better...but not if you can't tolerate it. I have had this experience and my lipid panel is great with no side effects now that I am on the right dose for me. And I have plenty of risk factors, especially family history.
2
Thanks for the article. I am curious to know whether your drug holiday produced any insights to the difficulties in cycling, walking and swimming you were experiencing and, if so, how will you handle your situation going forward? My own statin holidays dramatically relieved liver pains and general fatigue and malaise. However, having a history of stroke (very minor) I worked with an M.D. to find a very low dose, theoretically non-therapeutic, that I can tolerate and that still keeps my cholesterol way down where the M.D. wants it. My doc says, "Something is better than nothing."
5
Thank you, Ms. Brody, for framing this enormous topic so well in just a few paragraphs. It is challenging to find ways to connect with our patients in the time crunch of modern American clinical medicine to make them feel that their physician legitimizes their concerns and is advocating for them from both the point of understanding them and practicing individualized evidence based care. You could have used your article space to talk about any of several aspects such as similarities in rates of perceived intolerances between statins and placebo in blinded trials; dose dependent intolerance; overprescribing to low risk individuals, or others. Thank you for focusing on the magnitude of how many people don't take them, despite a large personal reduction in their risk, from fear of side effects. As an interventional cardiologist who also practices longitudinal preventive cardiology, I help people with these questions and deal with the consequences of fear of statins every day.
5
Excellent article. Statins for sure, saved my life.
4
If you are sedentary and eat poorly and have signs of metabolic dysfunction (high blood pressure, expanding waistline, elevated blood sugars) yes a statin will help you. If you eat well, are active and manage stress well, a statin will likely do little to add to that... you're not going to magically live to 150 because of a statin.
I've had high cholesterol issues for 30 years (I'm 69). I can't sniff a statin or their cousin red rice yeast without getting burning and cramped legs. So, I eat what I want and will deal with the consequences.
1
A glass of Tonic on ice taken an hour or two before bedtime might help with the cramping in your legs... Cheers
2
I’m 80, and have been on statins for several decades. I never felt comfortable with them, but took them following my doctor’s advice. Recently I’ve begun to experience memory and other cognitive issues. Current research on Alzheimers disease and dementia, I find strong evidence that cholesterol is neuro-protective, with high levels of cholesterol correlating positively with cognitive performance. The Framingham Heart Study, which demonstrated the relationship between cholesterol and CVD, also showed that the participants with the highest cholesterol levels scored higher on cognitive tasks than participants with lower cholesterol levels. (David Permutter, Grain Brain, p.34)
Human beings are complex systems, and few of the interactions in those systems take place in isolation. The push to use statins to lower cholesterol to improve CV outcomes looks only at cholesterol/CV interactions, and ignores any other roles that cholesterol might have. But if we also look at cholesterol/cognitive interactions then the goal of lowering cholesterol itself becomes questionable. At this point in my life, I’d rather die of a heart attack than live longer with senile dementia.
Many of these comments suggest asking your doctor for advice about whether or not to take statins. But my doctor, at least, seems to see that issue primarily through the cholesterol/CV lens, and not much in cholesterol/cognitive terms, so I can’t really expect to get balanced advice from her.
14
Years ago, I had an internist as my PCP. He was very thorough and talked to me about risks and benefits, including of statins. I have a genes-influenced propensity for elevated cholesterol, strong family history of premature CVD. So I took lipitor preventively for many many years. Cholesterol consistently below 200. In my late 50s, in good health and no other risk factors for heart disease, I went off statins. Cholesterol crept up, but not enough to raise flags with current PCP. I've gone back on them at a low dose for 6 months. I may be misinformed but it seems to me that after 20+ years of keeping cholesterol low, and having great ratios, that the statin has done its job and it might not be something I should continue taking. I never noticed muscle pains all those years, but now, I do feel more achy doing my usual physical routines, hard to say if it's the lipitor or aging parts!
1
The modern patient is burdened with internet "facts", social media personal stories and an ocean of mainstream TV ads promoting major prescription medications. Further, even sitting with the most erudite and articulate physician, most patients lack the context to fully grasp risk/benefit issues of peer reviewed, evidence based studies in the best of medical journals. The patient and doctor have a difficult decision road at times for sure.
1
I come from a medical family. We didn't have so much as an aspirin in our medicine cabinet. We were taught to avoid drugs as much as possible. All medical students learn " the dose is the poison" The terminology "side effects" is misleading. These are possible effects from a potentially poisonous substance. Approach with caution and remember no one has done research regarding the net effect of the multiple drug combinations most over 50s Americans are ingesting.
15
A very interesting viewpoint fro Jane Brody. One of the traps, engineered by the pharmaceutical marketing teams, is to judge the effect of statins as a 30% reduction in cardiovascular disease risk. That sounds impressive, but it may not be. Much better to view it as an improvement in cardiovascular disease-free survival.
If the 10-year CVD risk, as given in the article, is 19%, then a statin will improve the survival from 81% to 87%. That might or might not be worth having -- the choice is the patient's, But is an improvement from 92.5% to 95% really worth the inconvenience, expense and (often) discomfort of daily medication?
16
I have been taking statins following stent. After 1 month or more was not able to move with excessive pains all over my body until my family took me to ER and I was advised to stop the medicine and be under IV to clean my body from statins. My kidneys were in danger and urine was dark brown because muscles were damaged.
I depend on whole oat and berry to lower my cholesterol levels. it is much better than medicine.
9
There are many different types of stains. Lipitor caused me to have muscle pain. Zocor (simvastatin) does not.
5
My husband and I have been taking OTC red yeast rice for several years which works great and we have no side effects. It’s a natural statin.
1
Not in the US! The FDA required they take the active ingredient out since it's not regulated. It's essentially nothing.
The author writes about "scary stories about possible side effects", but not the side effects themselves. The "scary stories" have some basis in real side effects, which can be debilitating. The article could lead one to believe that there are no real side effects, only misinformed rumors about side effects.
11
At least Ms. Brody reveals that she is one of the people blindly taking statins. But this is nothing but the pharma promotion on this drug. I am disappointed that Ms. Brody is just confirming her own choice, and not really assessing the pros and cons. I had the severe muscle and memory side effects and went off the drug and still struggle with high cholesterol. But I could not tolerate the side effects. And I agree I'd rather have an active, coherent life shortened by a heart attack than be miserable and confused in a rocking chair. Thanks to all the comments with links to other research.
12
You must have read a different article than I did. She clearly stated that there are potential side effects and that each person should discuss with their own doctor the potential risks and benefits of taking a statin.
In addition, you speak about"the drug." Stations are not a monolith. Different ones carry different potential side effects. Lipitor caused me to have muscle cramps. Zocor does not and it's been reducing my risk of dying, with no side effects, for years.
3
What is the purpose of this article? It offers no help to a person who has been prescribed a statin and is trying to decide whether or not to continue using it,
5
Use your brain. Read up on the issue, then find a doctor willing to discuss the pros and cons specific to YOU and only you. Devise a strategy. Implement that strategy.
4
Statins are way over prescribed. In the example given over 10 years you'd need to treat 100 people to prevent 6 coronary events.
The author should consider getting a CT Coronary Calcium score. If low or zero she should not be on a station. She didn't even mention this test in her article. Is she even qualified to be a medical writer? In my opinion not based on this article.
10
If her grandfather and father died of a heart attack, she's at significant risk. Regardless of her CCS results.
2
Both my parents suffered from severe muscle cramps while on Statins. My husband was told his problem was genetic. Instead of going on statins he lost weight, quit smoking and eats healthy. No drugs and he got his numbers down. Doctors tried to talk him into the drugs throughout the whole process. They have no faith in their patients making changes in there life.
No where in the article does it say that people can get off these drugs by changing their ways. Doctors should demand people make changes instead of handing out drugs to cover up their bad habits.
9
Good for your husband for making lifestyle changes and losing his cholesterol. The overwhelming majority of people do not. Doctors can't force their patients to change. If they could, no one would smoke cigarettes or drink soda or eat enough for a small family.
9
I’ve been taking statins since 2004 (now Crestor 2x/week and Ezetrol daily) , and I regularly take breaks every 3- 4 months to lower my CK levels. When that goes up I cramp. My GP still feels my family history of high cholesterol (with everyone on treatment) merits treatment.
1
I am the 3rd generation of my family cursed with familial hypercholesterolemia. Sparing the extensive family history of heart attacks, I was 31 when I had a near miss and had 2 stents placed. I was on my meds per doctor's orders and I'm an athlete. When I was 35, I dodged another and had a double bypass surgery. A few months later, I had chest pain again. The RIMA graft failed and they found a 99% occlusion in my lower LAD that was 50% just before my CABG. They placed 2 stents to open up the native RCA and another in the LAD.
Being 36 and highly active, I've been through 6 statins now. I once spent 3 days in the hospital with Rhabdo as a side effect of atorvastatin. I'm statin intolerant. But now we have REPATHA! It's amazing. My cholesterol levels are below optimum and I feel like I'm in my 20's again and am currently a wannabe ultrarunner. I'll never go back to statins because they didn't work for ME. I'm also vegan-ish now, which helps. Bottom line, consult with your doctor!
12
I accept that “big data” from millions of patients informs us that statins do a world of good.
However, when statins were new, I was prescribed one - Lipitor to be exact. If I was told about risks, it certainly didn’t sink in. What I did know is that my male relatives who smoked had all died of heart attacks at an early age. I had never been a smoker, but, given my “ominous” (quoting the doctor) family history, taking a statin certainly seemed logical.
After a while, I began to experience such profound muscle weakness that it became difficult to walk down stairs that months earlier I could practically fly down. It seemed to affect my quads the most. I did my own research and discovered that muscle problems can be caused by statins.
Thank goodness the symptoms were reversible. Several weeks after stopping the drug, I was back to normal. That was more than 20 years ago.
I’m still here, and I still don’t smoke.
10
I've made this comment several times already- Not all statins have the same side effects. Lipitor have me painful cramps. Both Zocor and Crestor do not.
1
Please share the percentages who get the major side effects. Claiming that this is an unbiased article while only sharing the numbers on one side of the equation (heart attacks reduced) is reportorial malpractice.
15
@JD. Mayo Clinic in 2016 said 29%. Probably higher today. Become well-informed and make informed decisions. The medical wisdom is “take them.“ Talk to more than one doctor, read everything you can, and make that decision for yourself. There’s no knowing if statins kept me alive. But it’s easy to know they crippled me.
https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in...
2
Genetics are responsible for only 10% of illness - check your lifestyle - primarily vegetarian, no fried foods, use olive oil, no processed food- and exercise - watch your health improve!and your a wallet!
7
I've been on a satin for decades (currently 62 y-o, female). When I was younger, weighed much less and more physically fit, I could not control my cholesterol so the doc put me on the drug. During the past 6-8 months, I've been a vegetarian. My cholesterol went down to the point that she remarked it in my record. We're watching it and will test it again in a month to see if the change is not a flukey, one-time event. Improving my health wasn't the primary motivation for becoming a vegetarian, but what a nice surprise if it turns out to benefit me in that way!
5
As a patient with a cardiac quad bypass in 2010 and AFIB early in 2016 (and a regular statin user), I qualified for the local hospital’s ORNISH heart disease reversal therapy, which is also accepted and paid for by Medicare. Dr. ORNISH pioneered his technique which focuses on a vegetable based diet (and yoga-like meditation, group therapy and of course aerobic and strength building exercise).
My cholesterol levels went through the FLOOR (not the roof!). In three months, after I started the ORNISH training. My internist remarked the statin “finally kicked in”, but we know better!
A year after ORNISH training completion, I still eat a vegetable based diet. (Cholesterol numbers are so low, still!) So does my wife. It’s not hard. And I’ve had enough steaks and hamburgers for one lifetime. Chicken and fish are a rarity now but that’s tolerable.
I don’t know why the ORNISH technique is not marketed harder to medical professionals. Really. I’ll still take the statins. I’m not a radical but the real progress is our veggies.
8
There is no money for the medical and pharmaceutical industry in promoting lifestyle changes such as eating veggies, quitting smoking and exercising. I admit they are doing a good lip service of it.
3
Regarding the article’s comment section... Allowing a bunch of amateurs’ opinions to pollute this debate is dangerous. This type of sky-is-falling chorus-of-doom is the exact type of thing the author warns against. Too many anecdotes and too few data to support any of these claims. Clinical researchers and statisticians should be the only voices here, instead of this cacophony of chicken littles.
12
@ Melba Toast. You’re correct. Amateurs shouldn’t be weighing in. We should be listening to clinicians. But we can still learn from anecdotal information.
3
You're assuming readers aren't smart enough to weigh these comments for what they are. Sharing personal stories show people they're not alone and can steer some people to discuss issues with their physicians. I, for example, did not know about the muscle weakness issue. I haven't experienced it, butI can imagine how it would be a relief to someone with that side effect that there are others who have experienced it (and that this side effect can be reversible, but a doctor should be consulted). I don't see any harm in the article or the comments. We are smarter and have better critical reasoning skills than you're giving us credit for.
5
But allowing only MDs to comment (free speech?) would be better since they seem to be part of the problem. And the author seems pretty locked into a pro pharm position.
2
FYI my friend is a cardiologist and he suggested I look at Numbers Needed To Treat before starting statins.
http://www.thennt.com/nnt/statins-for-heart-disease-prevention-without-p...
5
A nice link to include/mention would be to the mayo clinics statin patient decision aide (https://statindecisionaid.mayoclinic.org). It might help for people to plug their numbers in and see their risk - and then decide if the very low risk of myalgias/myositis trumps having a heart attack over their next 10years.
This discussion is made more difficult when you understand that pharmaceuticals are not only science based, but often greed based.
There are too many things in our culture that are distorted by our embrace of greed and competition over cooperation.
When an Epipen that costs roughly $10 to produce is sold for $$300-$700, you have to wonder.
When the health insurance industry makes it’s profits by denying care, who can you trust?
Part of the discussion has to be how to tell between the truth and a wolf in sheep’s clothing.
5
Statins were never thought to be a panacea to prevent all premature cardiovascular deaths or disability.
There were and are part of a program that includes weight controll to prevent diabetes and help reduce hypertension and above all exercise.
If you decide not to take stains for what ever reasons and do everything else even if you have a gene or genes that predispose you to early cardiovascular death you will live longer than if you don't exercise etc.
There is a certain Darwinian event going on here where folks hate or fear medicines that may help them and refuse to take them for cockamamie reasons.
There are too many people on the earth anyway so go right ahead and proceed as if you know better than experts who indeed know better and also take statins.
1
I'm probably at a higher than average risk for a cholesterol related cardiac event. The FDA seems to hold the view that statins do not prolong life. And while statins may reduce cholesterol readings in the blood stream, there does not seem to be much evidence that statins have much effect on the build-up of arterial plaque.
Unless there is a clear and obvious benefit to a medication, I'm inclined to pass on it. Frankly, I'm at the point where Big Pharma has almost no credibility at all with me.
13
I’d love to join the pile-on of doubters. I had a friend who was praising statins when they first came out. He said,we should put this stuff in the water supply. A month later I asked him about the statins. He said the sexual disfunction made him give them up. The real truth is that statins work on bad cholesterol by interfering in our biochemistry in ways we do not fully understand. Given that you can take diet and exercise instead, why would anyone except someone with seriously uncontrollable high cholesterol ever take statins? Without statins I might die earlier, with statins perhaps the same.
9
Great writing by Jane Brody. I have to laugh... at myself. I’m on a statin.. duh.
Ten years ago, while on the statin (at that point for five years) I got severe joint pain. I got really scared, mainly because I had a ski trip to the great Park City. I quit the statins. I succeeded in hobbling through the ski trip.
A year later, after the pain was long gone, a doctor succeeded in convincing me to resume the statin (they are so good at this). But keep in mind, I had *joint* pain, not muscle pain. Since then, I’ve had no problems.
As for cycling, a group of us *used* to ride at 21 mph. Sigh, no longer. Is that due to the statin? This Winter I was banging the bumps at Crested Butte and Deer Valley. What am I to tell my physician? Statins are a problem for me because of slow cycling speed?
It’s a call. As time goes on we’ll have more data on statins. Meanwhile, a good diet and exercise are recommended as well.
1
Large-joint pain (knees. hips, shoulders) is a common side effect of statins in my experience. Many doctors and patients don't seem to recognise this association.
4
My spouse, who has not been diagnosed with heart disease, was given statins for his high cholesterol as a preventive but started having muscle pain. He switched to different brands but kept having the pain. As an active guy (swimming, hiking, etc) this was not acceptable. He stopped the statins and started on a mostly vegan diet with an occasional fish meal. His cholesterol is now well under 200. You have to have a lot of motivation to stick to that diet but he is so grateful to be in good health that he never complains. This is a sample size of one, but wanted to share what worked for him.
16
New study links use of statins with increase risk of ALS. There are many more common side effects. Most doctors fail to discuss benefits of a plant-based diet, exercise & targeted supplementation to reduce high cholesterol. And most are ignorant about other risk factors.
1
I'm nearly 60 and drug-averse as US doctors seem to think the answer to everything is in that little pill. Unfortunately, I let myself be convinced to start synthroid and will be on that for the rest of my life. So, I will say "no" to statins....watch what I eat, exercise regularly including yoga for strength, balance and flexibility. If I die tomorrow, well, I have lived a good life!
2
This article is not helpful. At all. Brody does not elaborate on those "...possible side effects." Those side effects may be significant esp. to patients with certain pretexting conditions. The article also does not present the perspective of the updated guidelines issued jointly by American College of Cardiology / American Heart Association guidelines which recommend to consider a list of criteria for decisions on intervention of high cholesterol.
Certain disease conditions result in elevated creatine phospokinas or CPK levels. I have genetic motor neuron disease SBMA (spinal bulbar muscular atrophy) which results in elevated CPK levels. My cardiologist put me on atorvastatin for LDL level of 120. My CPK skyrocketed to 1000 mcg/L, from around 450 mcg/L; while normal is 50-125 mcg/L. My neurologist went through the roof at the cardiologist, with whom I had discussed in detail and given 7 years of lipid panel and CPK level data. The cardiologist paid no attention. I have had many good doctors but the best ones are the ones with whom I can have intelligent discussions and listen to me especially when I have done substantial / significant research on the topic.
9
If Jane E. Brody is reading this, you left us hanging as to what happened after you decided to take a holiday from the statin drug. You said: "After being on a statin for nearly two decades to lower a genetically influenced high cholesterol level, I recently decided to take a drug holiday after reading about how the medication can affect muscle metabolism and sometimes cause muscle pain and damage."
Did you go off and what happened? Did pains vanish? Did you decide to resume taking the statin medication? Inquiring minds want to know.
11
18 months ago I opened a practice of Addiction Medicine and Psychotherapy, ACT, Acceptance and Commitment Therapy, in Saratoga Springs, NY. I am an MD and if I had joined the local hospital Addiction Medical Center they would have allotted me 20 minutes or so per patient. I spend 60 or 90 minutes per patient, and we really take care of rebuilding the skills inside -- regarding the hurts from childhood and how we felt and how we feel and function. We Americans need to stop being so bashful about being in touch with our emotions, our bodies, and our here and our here and now, to make progress in our emotional and psychological lives.
5
I question why Ms. Brody continues to push the cholesterol-heart disease paradigm when so much new evidence exists to show that heart disease is the result of a much more complex process.
17
NYT continues to push the pharmaceutical industry agenda when it comes to healthcare. I suspect advertising dollars are a major factor.
3
We don't treat cholesterol numbers anymore. The article even mentions that decisions to treat are very much part of a more complex process that takes into account cholesterol along with blood pressure, smoking, diabetes, age, gender, and race. The interaction between these risk factor and CVD is well established, as the article mentions.
6
At least you point out that there is no valid evidence that statins prevent premature death or heart attacks in most people. I think it is callous to imply that at worst these drugs are benign. The cholesterol myth has been debunked, and drugs that block cholesterol may impact out health in several important ways. The brain has a significant amount of cholesterol and relies on both cholesterol and fats to function optimaly. Now that we have tens of millions taking these statins, rates of Alzheimers and other cognitive conditions have skyrocketed. Also, keep in mind that many patients, including myself a long time ago, are prescribed a statin and then feel as though they are protected and continue to eat a diet that is much more harmful and likely to cause heart disease and Type 2 diabetes. I know I am going to continue to eat the highest quality (clean) high fat, low carb foods, and have my 2 egg yolks daily. The SAD (Standard American Diet) is what is fueling Type 2 Diabetes and Heart Disease and the statins are not part of any solution except to boost earnings of Pharma companies. But the money chain continues. From Agri-Business to the Pharma companies and then on to the Hospital systems that perform the medical services. From Insulin, to Statins, to Dialysis, it is a very sad state of affairs. Be critical and do your own research, don't rely on anyone, especially the Government or any press source. They often don't even properly evaluate the studies they are citing.
16
Yes!
Thank you for adding this often overlooked bit of information.
1
Jane Brody should retire.
13
Dear Jane Brody,
I have a recurrent question. When you--and others in the health world--say "Talk to your doctor," there's a little voice in my head that always wants to shout, "What doctor???" Who has "a doctor" these days? Particularly one who cares enough to sit and discuss the pros and cons of, say, statins for an individual? That construct is a dated dream, far from the reality that most of us encounter in our brushes with the health industry. It irks me to see it in print, as if it is a useful strategy, or even a possibility for most of us. Please consider this in your otherwise very thoughtful columns.
35
I'm sorry you have had such a bad experience finding decent healthcare. I see my GP (primary care physician) regularly for physicals and follow-ups on health problems. I've had the same doctor for over 10 years and am very happy with her. My insurance is Healthnet, which I had as an employee and converted to Healthnet Senority when I retired. Medicare is my primary insurance now. You can begin the discussion about your health by scheduling a physical, which should include a fasting cholesterol panel and other lab tests. A general practitioner can request these tests for you. Good luck.
1
Good article, but the title (Pros and Cons of Statins) is a mismatch. I started taking a statin a couple years ago and it has lowered my cholesterol dramatically. I have no other risk factors so the risk calculator does NOT recommend me to take a statin. But I'm going to stay on it because I'm not aware of any side effects, and heart disease is the #1 cause of death in the US. Not #8, or #2 -- #1. I can't ignore that. I'll probably die of cancer.
5
Let's take a step back from the "statins or no statins" argument for a minute to look at the bigger picture. It's a truism that every system is designed to get the results it gets. If it is true that 73 million Americans have unhealthy levels of cholesterol, there is a serious problem with the way our American way of life is designed. Shouldn't redesigning the system be the focus of attention, rather than trying to fix the results? Safe neighborhoods designed for walking, bike paths everywhere, effective food regulations, no subsidies for agribusiness to produce food that's killing us, etc. And if the cholesterol theory of heart disease is bunk (propagated by "experts" that had been bought by the sugar industry), that's just another sign that our American system is designed to put moneyed interests first and people last.
https://www.nytimes.com/2017/11/21/well/eat/sugar-industry-long-downplay...
7
Dear Jane Brody,
Let me see if I have this straight: You plan to go back to taking statins, even though they are probably causing you serious muscle pain (which could be irreversable), and they have been shown to have virtually no benefit for a woman your age; you are worried about your LDL even though tons of evidence shows that high LDL has virtually no causal relationship with heart disease, and that high LDL is associated with longevity; and you haven't considered getting a CT scan to find out if you even have a heart disease problem in the first place?
Did I get all that right?
Wow.
40
New research has found a much higher incidence of ALS (Lou Gehrig's disease) in people who take statins. https://www.ncbi.nlm.nih.gov/pubmed/29427042
8
I'm a 64 year old pharmacist with 42 years experience working in the hospital setting. My opinion, for what it's worth, echoes that of Seinfeld's Cosmo Kramer when discussing motion-powered carpet sweepers: "Statins are the biggest scam perpetrated on the American public since One Hour Martinizing."
26
Cons: Excruciating joint pain, severe brain fog, the newer version is unaffordable Pros: I'll take my chances.
8
"Healthcare" should not be about profit (like education, for example). Look at the United States' health outcomes which have us in the mid-20s rank compared to other developed countries, third-world levels for maternal/infant mortality and forty-first in longevity. These are sad, disturbing statistics considering we pay more than everyone else.
Cholesterol is not the reason behind heart problems. Stop pushing statins on everyone. If your heart is clogged, try nattokinase and serrapeptase. The science backs it up, no downsides and your health and pocketbook will thank you.
8
Folks
Get a coronary calcium score in addition to getting your lipids checked.
If you have evidence for coronary atherosclerosis (I.e evidence for coronary calcium), the scientific data would suggest you should be on a statin to prevent this plaque from progressing and rupturing and potentially leading to a heart attack.
I’ve learned after almost a decade in practice that the only thing more polarizing than statins is probably discussing abortion! It’s turned into a matter of belief.
You either believe in it or you don’t. There is no middle ground anymore.
There’s nothing wrong with questioning the data. Ask your doctor questions. Ask to see the studies. Than listen with an open mind and make your decision.
I’m not here to push a statin. I don’t take speaking fees. I have no vested interest in recommending them (in fact in a twisted way, I have a vested interest in NOT pushing them since more people will develop heart disease and have MIs) other than what I believe to be true.
My parents take a statin. My family members do. I’ve gotten my own coronary calcium score done and also have started.
Don’t fall for pseudoscientific hype. Listen with an open mind and make your decision.
It may be the most important one you make.
12
Cardio Doc - What strikes me as unscientific is the medical profession’s discounting and minimizing patient-reported side effects that subside when discontinued while pushing a one-size fits all “preventive” of marginal effect. A basic scientific fact is that we cannot prove the null and there are no check boxes on death certificates that state that someone did or did not take statins and for how long, who died of coronary heart disease, their cholesteral levels at death. Death certificates already contain age at death info. Easy to study.
If statins imcrease blood glucose then perhaps there is your clue to the diabetes type 2 “epidemic”.
7
Docs who don’t listen to their patients are just bad docs.
You can’t generalize your own experience to a community.
I often times will tell patients “this is not a typical effect but you know your body more than I do so let’s stop it and see”. When they come back and their issues are gone we again have a frank discussion on what to do to reduce their risk:
1. Try statin again but at lower dose or another statin
2. Try a non statin drug to lower lipids
3. Observe off meds
If they ask me what I advise I would say “1” but i remind them I’m not here to force therapy. I’m here to offer guidance.
And of course It goes without saying that therapeutic lifestyle changes would have to obviously continue with any of the above options.
Only a fool of a physician ignores patient’s complaints.
6
I feel better already knowing there are doctors out there with the approach you espouse. It's just a matter of finding one. Aware that I can't generalize my experience to a community, I'm nevertheless convinced that given my current fitness level and health the greatest threat to my continued well-being is contact with a medical provider. I've seen so much of the harm that's been done, and then there are the numbers--of people ruined by medical bankruptcy and of deaths resulting from opioid addiction just this past year alone as well as from other prescription overdoses. The days of "doctor knows best" are long gone, I'm afraid. But I would be very grateful for the right guidance by the right doctor.
3
this is not a one-size-fits all situation. Much better to eat "healthy" and maintain a normal BMI than take meds. But even with optimized diet and weight and exercise, there are some folks due to the genes they've inherited that can reduce their risk of MI with a statin. The 7.5% was based on the original ACC update in 2013. subsequent guidelines from USPSTF, AAFP, & the VA have suggested this threshold risk should be 10% or even 12%. The updated risk calculator even advises there are some ppl who may benefit if their risk is > 5%. Another tool to help risk-stratify is a coronary calcium score, but this involves some radiation exposure (it's a CT). Too bad we don't have a crystal ball yet. We can only try to predict how ppl will behave based on large studies of ppl and hope the individual will behave like someone in the study. ymmv. updated risk calculator here:
http://tools.acc.org/ASCVD-Risk-Estimator-Plus/#!/calculate/estimate/
1
Let’s get this straight: Medicine is not healthcare. Food is healthcare. Medicine is sick care. If you have disease, it will help you. If you are well (primary prevention), look at your plate.
13
So many victims here! What do we want?
We want an effective system for reporting the adverse effects of drugs?
We want no more ads on TV and even in the medical journals pushing statin drugs?
We want some research into the devastating neuromuscular diseases that many of us have gotten?
How about reversing the 2011 and 2013 Supreme Court decisions that make it impossible to sue generic drug companies for not staying current on warning labels or for faulty drug design?
There are obviously a whole bunch of us whose lives have been turned upside down and inside out by the effects of a statin drug. Why so much effort to deny this?
Even if statins benefit those who've already had a cardiovascular event, why push them on the rest of us? As someone with a triglyceride/HDL ratio of .68, why did I have a statin shoved on me? As someone with an LDL/HDL ratio of 2.15, why statins? Simple LDL number falls way behind these ratios as a predictor of heart disease...but statins make billions.
Why did Big Pharma try to put language into the 21st Century Cures Act that would remove the obligation of pharmaceutical companies to report payments to doctors? (See Dollars for Docs, ProPublica.) Why did the cardiological group I went to for a second opinion before taking a statin take almost $300k from Merck and Pfizer? Why would they dream that this didn't influence their thinking?
Please we need to form a non-profit, like MADD, to fight for help. Post your stories at StatinVictims.com
10
when are American doctor's going to tell the truth?! WHO drs across world that used2 practice in USA& go other coinyries-laugh@ usa patients so easily persuaded cholesterol level leads2 heart attack. Since 1984, all studies, number 1 were all done byRXco. make statins, never have women ever been studied! All was found wAsian American males w low cholesterol levels had probs w liver&kidneys. Indie study show patients taking statins never prevented heart problems! plaque buildup isnt problem.
The high number or any range of cholesterol levels that are supposed to be normal, is all random and not scientifically based in any way shape or form.
When American patients found out that open heart surgery was the most useless and harmful and unnecessary surgery done to Americans, it finally lesson 2. The number one unnecessary surgery for women is hysterectomies but yet is still killing women because American women are choosing not to educate themselves or doctors are too persuasive to these lies?!
I was born with juvenile type 1 IDDM, my life depends on trusting American medical professionals. It breaks my heart to find the doctors and professors in your article are perpetuating lies and not even opening a conversation about facts!
I demand for them to read the articles I've enclosed& book by Thomas J Moore- HeartFailure
https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no...
6
No mention of statins in the Atlantic article... and it’s looooong....
1
It would be nice if the cvriskcalculator showed the results when you include statins, too. However, alcohol helps a lot, as well.
The CV risk calculator plus on acc/aha website DOES show the risk reduction with addition of statin compared to without.
I took statins for 5 years at increasing doses to deal with high cholesterol and arterial blockage. FYI: I practice ashtanga yoga for 1.5 hours each day, weigh the same as I did in college and have tried vegan diets to reduce cholesterol without success. I found that increasing CoQ10 was necessary to reduce muscle pain and stiffness. The use of CoQ10 is not suggested by most doctors. One reason to question prevailing medical advice. After this 5 year period I was so stiff I could barely stand from sitting or prone. A new doctor suggested Repatha as an alternative to statins. Now almost 6 months after stopping the statins I am off CoQ10 as well (took 4-5 months before I could stop CoQ10). My yoga practice is returning to where it was 5 years ago and I can rise up without pain. In my single case, the advice offered in this article is not helpful.
4
please take the time and effort to read a book
heart failure by Thomas Jay Moore, a critical inquiry into American medicine and the revolution in Heart Care.
Also just Google search heart attack due to high cholesterol
and you will find many articles showing that never has there been any studies that have shown the correlation! Only the Statin making companies have funded research to find low cholesterol levels were harmful to asian-americans.
Here's another article saying American doctors are theonly ones in the world that persuade patients to take statins and still to this day is not prevented one heart attack
https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no...
2
Or you could change to a whole food plant based diet. no side effects other than better health and weight loss.
7
I tried this calculator to estimate my risk factor and discovered that at my age (70s) I cannot bring the numbers down below 13 no matter how much I fudge the input numbers to try and bring it down. So according to this calculator every man over a certain age should be on statins no matter what your overall health may be. Is that right?
3
I had exactly the same experience. Inputting my age (69), I got 12.5 but knocking 20 years off my age I got 2.4.
https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no...
the cholesterol numbers in America were created at random by the Statin making drug companies
To this day World Health Organization and other world Medical experts laugh at how easily American patients are persuaded to believe that cholesterol level has anything to do with cardiac problems.
The Atlantic Magazine Link I've been closed shows that no Statin has ever been proven to prevent a heart attack...
Also a very informative book of a reporter research the Statin drug industry and found it is useless. heart failure by Thomas J Moore
1
ok I fell for it. There is not one reference to any statin in the entire Atlantic article
3
Yes, think long and hard before taking a statin for primary prevention. We have no system except self-reporting for adverse effects, and they’re hugely under-reported. Just call the F.D.A. and ask. Your doctor isn’t required to report and almost never does. Warning labels on generic drugs are not required to contain newly-learned adverse effects.
On top of this, there’s a cadre of statin-believers/pushers who suppress and dismiss the side effects that do get reported. I didn’t have to click on the Lancet link to guess that this would be Rory Collins’ show, proselytizer of compliance (take your statin). Merck, contributed 217.5 million to Collin’s Cholesterol Treatment Trialists Collaboration.
Yes Merck, the Zocor company, the generic of which is simvastatin, which is what I took for 7 months. I had no warning at all of what could happen to me. First incipient foot cramps, then tightening of tendons, then a snapped tendon, torn shoulder and hip labrums, blood clot, and finally waking up in the night screaming, both legs like blocks of wood from the knees down. Now why wouldn’t your doctor want to warn you about the early signs?
Because the end of the story is some kind of neuromuscular disease, with huge myopathy. You can see photos at StatinVictims.com.
I know four other people personally who got a neuromuscular disease within a year of starting a statin; also one more, who died. This isn't "one in a million", as my doctor said. It's simply unreported. Send us your sto
46
My mother was given statins 15 years ago. She has had muscle issues since despite discontinuing after three months when her muscles were painful and became weak. Today she is in a wheelchair. She suffered from rheumatic fever as a child which permanently damaged her heart valves. She did not have high cholesterol, yet her internal medicine provider prescribed Statins to help keep her valves open. Do. Not. Take. These. I’d rather die of a heart attacking than have my husband have to care for my every need as my wonderful dad does for my mom. We never sued. We should have.
5
Please send your story to StatinVictims.com. Sorry for your mother's situation. Mine is very similar. It's brutal and of course unreported.
3
inform everyone you know! Only in America do we get easily persuaded and force-fed statins by the medical professionals! World Health Organization and Global Medical experts laugh at American patients...
Are you familiar with the book heart failure by Thomas J Moore? it is a critical inquiry into American medicine and the revolution in Heart Care. Years of study by a journalist and went to all experts and pharmaceutical companies.
as of this date, and studies from the 1980s to current date, they find humans taking statins never prevented their heart attack! cholesterol numbers are randomly chosen by the pharmaceutical companies and there's no correlation with Heart Care only they found low cholesterol numbers cause vital organ problems among Asian American males. And to this day not one study has been done on females!
Also this article in the Atlantic Journal,https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no...
please point out any statin reference in this Atlantic article
2
Not every statin affects each person the same way. If a person at high CVD risk needs to be on a statin please try several , with a holiday in between, before giving up. That being said they are over prescribed to people with low CVD risk.
2
Dear CTMD
Some of us never get a second chance, and it's important that this be acknowledged. I took 20 mg simvastatin for 7 months, and from trekking in the Himalayas can't walk around the block. Look at StatinVictims.com, click on the photo of the guy standing on one leg. For six years I've had some kind of neuromuscular disease. The symptoms started within weeks of starting the statin...but no one had warned me what to look out for. I'm dying twenty years before my time, and in great pain. And I know four other local men, same thing.
3
https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no...
if you are an MD, you gave an oath to do no harm! Yet you choose to continue harming! To this day there is no proof whatsoever of any correlation with cholesterol levels and heart problems. World Health Organization, medical experts around the world laugh at American patients being so easily persuaded buy a pharmaceutical company and their doctors pushing meds. No one else has opioid addictions other than America.
It breaks my heart that I cannot trust American doctors. And my very life depends on it.
Protect yourself and your brethren and listen to these victims and do objective research and stop pushing harmful drugs! all we find is heart attack victims we're currently taking statins for decades, statins do not prevent heart attacks in anyway! Stop perpetuating lies! or find a different way to earn a living...
Heart Failure by Thomas J Moore
There is a ot of fight back in the Comments. Perhaps you need to go into more detail about alternatives, both medications and diets. I ended up getting bladder cancer which was determined to be party due to taking Actos.
More research is needed on many popular meds.
5
https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no...
MEDITERRANEAN DIET
When I was 40 my blood tests showed high bad cholesterol. My doctor told me to cut out fatty foods. I went on a Mediterranean diet: chicken, fish, veggies, fruits, olive oil, walnuts, avacados...all good fats. Next year my blood test showed my bad cholesterol was VERY LOW. My doctor was amazed. He asked what I did. I explained that I had switched to a Mediterranean diet. I'm 62 now and my blood tests are still great!!
7
Charles, this is great. But it's also true that some people, no matter what they do with diet and exercise, will have high LDL.
The question, however, is how much this number alone means. Triglyceride/HDL ratio is much more predictive of CVD than simple LDL. The HDL/LDL ratio is also more predictive.
And with those ratios being good, the type of LDL is less dangerous--more large fluffy, less small, dangerous BB type.
As an older man, want to raise your LDL? Lift weights. That's right, this stuff is not as simple as the statin-pushers want people to believe. Statins are a huge business, and most of the "science" is paid for by Big Pharma. Studies have shown that this increases the odds of a good outcome by 500%
I'm not anti-statin: for secondary prevention statins seem to work.
But for everyone, adverse effects are possible, and no one is reporting the bad stuff. It can be at least as bad as heart disease. See StatinVictims.com
4
Cramps, muscle pain and muscle weakness presenting in people taking statin drugs can be due to low levels of Co-enzyme Q10, a necessary co-factor in the production of ATP (adenosine tri-phosphate) which is the main source of energy for every cell in the body. Cells that are the most metabolically active use the most ATP.
Statin drugs work by blocking an enzyme needed to produce cholesterol in the liver, the source of 85% of the cholesterol in our bodies. However, this same enzyme (HMG co-reductase) is also needed to make Co-enzyme Q10.
For more than 20 years I have been recommending that my patients on statin drugs take a daily Co-Q10 supplement. I suspect Ms. Brody could benefit from this supplement given her symptoms. Ask Dr. Google about the biochemistry of statin drugs and Co-Q10 levels before your next visit with your health care provider if you're taking a statin or considering it. If you decide to take CoQ10, do a little research as not all brands are created equal.
ConsumerLab.com is a good resource for information on supplements. They test a wide variety of supplements to ensure that what is printed on the label is consistent with what's in every pill or capsule in the bottle.
8
World Health Organization has proven every person taking statins for decades still had heart attacks! It prevents nothing and there's no correlation with cholesterol levels and heart problems!
Prove your thinking with world-renowned non-pharmaceutical paid studies. To this day there's been no studies on female patients and cholesterol levels!
Take the time and effort before you harm another patient, objectively Reed the research and studies done for decades and Great Britain and Japan and by unbiased American Medical professionals, heart failure by Thomas J Moore critical inquiry into American medicine and the Revolution and Heart Care. And most recently in the Atlantic Journal. remember you took an oath to do no harm! Perhaps try a different profession
https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no...
where does this Atlantic article mention statins, elle?!
4
I have tried every statin that has been made. Whether it was a older med or a new med I experienced the same reaction every time. I have spinal stenosis and several disc that have no cushioning. Every statin has caused me unbelievable pain from the back to the hips to the thighs to the knees. I try to keep it in check eating healthy, but I'm human and sometimes I eat all the jelly beans immediately. Sometimes people just can't take the medication. The new repatha sounds great, but side effects are pain and muscle weakness.
3
don't spend another day worrying about your cholesterol levels. These were random numbers made up by big Pharma. Decades of research from the 1980s to current day has proven this and only in America. World Health Organization laughs at American patients that are so easily persuaded. Remember only in America do we have an opioid crisis that was created by big Pharma in the medical profession in America... I depend on doctors for my very life since being diagnosed at Age 4 with juvenile diabetes type 1. It breaks my heart every time I learn that only 50% of doctors or maybe less, in America can be trusted with your life... I don't know if you've ever seen a Seinfeld episode, but there is a comedy from the 1990s, and they had an episode where one character, Kramer, says he would trust a veterinarian over a human doctor any day because they see several different species and resolve the problem all in a day... Haha
Also read the book, heart failure by Thomas J moore. a critical inquiry into American medicine and the revolution in Heart Care
https://www.theatlantic.com/health/archive/2017/02/when-evidence-says-no...
1
Not often talked about are the additional benefits of statins beyond those of decreasing LDL and overall cholesterol. In addition to lowering those, statins have shown benefits of increasing vascular elasticity - making vessels more flexible and less likely to develop vascular wall irregularity. They also have been shown to be anti-inflammatory, reducing the risk of vascular inflammation, a consideration in the causation of plaques in the arteries.
A a doc (although not a cardiologist), I have long held that the combined benefits should be made known to patients as they determine their risk/benefit tolerance for these medications.
Curr Vasc Pharmacol. 2007 Jul;5(3):227-37.
Beneficial effects of statins on endothelial dysfunction and vascular stiffness.
Dilaveris P1, Giannopoulos G, Riga M, Synetos A, Stefanadis C.
5
@seth borg:
So... why the focus on LDL and cholesterol, then? Sounds like all that other stuff is a much more direct approach to the pathology of heart disease...
2
For secondary prevention, statins do seem proven of benefit.
For primary prevention, any benefit at all is still being argued. See the Nov 15, 2016, issue of JAMA, with articles such as "Statins for Primary Prevention. Lots of Studies But the Data Are Weak."
Health care professionals seem to focus exclusively on benefit, but all patients deserve clear warnings of risk. Instead, clear instances of severe adverse effects are dismissed as "one in a million", or worse, simply denied. The US depends on sick patients reporting their own adverse effects to the F.D.A. Are you surprised that under-reporting is huge?
2
Doctors keep on saying that all of the people who have problems with statins are imagining them. I took one statin and collapsed, I couldn't even walk. I recently tried another statin beginning with very small doses and started shaking so badly that I couldn't drive. I would love to be able to take statins but there are some very real side effects
4
'The Operation Was a Success, but the Patient Died'
4
I am almost 67, but when I was 43 I had 90% blockage of my LAD (one of the ones you need in the heart). They didn't have stents, so a balloon was used.
I had muscle pain so the doctor prescribed Cq10. I have been taking 5mg statins and 100 mg of cq10 and have not had any problems since.
2
This is horribly one sided and inept. Side effects from Statins in "your head?" Tell that to the people (women are more likely to be affected) that have experienced cripling muscle aches, fatigue, and diabetes. Or the people struggling with dementia after being on a statin for decades. High cholesterol is not the best predictor for heart disease. Cholesterol is not inherintly "bad" - in fact higher cholesterol in the elderly is actually linked to a longer life! If you want to know how to take care of your heart and prevent heart disease - read books by Dr. Mark Houston ("What Your Doctor May Not Tell You About Heart Disease") or Dr. Steven Sinatra ("The Great Cholesterol Myth).
6
Dr. Steven Sinatra is a great resource for health in general. He is a cardiologist and board certified nutritionist (as well as a psycho therapist.) He has a lot of good information on heart health, the right kinds of tests to get, etc. To read a good summary of short-acting Niacin (Vitamin B3) as an alternative to statins see this link: https://www.drsinatra.com/is-niacin-effective-and-safe-heres-my-take
My husband had a mild stroke almost a year ago. He was put on statins. He took himself off shortly after. He started with 250mg of Niacin a couple of times a day and gradually built up the dosage. He had a few "flush" episodes, but I think a temporary "hot flash" is a much more acceptable side effect than what one might experience under prescription drug use. Like others here, he lost some weight, started to exercise more, eats good fats (avocados, olive oil, nuts). His numbers are good. Do take a look at Sinatra's site. He has videos, articles, interviews. He is excellent at explaining how and why he recommends one thing over another. Sinatra also stresses that if you are taking a statin, you must take CoQ10. I don't think doctors give their patients enough credit and most don't recommend life style changes. Doctors are not nutritionists. I believe they should be. It really is true - you are what you eat. Do your homework and be informed. Prescription drugs have their place. But they are woefully over prescribed in our country.
2
My friend's doctor told him his choice was either statins or a diet of "twigs and berries."
1
Arbitrary rigid guidelines insisting that you need to take Statins to prevent the possibility of heart attack is truly bizarre especially when you know it results in Pharmaceutical companies making billions of dollors off of the medicine.
3
My goodness that was disappointing to read from NYT. Where's Aaron Carroll when you need him? Number Needed to Treat, anyone? From:
http://www.thennt.com/nnt/statins-persons-low-risk-cardiovascular-disease/
"In summary, studies have found no significant overall mortality benefit with statin therapy in low-risk patients, as well as no reduction in the risk of serious illness overall and very small benefits for nonfatal heart attack and stroke. Statins also appear to cause diabetes. Although this is uncommon, diabetes may occur more often than the prevention of a heart attack or stroke in patients taking statins. It appears that the existing evidence is in disagreement that statins should be used for patients with a 10-year cardiovascular risk below 20%.4,11,12 With no mortality benefit, no reduction in serious illness, an approximately 1% chance of avoiding a nonfatal heart attack or stroke, a similar or greater chance of developing diabetes, and a one in 21 chance of muscle damage, it seems wiser to focus on lifestyle changes (such as adopting a Mediterranean diet, exercising, and not smoking) instead of cholesterol drugs in low-risk patients. These individuals should be informed of the known risks and benefits of statins, and the decision to start statin therapy should be shared by the patient and physician, rather than imposed by guidelines."
7
As the 2016 JAMA review you quote concluded, people with little risk should avoid unnecessary prevention strategies.
3
Nowhere does the author mention all-cause mortality figures. Yes, taking a statin may reduce your risk of cardiovascular death but it also increases your risk of dying from cancer. Articles like these are nothing more than ads for the pharmaceutical companies; please, think critically and actually inform your readers.
5
My Doctor recommend I take a Statin when I was 69...can't remember the name...about 3 months later I developed a cough, everything, I did, did not help...at a senior center meeting I mention my annoying cough, one of the members said, your'e taking a statin, right!...yes I said...he said," I had that cough it went away as soon as I stopped taking the statin"...Told him I read most the reports on statins never heard about that...anyway I stopped...cough went away...I started eating pink grapefruit , I had read an article if you don't have a problem eating fresh grapefruit , due to other meds, it would hold your cholesterol level down...I'm not recommending you follow my lead...just telling you my story...it worked for me.
3
I am on a combination ezetimibe plus statin therapy and have been for more than a year. I understand this is still a somewhat experimental approach but it my be working for me. My father died from heart problems in his early 60s and a number of his brothers died from heart related problems at even younger ages. I am now into my 70s and so far no angina or other signs of artery plugging. I take my pills with my fingers crossed.
1
I have always been thin but with high LDL and decent HDL and Triglycerides. I was tired of starving myself afraid to eat certain foods that would raise my LDL while all my friends were on Statins eating meat and lemon meringue pie (eggs). I had to beg my Internist for a Statin (3months and O.K.)
But another reason to take them is the fact they are Ant-Inflammatory. Some doctors and researchers have written about the possibility they may prevent cancer. See: David Agus M.D. An End To Illness
1
Meringue is made from egg whites. The cholesterol in eggs comes from the yolks. That said, pie has a lot of sugar which is probably worse for you than eggs. Statins do nothing to protect you from the sugar in desserts.
My three brief experiences taking a statin were all the same: after about 7 to 10 days I felt so ill throughout my body that it felt like I should see a doctor ! --- something I thankfully rarely do. Instead I stopped the statin and returned to feeling normal and good within a week or so.
Look up the NNT ("number needed to treat") for statins, which is apparently 104. As I understand it this means that 104 people have to take a statin in order for one of them to be helped. Of course if that one is you then the misery of statin use might be worth it, tho' I believe the way you live matters more.
3
I was prescribed statins 5 years ago and after reading possible side effects I decided against them. I tried to reduce cholesterol on my own but ended up with 2 stents due to 95% blockage. I know take them daily and have not had side effects. Lesson learned.
4
I know someone who had a bad reaction after switching statins. Muscle fatigue on exertion and overall fatigue. Turns out his mother had previously had problems with that statin so family experiences should be part of the information that guides statin selection.
6
My brother and mother had problems on statins but I had none.
1
I had slightly elevated cholesterol, and my doctor asked if I would be willing to try red rice yeast, the "natural" treatment to lower cholesterol. I took one dose and my body and brain reacted as if I'd just taken a long transatlantic flight-yes, I felt as though I had that serious jet lag-strung out condition without the benefit of landing on foreign soil. I stopped immediately. About six months later I went on a ketogenic diet, and despite consuming bacon, eggs, cheese, butter and heavy cream, as expected, my cholesterol and triglycerides and blood pressure dropped-significantly? How? Read about the biochemistry behind the ketogenic diet-Dr Eric Westman from John Hopkins is a good place to start. Thanks to my partner, about two years later I began takin Niacin-vitamin B3- and further lowered my cholesterol, and stopped my menopause induced hot flashes- read "The Niacin Story" by Dr Abram Hoffer, and discover how Niacin depleted our population has become over time due to reduced amounts in soil that goes up the food chain due to poor crop management. To me, niacin is a " wonder drug" and has helped me significantly curtail my urges for alcohol and tobacco as well as giving me a feeling that I've just smoked a joint without the side effects of feeling stupid-stoned. My brother in law is on Niacin as prescribed by his Yale cardiologist because Dave was having adverse side-effects to statins-I applaud his Dr for being open to using a cheap vitamin to lower his cholesterol.
5
Those of us who are interested in issues affecting our health are reluctant to disconnect from our shibboleths. But I see no harm in trying treatments found by the medical establishment to have helped numerous people - even if they don't turn out to help me. None of us is getting out of here alive but I wouldn't mind being reasonably healthy for my age right up until the end. However, I will not go broke while "raging against the dying of the light."
8
The prevalence of statin use in America underlines how unsafe it is to take medical advice from an American doctor. Even a message therapist will have enough sense to tell you to avoid statins. But to an American doctor, the pain is all in your head. You'll find better medical advice on the internet.
2
Absolutely, it’s either ignorance - unlikely as the information is everywhere - or financial interests..
Diet (less meat, dairy, salt, fat & more veggies and fruit and fish), more exercise and less tv couch potato behavior, and weight loss are time proven to lower cholesterol, and advised by MDs for years. This plan will lower cholesterol unless you have a rare genetic defect. Also be aware that food manufactures know that sugar, fat and salt are addicting and lace their food with them. Read labels if you are serious. A weight loss diet is measured by weight you loose, not by what advertisers say.
Congratulations to those who change their lifestyle they are the real winners.
Unfortunately many people are "unable" unwilling or unmotivated to change their life style that leads to increased cardiovascular risk and premature death.
7
Allan, less meat, dairy and fat does lower cholesterol! But fish is also harmful! As is chicken and eggs. All animal products contribute to a higher cholesterol. I came off statins after eliminating animal products from my diet and I feel great!
1
For my family, diet has absolutely no impact on serum cholesterol.
6
@Allan:
Dietary cholesterol has little to no effect on blood serum cholesterol. This has been known for decades. Lots of people have success with variable amounts of meat, dairy, and other naturally fatty foods in the diet, it's the refined carbs and refined oils which do the damage.
5
I just came off a statin. The reason: It made me depressed and lethargic; there were days I had difficulty doing anything. I stopped taking it three weeks ago and feel enormously better. A side effect of statins can be reduced serotonin levels, and the depression associated with that. This article is eager to dismiss side effects, but for those of us who have experienced them, such dismissiveness is not so easy.
13
Perfect case to consider placebo effect. Cause and effect only established with a restart of medication to see if symptoms return, but even then can be fooled. Results often respond to what the person expects to happen. It is not easy. Our brains work in mysterious ways, that are being elucidated slowly by Science. But remember Science is book being written with many pages being torn out and replaced with paged of new data.
2
Yes, I am actually a clinical neuropsychologist and considered the possibility of psychological explanations in my case (it would be the nocebo effect in my case, not placebo, since the effects were negative). But actually I did not initially make any reasoned connection between the statin and my decreased mood and energy. I went months wondering why I was suddenly so much more fatigued and feeling down. It was only after doing some unrelated research into statins that I realized some of the atypical side effects of atorvastatin could be just what I had been dealing with: Depression and fatigue. I went off, and the symptoms stopped. I also was found to have exceptionally low vitamin D levels and never-before pre-diabetic levels of glucose. Now, were the biomarkers of medication side-effects also nocebo? No. At some point we need to be willing to acknowledge that there are true side effects to medications that alter our physiological functioning. Be careful about pharma wanting to attribute all good outcomes to their products, and all bad outcomes to....nocebo. Not everything is due to psychology alone. And keep in mind, I say this, reluctantly, as a psychologist.
7
Thank you, tintin.
My Doc wanted me to take statins for a cholesterol level of 215-225. I said, "No way". Two years later, at my wife's naturopath, I saw an article by him saying that mankind is the only mammal in the world that drinks milk after weaning. I was a long-time dairy user, especially cheese and ice cream. I decided to put it to the test in April of 2016 and went entirely dairy-free. My prior cholesterol test was 215. In August of 2016, my cholesterol was 184, without dairy. In October of 2017, my cholesterol was 165, still without dairy. I'm due for another blood draw for PSA reasons but I'll get the cholesterol checked at the same time.
I am 80 years old. My father had three heart attacks before he died at 93. He had serious ulcers all his life that were 'treated' with cream, which he drank. Also, we all ate cheese, ice cream, etc. It is sad that medicine didn't discover that most ulcers were caused by Helicobacter pylori and can be cured with an antibiotic cocktail.
I am offering my story so that anyone can put it to the test and see what results they get. I have to say I miss cheese a whole lot. Not to mention pizza. But, cholesterol levels like I have now are worth the price, to me.
13
I make cashew cream and use it as a substitute for cheese on pizza. It is delicious! Just soak a cup of cashews for four hours. Drain. Blend in food processor with about 1/2 to 1 cup of water to desired thickness. Add salt and lemon juice to taste. I use this in lasagna as well.
3
Our household is doing a low fat whole food plant based diet, and feel great, and numbers are great.
4
Paul, all animal products contribute to a higher cholesterol! Milk and cheese specially because of the saturated fat content. I gave up all animal products and came down from 360 to 154.
2
I'm one of the people who takes a statin only because my doctor applied this formula, and the answer came up that I should. I was a little reluctant, but I eventually acquiesced. I've been doing this for months, and I don't seem to have any side effects.
But here's the problem. I'm reading the many stories from commenters on side effects, and all of these people are sincere, and we must assume their stories are 100% true. Yet there are zero countering stories saying, "I took a statin for three years, and then I did not have the heart attack I otherwise would have had." I'm not making fun, I'm trying to make a point—if the statins are hurting you, you probably will see this, but if they are helping you there's no way to know. So this is a tough decision.
One commenter was unhappy with Ms. Brody's article and said she should retire. I know why the commenter is unhappy, but I found the article helpful. And what I found more helpful were the comments. I live 1,000 miles from New York, yet I'm an online NY Times junkie, partly because I like the combination of the articles and the extremely intelligent comments, and that's what made this article work for me.
26
I've been taking a statin for 12 years and haven't had a heart attack. I have numerous risk factors including both parents dying from heart attacks.
Does that help?
6
Mary Ann, thanks for weighing in. You're maybe the best possible example of what I'm talking about. You're a very happy customer, although we have to stop short of saying the statins prevented the heart attack you WOULD have had, although we CAN say they prevented the heart attack you PROBABLY would have had.
Like you, I have bad family history; the men on my dad's side of the family all died of heart attacks at ages 53, 55, 66, and 68. My older brother died at 58 of other things. So at 67 I'm like you; although I have low cholesterol I want to stack the deck in my favor, and so like you I'm doing the statins. My only point was this is somewhat different than a doc saying "you're dying of cancer," but if you take this chemo it will save you."
1
I'm with you Jerry. My severe heart attack that also left me with heart failure was 2 years ago, so I don't yet have the long history that Mary Ann does. But the statins, along with diet and lifestyle changes seem to be working for me, while under the watchful eye of my great medical team. So far, no research on statins or diet is definitive, as evidenced by the widely divergent views being expressed in this forum and the medical journal articles I read regularly. No single solution to combating heart disease yet exists, but multiple studies of varying credibility do suggest that leaning towards a plant-based diet, exercising regularly, keeping a healthy weight, and using the right meds do indeed make a big difference for those of us with heart disease. In my case, following those guidelines has certainly improved my quality of life, and based on the testing I undergo quarterly, (blood chemistry, metabolic panels, and echocardiograms), the test results do indeed show that the advance of my heart disease seems to be in check. The meds are a big part of that, particularly with my heart failure. They're a big part of keeping me alive.
6
Like tuna-noodle casserole, the "high cholesterol" shibboleth, and the way Ms. Brody writes about it here, is so 70s. So much counter research has been published that calls the "high LDL" theory into very questionable territory. Kaiser Permanente researchers showed in 2016 the risk calculator vastly overstates true risk. One study in the UK showed that triglyceride/HDL ratio is a better indicator of cardiac risk, and most recently, a study at the University of Nottingham used four AI/machine learning models on a cohort of more than 300,000 people. That study found out the risk calculator's emphasis on blood pressure and cholesterol are far less accurate than age, Afib and social deprivation in predicting who will develop cardiac issues. This story does many, many researchers' work a disservice, and I think many readers who know their way around a search engine can find a plethora of firsthand information that will help them much more than this.
11
I’m 41, have been on atorvastatin for 4-5 years. It has been extremely effective at regulating my cholesterol level. I had started at a “mid-level dose” for a few years, but some muscle pain issues forced me to go to the lowest dose. And lo and behold, my cholesterol level is still good! If you have muscle pain, try lowering the dose or skipping nights to manage it. The prospect of a heart attack is much worse than the minor side effects of statins. If your liver function is good, you should probably take it. I would like more info on the diabetes risk, but that seems to be something that can be predicted by watching blood work.
Controlling your blood pressure and cholesterol are the two biggest weapons against heart disease. Also maintaining an active lifestyle.
10
My mother took statins for high cholesterol. She died from Lewy Body Dementia. I always swore it was the statins and the low cholesterol diet th at made it worse. Low cholesterol low fat diet also means very low dietary choline. There is a lot of cholesterol and choline in egg yolks. Choline is an important component of acetylcholine, and that happens to be the neurotransmitter that is affected by aricept, the Alzheimer's medication. My mom's sister died of dementia at 95. My mom was 82. My aunt never took statins. My aunt ate whatever she wanted. My grandmother (their mother) died at 92 from dementia and she never took statins and ate a normal diet.
I swore I would never take statins. But then I found out my carotid arteries had some blockage. So I took the statins reluctantly. I didn't think anything of it until I started getting so depressed and fatigued i started taking naps. I found myself slipping at work and feeling cognitively impaired...foggy. Suddenly a bulb went off on my head. When I stopped the statin it went away. I don't think they're bad for everyone. But I believe they affect some people adversely. Sad. they are wonder drugs. Incidentally, when I started back on the statin, the fog returned...
9
My husband took statins without my knowledge. If I had know I would have put a stop to it immediately since I had read the damage they can do to your health. First he seemed to have a memory problem, then lost 30 pounds in less than 10 months. My daughter and I were alarmed. The doctors we mentioned it to ignored it. Then he worsened. We took him to Emory and he was diagnosed with dementia, Alzheimer's and Parkinson's with lesions and bleeding on the brain. He died a very painful death this January. All this because he had a slightly elevated cholesterol level. I'm just waiting for the class action suits to begin.
5
Try taking it only at night.
1
I'm in internist, so I have conversations about this daily.
There does need to be an in-depth conversation before starting a statin for primary prevention. I do believe the 7.5% 10 year risk cutoff is too stringent, as basically every elderly male is above the threshold. But there are two points I'd like to make about many of the criticisms of statins:
1) Many say statins are a scam by "big pharma": All the major statins are now generic and cheap. Nobody is making billions of dollars off lipitor or crestor, because patients are getting generic atorvastatin and rosuvastatin. They are quite inexpensive.
2) Side effect/benefit tradeoff: Critics emphasize the potential side effects of statins. Certainly there are side effects that are possible and not that unusual, including muscle pain/weakness, liver inflammation, occasionally memory issues and sugar elevations. A good doctor will discuss these and monitor closely for them. BUT--you're not going to read testimonials by patients whose lives were saved by statins, because no single person will know that they would have had a heart attack that was prevented by the medicine. People read the negatives, but for the right patients, there is definite benefit.
13
@ John in Georgia,
There CAN’T be a “definite” benefit for any individual, since that involves predicting the future.
Benefits are describable only for historic groups of patients whose outcomes have been observed. The best that a patient can hope is that he (or she) is actually a member of the group which the calculator uses.
Note that the guideline says to use the group that best represents you instead of the calculator, if there is an alternative group for which long term data exists.
In my case, I should in theory use the Physicians Health Study experience since I am in that study. However, I don’t know I how to adjust (if at all) for the fact that I am on a vegan diet for the past seven years.
Steve Rinsler, MD
2
Thee omitted information contains good reason to think very, very carefully about starting to take statins--myalgia, leg pains that are crippling for many, more patients getting "symptoms of diabetes" than benefiting from reduction in cardiac events being the two I'm most familiar with. Intimately familiar with.
No, Ms. Brody, the scary stories are pooh-poohed by docs, including mine. But people reporting that their legs have been stolen by statins are telling their stories, not some research results. Find out who was excluded from the study before you read the results. Perhaps research has not been able to reproduce it, but if it happens to me, what difference does it make? None, to me. It isn't a nocebo that I can't take a walk with my grandchildren any more. It wasn't long ago I was running short triathlons, training almost daily. And I can't walk a quarter mile now without pain. Thank you Lipitor.
We are each one of us a experiment where n=1, with selection bias, and no control. Be careful starting these drugs. The "scary stories" aren't just the side effects;the justification you are given for the drug may be the real scary story.
13
Sadly, at my age (67) more of my peers seem to be dying of cancer than heart disease.
The strongest reason to modify diet is to lessen the chance of dying of the big "C". Statins have no role here. Their precursors were found to increase the chance of developing liver cancer.
Our lifestyle choices matter more than any drug.
35
Why not mention the option of getting a cardiac calcium score when your numbers are high and your family history isn't so hot? It can be a good tool in deciding whether or not to go on a statin. It is a CAT scan that will show if you have developed more blockage than average for someone your sex and age. Even shows you which arteries they are in. Knowing that a statin can stabilize this plaque can be peace of mind. And by the way I have absolutely no symptoms from my statin.
12
That's exactly what I did -- and accepted the statin. Also went ahead with a stress test, ultrasound, etc. at age 65 to get a baseline on all heart functions. I am physically active and stick to a diet very much like the Mediterranean. Feeling great as I approach 67.
2
This is what I said in another comment here. My cholesterol, BP and heart rate are normal, but my CT scan with contrast showed some soft calcium with a calcium score of 1. My cardiologist and internist both wanted me to take low-dose statin (10mg. avorastatin). I have been taking it for 4 weeks. In 2016 I had a CT chest scan simply to get a calcium score, which was 0 (it only measures hard calcium, not soft). I have not had a stress test. In 2016 my brother went into cardiac arrest while on the treadmill taking a stress test. It was routine and he'd had a number of stress tests previously (he had CAD and A-fib).
Here, here!
Why not get a CT scan indeed? If you are worried about heart disease,why wouldn't you have this done?
After following a low carb diet for several years, and to placate my doctor who was worried about my so-called high cholesterol (LDL around 200, oh my!), I had one done. My report revealed ZERO calcium, therefore probably no risk of heart disease. So much for the evils of saturated fat (I eat loads) and for the dangers of high LDL (at least in my N=1 case).
Also, hasn't research shown no benefit from statins for older women?
Nowhere does it mention that before taking statins, you should have a doppler of your carotids to see if you really are at risk, although your cholesterol is elevated. This article also seems a little bit biased towards big pharma... saying that sometimes the side effects of statins are in people's head... the nocebo effect.
6
My cardiologist considers that a calcium score screening for the heart is a much more accurate indicator of whether a person is ripe for a cardiac "event." All the several doctors that wrote me a statin prescription only looked at my LDL even though I had NO other indicators. This article is not on point.
12
The article illustrates how the framing of statistics can influence a decision when statins (or just about any health topic) is discussed. Using the theoretical risk stated in the article of 19%, the author notes a potential decrease in risk of heart attack or stroke by 1/3 with the use of statins. This is RELATIVE risk, whereas a 1/3 decrease in ABSOLUTE risk is only ~ 6%. Put another way, if your risk for heart attack or stroke in the next 10 years is 19%, you can decrease this to ~ 13% by taking a statin for 10 years ( 1/3 of 19% is ~6%). Putting it even better, if 100 people with a risk of 19% take a statin for 10 years, 6 will be spared a heart attack or stroke, while the other 94% will not see this benefit (including 13 people who will STILL have a heart attack or stroke). If you frame this conversation by saying your risk will drop 33% if you take a statin, your are correct. If you say your likelihood of benefit with a statin is 6% you are also correct. However the latter is rarely discussed in the doctor's office ( or health articles).
17
beautifully explained statistics lowrider. Are you a statician?
1
What this article fails to recognize is that the integrity of research supporting many pharmaceuticals continues to be degraded through exposure of conflicts of interest among the researchers. Of course people will be skeptical about research findings when the evidence continues to mount that many researchers are in some way 'in the pockets' of pharma companies. When you are deceived 10 times, it becomes hard to believe something the 11th time.
7
Medical professionals, in general, also appear ill-prepared or unmotivated to discuss lifestyle and nutrition changes in lieu of the 'take a pill' approach to health issues so prevalent with statins. My wife and I, both retired, took charge of our healthcare through a whole food plant based lifestyle with regular moderate exercise. We were able to get completely off high blood pressure and cholesterol medication. Doctors are either not knowledgable of the literature or unmotivated by patients difficulty in adhering to lifestyle changes. There is a better way.
15
Actually my experience getting a Ph.D in a Bio field while my neighbor got an MD, makes your case.
I was taught and had to exhibit critical thinking and logic skills, as well as being able to convey written and oral--MD neighbor was memorizing stupid menomic phrases to remember stuff.
And as a friend of mine (med school prof) said, they will NEVER kick anyone out of Med school because reflects poorly on their admissions criteria.
MDs are actually dissuaded from critical thinking and evidence-based science.
1
My LDL was 190, being a physician I still balked at the idea of taking a statin myself even though I have prescribed it for many patients and seen the side effects of diabetes, weight gain and more commonly painful muscles called myalgias.
I told my very upset wife who prescribed statin for me, to give a chance to turn around my lifestyle and reassess in 3 months.
I ate oatmeal for breakfast with a pomegranate smoothie, enrolled in kickboxing (tiger schulmann) and then Chipotle veggie lunch and a not so healthy dinner and LDL came down from 190 to 115 in 6 months.
Statins are necessary for familial hypercholesterolemia, but for most others, diet and exercise will bring down LDL.
I hope medical students will be taught the benefits of nutrition better. And physicians realize, to keep an open mind and learn there are other ways than just pills to treat a human.
16
Med students are not "taught" anything, especially not critical thinking.
Statins apparently have their plaque inhibiting effect by stopping bone marrow stem cells from developing into macrophages (which are important in the formation of atherosclerotic plaque). They also stop the development of stem cells into other cells such as neurons (which may be why statins can affect memory). I prefer a whole foods plant-based diet to reduce my cholesterol (see Dan Frazier's post below).
8
In general, I don’t like taking medications. Statins are no exception. With reluctance, I started to take 10 mg (the minimum pill size) of Lipitor daily. It lowered my cholesterol to acceptable levels. So, I then cut the pills in half and found that 5 mg. still kept my levels acceptable. For me, this is a reasonable compromise considering pros and cons of statin usage.
2
The heart risk calculator does not take into account any patient history relating to having a heart condition, heart attack, stents, and so on but just ask you to input HDL, LDL and totals and then blood pressure.
Very misleading not very accurate. Go to your cardiologist for real advice.
6
@ Surfer,
The calculator is only to be used for people WITHOUT “established” cv disease. The decision to recommend/prescribe a statin in people with established atherosclerotic cv disease is made on clinical grounds and more easily justified in most cases.
2
"The importance of the adverse effects of statins, although historically minimized, is becoming increasingly apparent. The Effect of Statins on Skeletal Muscle Function and Performance (STOMP) trial found that statin-induced myalgias are relatively common at 4.8%."
http://www.thennt.com/nnt/statins-persons-low-risk-cardiovascular-disease/
7
Cholesterol is essential to life. It metabolizes about 25 steroids and it fights inflammation throughout the body. Half of it is used in the brain where it protects neuronal connections. Yet, there seem to be no studies related to the effects of cholesterol deprivation. Yes, statins kill liver enzymes which produce cholesterol, thereby depriving the body of essential protection. This is not a side effect; it is the central effect of statins, and it is poorly understood.
The consequences of taking statins are many: muscle pain and weakness, type 2 diabetes, Parkinson's disease, and even progressive supranuclear palsy. One person in my family - not a blood relative - is 72 and dying of PSP. Because of his father's premature death due to a heart attack, he was put on a high dose of a statin for about 15 years. I had a long talk with him before he lost the ability to speak, and I am convinced that the cholesterol deprivation caused his irreversible disease.
I know it sounds strange, but cholesterol is good for you. On the other hand, progressively tightened LDL norms are good for pharma companies. $35B/yr good.
20
The Lancet was mentioned. That requires equal time for Dr. Malhotra and the BMJ.
https://well.blogs.nytimes.com/2016/08/23/an-unconventional-cardiologist...
With a knack for controversy, Dr. Malhotra has pushed on. In the past year he has also taken aim at statins, the most widely prescribed drugs in the world, arguing in academic papers and on some of Britain’s leading news programs that the cholesterol-lowering medications are overused.
2
Statins are a personal choice but it is misleading IMHO to minimize risks. My mother, then 80, was put on a statin by her GP because her cholesterol levels were borderline high. At that time, she was also overweight and had some chronic pain issues, but no significant heart issues. Over the course of about six months, she began to experience severe joint pain, which her GP treated with higher and higher doses of opioids. It wasn't until my brother found her unable to get up off the toilet one day and rushed to the hospital that she diagnosed with rhabdomyolysis and spent several weeks in rehab. I have no proof, of course, that a diagnosis of a blood cancer a few months later, and her death at the end of the year from a
C.Diff infection were related to statins, but I can't help but wonder if the not really so rare side effects of the statin put her on a road which destroyed her health.
5
This highlights why people are skeptical, the medical profession keeps going all over the place. For years fat was a dirty word in medical circles, then suddenly they figured out dietary fat has little impact on cholesterol. The whole focus on cholesterol was questioned when they discovered cholesterol needs to be aided by scarring to stick to the artery. Then it was discovered that inflammation was a big part of heart disease, that cholesterol and saturated fats were involved in that, then we discovered that sugar plays a big role. Doctors used to tell patients to take folic acid and niacin because they altered the hdl/ldl ratio, since then they found out they altered the ratio all right but didn't help heart disease, which means HDL/LDL ration is not the root cause.
The reality is a lot of what is known about heart disease is subject to change, they don't know. Statins have a major side effect doctors often ignore, that it lowers COQ10 levels that the heart needs, yet standard protocol is still not to take COq10 supplments when taking Statins.
In reality, statins are like many things in our lives, they represent a short cut. Our food and nutrition is horrible, the pre packaged foods many people eat is loaded with saturated fats and sugar, a diet that is low on these works, but most people don't eat that way, so they take the miracle pill. I don't blame people for being skeptical or worried, given how much bad advice was once thought to be 'good for you'.
7
Perhaps the CDC should, (supposedly) in the interest of public health, issue “guidelines” on statins, banning or limiting the prescribing of the medicines regardless of whether patients NEED them of not. Just in case.
I took a statin for the first time. A few days later I could not stand up. I had to be helped into the car and held up by someone in order to walk a very short distance. I am very fit. Doctors were perplexed. A nurse asked me if I took a statin. I told her I just started. She said that is why I was having terrible muscle weakness in my legs that was causing the problem. The doctor walked into the office and chuckled at the idea. I stopped taking the statin. In a few days my legs recovered and was able to walk again. Your mileage may vary.
15
My doctor told me that there has been a huge drop in patients who never have a second or third heart attack after having a first - and the reason is that everyone who has a first heart attack immediately starts taking a statin. Anecdotally, I feel that this is true - I know folks who've had one but not a second. I wonder, does the data support this?
4
First, consider that only a quarter of people who have a heart attack survive. I'd bet that instantly changing life style and diet buttresses the use of statins in the decrease of subsequent heart attacks that your doctor describes.
1
I had a heart attack 20 years ago. No second one since. I started statins. Then guidelines for "acceptable" LDL levels changed, I was pushed to maximum dosage. I lost my ability to walk without pain. From running three to five miles several times a week, I could no longer walk half a mile without pain.
Did the statin prevent a subsequent event? I don't know its contribution. But maybe it was the changes to my diet, or the bypass, five years later, or weight loss, or riding my bike. I don't know. I changed a lot.
But I am pretty certain that statin drug overdoses to achieve very low LDL levels were the cause of my irreversible loss of leg function. When I cut back on statin dosage (against medical advice) my glucose levels were no longer "prediabetic."
I suggest great care in accepting the currently trendy pressure to take statins. Those having heart attacks--not even a majority of them have elevated LDL's. When I asked about having a heart attack although my LDL levels were not very high, my cardiologist at the time said, "If you had a heart attack, your LDL's were too high, no matter what they were." That means that there's no predictive value to that number.
4
I was prescribed a statin a couple of years ago due to genetically high cholesterol. I am extremely careful about my diet (always have been), walk five to seven miles each day, do a half-hour of step, and press weights three to four times a week. I have never been overweight. Since taking the statin, my once trim abdomen has bloated out significantly and I'm sure it's because of the medication.
1
Living longer sounds overrated.
5
Drug companies and insurance companies are responsible for politically pressuring doctors and healthcare institutions to give up what patients primarily seek in their doctors: common sense and superior judgment that they can trust.
When doctors started down the road into pressuring patients to take a given drug for the rest of one's life -- simply because insurance companies required it -- they violated their relationship with the patient, and played a direct role in the destruction of America's healthcare system.
6
My doctor put me on a statin (10 mg of rosuvastatin) daily. My blood work showed acceptable levels of LDL, but my liver enzymes (AST and ALT) became elevated. Additionally, my body became very achy to the point where it was impacting my work.
I stopped taking the rosuvastatin for one week. My aches went away. I then decided to reintroduce the statin at a reduced dosing to see if it was tolerable. I took 10 mg every other day and my aches never came back. Also, based on published studies using combined statin with bergamot polyphenols giving improved cholesterol management, I added a bergamot extract to my regimen. My blood work was taken again after 3 months and my results with the new regimen were slightly better than the old one. I was pleased, as was my doctor.
4
This was a good article on risk. Less of a good article on cholesterol and statins, where much confusion still reigns.
It is taken as fact that statins prevent heart attacks (“Regardless of the outcome, I expect to return to the statin lest I succumb to a “premature” heart attack, as my father and grandfather did.”).
In this newspaper, a few years ago, Gary Taubes wrote, “The other important piece of evidence for the cholesterol hypothesis is that statin drugs like Zocor and Lipitor lower LDL cholesterol and also prevent heart attacks. The higher the potency of statins, the greater the cholesterol lowering and the fewer the heart attacks. This is perceived as implying cause and effect: reducing LDL cholesterol prevents heart disease. This belief is held with such conviction that the Food and Drug Administration now approves drugs to prevent heart disease, as it did with Zetia, solely on the evidence that they lower LDL cholesterol. But the logic is specious because most drugs have multiple actions. It’s like insisting that aspirin prevents heart disease by getting rid of headaches. One obvious way to test the LDL cholesterol hypothesis is to find therapies that lower it by different means and see if they, too, prevent heart attacks. This is essentially what the Vytorin trial did and why its results argue against the hypothesis.”
1
Bravo! As above in my commentary, the medical industry does not appear to understand probability math - selecting a proper sample in particular. It is difficult and bad data warps perception as you show. Thanks. A lot of useful comments here.
1
@steel-
They have done that. You are correct, to test out whether Statins work or don't work long term they need to see a direct drop in heart disease among those who take it versus those who don't, and studies do seem to back this up.
However, Studies also have proven that it isn't the HDL/LDL ratio. Doctors used to push Niacin therapy, which in fact lowers LDL cholesterol, but when they studied people on Niacin but not on other agents, long term it was found not to change the rate of heart disease versus the control. It was much like folic acid and homocystine, folic acid dropped the levvel of homocystine, that is supposed to be the cause of scarring of artery walls that allows plague to stick, but over long term studies while homocystine levels did drop with folic acid, it didn't drop the rate of heat disease.
1
Concerning the cvriskcalculator, people over 70, as I am (77) should be told that given a "perfect" set of cardiovascular risk numbers, e.g., Total cholesterol 130, HDL 70, BP 120/70, no treatment for high blood pressure, no diabetes, and never a smoker, the calculated risk of a cardiac event during the next 10 years is 20.7%. Clearly the 7.5% cutoff is irrelevant for this hypothetical patient. For older patients, the risk calculator result should be interpreted relative to the risk for a "perfect" patient of the same age. I am pleased to see that this current version of the risk calculator includes text to help interpret the calculated risk (earlier versions provided the risk percent only).
4
As another 77 year old with LDL/HDL/ Tr. ratios that would be protective unless age is taken into account, i agree with BPP. And I'm glad the linked calculator includes text that recommends only that a moderate dose statin be "considered". Should also note that no supporting data exists past 79. My feeling is that if your lifestyle to date has produced lipid values that would have been considered healthy at 50, why add medication just because you're pushing 80.
1
Currently finishing my second year of medical school. We’re taught that statins are great, but diet modification and exercise are better. The latter just isn’t a reality for much of the patient population in Mississippi, though.
I see all of your comments about doctors not listening, and I promise I will do my part to change that.
Also, has the artist of the picture on this article watched Sketchy Pharm? The hot air balloon represents chylomicrons in one of their memory hook videos on lipid lowering agents.
2
As for cholesterol and heart attacks, Gary Taubes wrote: “The idea that cholesterol plays a key role in heart disease is so tightly woven into modern medical thinking that it is no longer considered open to question. …The cholesterol in low-density lipoproteins was deemed a “marginal risk factor” for heart disease. Cholesterol in high-density lipoproteins was easily the best determinant of risk, but with the correlation reversed: the higher the amount, the lower the risk of heart disease….Lost in translation was the evidence that the causal agent in heart disease might be abnormalities in the lipoproteins themselves….The truth is, we’ve always had reason to question the idea that cholesterol is an agent of disease. Indeed, what the Framingham researchers meant in 1977 when they described LDL cholesterol as a “marginal risk factor” is that a large proportion of people who suffer heart attacks have relatively low LDL cholesterol.”
8
Bravo. Folks simply are unaware how all this works - it ain't simple. I remember back in the 90s when my docs (team) and self were discussing all this, one of the researchers said to me, "You don't want to take that stuff, we don't even know how it works." Your example is extremely powerful. My family has "high cholesterol" - my Mom was 300+ and died at 94. We have a lot to learn. Docs tend to present the situation as a black and white issue. It is anything but. Also, "heart attacks" are not a black and white issue. Can be managed depending on the specific case. It is little wonder we blow so much money on health care in this country. Largely fear driven.
7
I wonder if you (or anyone reading this) could point me in the direction of published research on statins and whether they have any connection to reduced stroke incidence. Asking for a parent. Thanks.
1
Eating well and exercise will go a long to reducing cholesterol problems, but when that doesn't do enough muscle aches beat clogged arteries. And let's be honest, even when you try to eat well your friends and family are to drag you to restaurants which generally serve high fat, high salt, high sugar and high calorie meals.
You know I'm right, so at least take a low dose if your doctor recommends them. Don't argue with me now, just do it for your loved ones.
1
I order a salad when eating in a restaurant.
1
I have had two serious muscle related events during the early use of different stations. Issues resolved after stopping
2
If you haven't had an attack, and have low family risk history, there is absolutely zero reason to be taking statin's, other than to fill the financial coffers of the pharmaceutical industry hustling the product. I'd love to see the data on the explosion in statin use and the concomitant explosion, or reduction, in overall health attacks validating the need/use. Where's that data, eh?
Besides...and I'm jesting but you might get the drift. The older you get the less reason there is for using them isn't there? At some point there comes a time when you think, "What, I want to live forever?"
7
This piece is anecdotal blather.
4
These comments are illuminating!
I am MOST GRATEFUL for the link to a brilliant lecture on statins
by a British Cardiologist:
BIG FOOD/BIG PHARMA - KILLING FOR PROFIT - on You Tube.
7
Where does the "have a conversation with your doctor" fantasy-land exist? Is this really "a thing"? Perhaps in the offices of doctors treating the very well-heeled with Cadillac executive health care? Because it's not a reality down here in Blue Collar Worker Land. In BCW Land, doctors zoom into the room after keeping you waiting so long you are startled when they barge in like they just left the Benz parked on a slope without the brake, listen to your heart through your shirt while avoiding eye contact and zoom out. If you ask questions you get referred to a nurse who hands you a pamphlet and the brush off. Time is money, and they let you know it.
52
I just skipped one dose of my statin after reading the comments. Voila. Leg cramps GONE.
10
I used to take Lipitor and had terrible leg cramps. The Doc changed the statin and the cramps are gone.
2
Go to Costco and buy a big jar of CoQ10. Take it with your statin and you will feel much relief from muscle pain. Statins 'gobble up' CoQ10 which is an enzyme muscles need to function and recover from exercise.
1
Try a whole food plant based diet.
13
A question from this doctor for all you doctors out there who prescribe statin drugs to eliminate the blood stream cholesterol that "forms coronary artery plaques".
The plaques form in the middle, muscular layer of the arteries. How do the huge cholesterol molecules get from the blood stream through the internal membrane of the arteries into those layers? The molecules are much too large to penetrate those impermeable membranes. Neither they nor anything else can infiltrate out of an arterial blood stream, only out of non-lined capillaries.
The causality for coronary artery disease you propose is irrational, because your causative agent, cholesterol, cannot do what you say it does to cause it.
The proof is right in front of you. Look at it.
6
There's a whole science (hundreds of papers going back to the 60s) out there about how LDL infiltrates into the subendocardial spaces and then attracts monocytes etc. See Russel Ross' landmark reviews in the New England Journal and many others.
2
For us non-doctors, can you please elaborate on what it is that you're hinting at , Diogenes? What is the source of the arterial plague if not from the blood stream? Does it hold the key to perhaps said blockages ?
@Eli Butcher:
Hundreds of papers, yet the anti-cholesterol people still have failed to grapple with Diogenes' question: how does cholesterol get inside the walls of the artery?
NOTHING written about a low-oil, whole-food, plant-based diet?! My experience: vegan with 234 familial cholesterolemia. Statin caused stabbing pains. Quit. Heard about, read about, how oil is actually not a healthy food. Nutritionfacts.org. Went for it. In 10 days, cholesterol went from 234 to 169! In 3 months, lost 15 lbs! No statin, no pain. And my experience is not unique.....many others have had similar results. Cooking and eating without oil, dairy, meat is so much easier than I imagined and beats statins, heart surgery, obesity, and diabetes. I think this column owes the public a look at whole-food, plant-based, low-oil living.
15
Your approach works-if you can get folks to do it. Not so easy.
3
Ask your Dr. the number needed to treat. Specifically how many persons need to take the drug you are prescribing me everyday for the next 5 years for 1 person to not have a stroke or heart attack and how many will experience a significant side effect. If you are 55 years old and have a total cholesterol between 225-250 and you don’t smoke or require insulin for diabetes the number for benefit is about 100-200 and for harm about 400-500. Don’t accept being quoted a certain reduction in risk e.g. if you buy 2 mega millions lotto tickets you are twice as likely to win versus you will have a 1 in 50,000,000 chance of winning.
4
In earlier years, I spent considerable time in engineering working with the mathematics of probability. Worked with Dr. Edwards Deming. As I got older and had docs recommending meds, I found few of them have in-depth understanding of probability math. Sadly, it appears to me, they are being bamboozled by drug merchants who provide "data" that presents their products in a favorable light. Cherry picking the data. Easy to do if you know the game. But, there is a lot of good data out there from all over the world. Folks would do well to dig it out and decide for themselves. Hint: if you come from a family with reasonably good health and get regular exercise and a good diet, you will "likely" do just fine.
2
On average NNT for statins is 5. Treat 5 patients to prevent heart attack in 1.
Eli, this is utterly untrue. The studies are done in five-year intervals. Is it possible you are reading the wrong number as NNT. See "http://www.thennt.com/nnt/statins-persons-low-risk-cardiovascular-disease/
4
In this pharmacological culture we now live in, the majority of doctors are prescribing statins with a mind set that one size fits all based on dubious guidelines developed by the American College of Cardiologists and the American Heart Association. In my own experience with primary care physicians over the years, risk and long term use of statin side-effects have never been raised by the provider. Most drugs, including statins, are prescribed in a rote manner without detailed informed consent. Since individualized medicine no longer seems to exist now, patients need to become more skeptical consumers when faced with the decision to take these drugs and this includes performing your own research. Statins have been around for over 20 years and new side-effects are still being discovered, including diabetes in women. What else will be discovered through other clinical trials about this dangerous drug which is being over prescribed?
6
And they have saved thousands of lives. The literature on on this subject is incontrovertible if one has read and understood it. Too many well designed convincing trials to quote here
No drug or treatment is perfect. But statins are among the great beneficial breakthroughs of the last 40 years.
2
Has there been a study of the 45% of people who were prescribed a statin but didn’t take it or stopped within 6 months vs the 55% who were prescribed and took it? Did the 45% have more cardiac events and if so, what was the difference?
6
The equivalent groups are the control arms of large statin trials that established their benefit. Risk reduction in these trials ranged from 33-45%. Keep in mind that the the curves between statin and control groups are still diverging at the trials' end, which means that the longer you take the drug the greater the benefit.
3
@Eli Butcher:
Large relative risk reductions (and small absolute risk reductions) are an old marketing trick.
1
The article states that many people resist taking the drug ....
‘especially since it has not yet been proven that the drugs help such people live longer.’
And well they should. Essentially, there is no evidence that statins actually help people.
5
After my one and only illness so far, years ago, and now entering my mid-70s, I wondered about the statin effect. I'd already been briefly admitted and treated overseas (Italy--great care) for an acute coronary syndrome. As soon as the diagnosis was made, even before they put the catheter in my heart, the Italians immediately started a powerful statin.
Arriving home with a new-acquired, American-made stent in the "widow-maker" artery of the heart, I asked my new cardiologist "would this have happened had I already been on this statin"? His response: "what answer would make you happy?"
But as a physician myself, I'm entitled to my own belief about this. My answer, emphatically no.
1
I wonder how often someone refuses statins due to fear of side effects, subsequently has a cardiac event, and then goes on to say “my doctor knew I was at risk and did not do anything!”
I also find it amusing how often articles in the Times discuss a possible nocebo or placebo effect (or something else if the like) and subsequently a large number of the comments are something along the lines of “I know for ME it was real!” It’s as if the population commenting here is somehow immune. Many people refuse to consider that they could possibly have something that is affected by their mind.
2
If your doctor believes statins are wonder drugs that have no side effects, then your complaints will never be considered related, they will be treated as a new condition such as arthritis. I became so fed up with this attitude, that I self-medicate. When I can no longer climb stairs without a great deal of pain, I stop taking my statin, after several weeks pass and I feel great, I resume until new aches and pains emerge. My doctor says I have a seventy year old body which comes with aches and pains, it is not the statin. I don't think this discussion about statins will ever be resolved.
3
Statins cause muscle aching. If your muscle pain returns with statins and stops when you stop, statins are the problem. There are word class experts in your state in New have and Hartford who can help you navigate through this thicket if you are interested
3
I wonder about that too (last sentence).
I have family history of heart disease: mother's paternal line and both lines from my father. Maternal & paternal great grandfathers, both grandfathers, my father and his brother all died of heart disease (and those are just the ones I know of). By 45 I was running high levels of cholesterol and triglycerides. By my late 40s I began statin therapy which over the years has brought my cholesterol level down to 'healthy' levels. Now I'm diabetic too (probably genetics via my maternal line) so I'm glad that I addressed the problem early. I know my father and his brother didn't: his brother died in his mid-50s of a massive heart attack and my father had a heart attack and stroke by his mid-60s and passed away at 71. I figure it was worth the gamble of taking the statin (and putting up with some of the possible side effects like muscle pain) compared to the risk of dying early.
8
Let us not forget that there is a perfectly good, brilliantly designed drug, a biological called Repatha, that can replace statins and even lower LDL cholesterol more effectively than statins. Since it acts by a completely different mechanism it is likely the solution for patients who cannot tolerate statins. The problem? It costs $14,000 per year, for life. And those drug insurance plans that are supposed to cover your prescription drug expenses? Well they cover 40% or less if at all.
3
You would expect that, over time, cholesterol therapy could become more focused. As I understand it, the current state of knowledge is that statins show little benefit for those that do not currently suffer from heart disease.
It turns out that there are two types of LDL cholesterol: Pattern A and Pattern B. Pattern B is dangerous; Pattern A is apparently protective. Statins reduce both, so taking them might actually increase heart attack risk.
It seems to me likely that the reason that statins protect those who have had heart attacks is because those are the people likely to have higher levels of Pattern B.
Yet testing for Pattern A and Pattern B levels is seldom performed. I hope that the reason for that isn't to protect the profits of drug companies.
15
You are confusing LDL with HDL. HDL is protective. LDL is always bad.
1
@Eli Butcher:
Yes, the adaptive purpose of LDL is to give us heart disease. It couldn't possibly be serving any other functions in the body.
If only we could get LDL down to 0! Then we would cure heart disease forever!
1
Ed--I'm not. Pattern A LDL is "light fluffy" LDL Pattern B is smaller and more dense. Both are LDL, not HDL. See: http://www.amjmed.com/article/0002-9343(93)90144-E/pdf
1
I had a horrible year-long full-body rash from pravastatin. The side effects aren’t always muscle pain. The rash continued for six months after I stopped taking it. A few months later I took it again for a week and the rash started to come back. Extremely itchy, and I could hardly sleep at night. My doctor says he won’t try a statin again unless my risk factor goes way up. Currently it’s 3%. I’m sure it’s helpful for a lot of people, but not for everyone.
6
If your risk factor becomes unacceptable to you, you might want to consider a statin other than prevastatin.
I discontinued taking simvastatin after an emergency required me to walk up six flights of stairs. I was astonished at how weak I felt and decided to stop the simvastatin, hoping that it, not aging, was the cause of my muscle weakness. After several months off statins, I was easily able to navigate stairs without any fatigue.
My cardiologist suggested atorvastatin, which I have taken for several years with no noticeable side affects. I marvel at my recovered energy every time I skip the elevator and walk up the three flights of stairs to his office.
3
At my doctor's suggestion I started taking a statin last spring. Soon after, I twisted my hip on a treadmill (don't ever hit the wrong button!), causing muscle pain. It should have healed after a few weeks, but only got worse, to the point where I had to use a cain. I saw specialists and physical therapists with no relief. Finally a doctor asked if I was taking a statin. She suggested I quit for a few weeks since nothing else had worked. I was skeptical but I did and the hip pain vanished within a week. If my doctor believes I need it I'll begin taking it again, but if severe muscle pain returns I'll have to quit.
7
As a profession working on healthcare quality improvement I had to chuckle at the following part of the article: The risk score is meant “to start a conversation, not to write a prescription,” In modern medicine there is rarely time to actually have a conversation. Our electronic health record systems have terrible usability that when combined with all of the regulations and billing requirements leave little time for a conversation. Add the growing number of quality metrics that we are judged on without sufficient staff, IT support, and reimbursement levels and what you get is industrialized medicine where patients are treated as widgets rolling down an assembly line. We do need to dramatically increase the quality of care in this country and dramatically decrease the cost, but that will require a major paradigm shift in how we train providers, how we design health IT, and how we deliver and pay for care.
41
Heart disease ran in my family and my grandmother died of it at age 59, and my mother was diagnosed in her 50s. I was prescribed a statin around age 50 when my cholesterol reading was around 210. I took the meds for 10+ years, but then began reading about people like me with minimal high cholesterol. When I retired at age 60 I discussed with my doctor the possiblity of trying a trial without the statins and he agreed. I almost immediately felt better physically, lost some weight, felt less depressed and less cloudy mentally. Fourteen years later, age 74, my cholesterol has been lower than ever, nearer 150 or even lower, partly due to healthier eating. No other physical problems, happy I was able to get off them.
13
A couple of years ago I was prescribed statins to address high LDL levels. I should say there is heart disease history in my family though not evident in me. Aside from the statins I did something not widely discussed in this matter which, I should think is a more common issue among patients then heart disease, and that is diet modification. Americans are notoriously poor eaters, and loathe to give up favorite foods, but simple abstaining of foods like donuts,bacon and eggs can curb LDL levels - I’ve done it and have not looked back. Yes sometimes my levels have crept up and diet has always been the culprit.
10
Over the past few years I have noticed slowly increasing muscle and joint pain. As someone in my 60s I believed it was age and arthritis setting in. I started a work out regime and with healthy eating lost significant weight. Leg pains continued and intensified, and I attributed it to soreness from workouts. But I also started noticing on the elliptical machine I was getting weaker, not stronger in the resistance setting. Then I began to suspect the statin I was on over the past few years might be the issue and did some research on the web.
I took myself off the statin and almost immediately noticed the difference. The strength in my legs and my agility all improved, and my leg and shoulder pain disappeared. My workouts have intensified and I feel just great. I will not cripple myself again with a statin. Now that I am able to move more freely sans statin, I am hoping that my exercising and healthy eating habits will yield results at my next physical so that statins won't even be part of the discussion. I feel 20 years younger without them and want to keep it that way.
23
I’m a 56 year old male with a family history of high cholesterol. Because I was much more active and ate healthier than my father and brother who did have heart disease, I resisted statins for years. Once my activity level decreased as work and family started taking up precious free time, I reluctantly started a low dose of statins. So now a couple of years into taking statins, and with the kids grown enough to go hiking and running with, I started a new exercise regime. Tightness in my chest sent me to the doctor’s office and an angiogram showed 70-80% blockage in 3 coronary arteries, including the left main, that could not be stented.
It seems genetics mattered more than a healthy lifestyle, and while it’s not clear statins would have helped in my case, I certainly would give them more of a chance if I had to do it again. Anything to avoid the experience of CABG and the post-op I’m going through now.
11
A single point: I had two grandparents who died young from heart disease. Twenty-some years ago, my cholesterol levels began to climb. My Dr. said there was a new drug on the market to control cholesterol and put me on Lipitor. Two years ago, for unrelated reasons, I had an ultrasound of my carotid arteries: clear of plaques. I've had no side effects from the drug.
10
I was prescribed statins (tried several) for high cholesterol, which runs in my family. The side effects were debilitating and real. The experience eroded my confidence in the medical and pharmaceutical industries and lead me to look at integrative treatments.
Read "Vitamin K2 and the Calcium Paradox" to learn about a different approach and to understand why arteriosclerosis and osteoporosis are now chronic diseases.
10
I recently prescribed a statin (in addition to a blood thinner) when a suffered a mini stroke 3 years ago. About 6 months ago, I started getting muscle spasms and cramps along my legs. Now I've been a competitive athlete all my life competing in national handball tournaments, working out vigorously 4 times a week since I was a kid and an expert skier. I'm probably in better shape than most people my age at 66 years old.
So suddenly, I'm experiencing pain that would only happen if I got hurt in an athletic event. So why was that? I talked with my cardiologist who suggest going off the statin. I feel much better, but still in muscle pain especially after waking up and working out. I'm confident that it was the statin the contributed to this pain. It appears the statin did contribute greatly to muscle pain.
17
Last year, I had asked my PCP after some sensations of chest pressure under certain circumstances whether there was anything to worry about.
After an EKG proved negative, she decided to forgo additional tests she had initially recommended - such as a stress test- or considered referring me to a cardiologist.
Yet she urged me to take statins. I had to inquire about side effects for her to print them out (without bothering to discuss them with me); she pressed me to give my decision by the end of the weekend, holding the specter of an untimely death over my head.
As part of the pressure, she lied about my prior PCP’s recommendations, and exaggerated my cholesterol levels.
The over manipulation both worried (was I at such high risk?) and made me wonder as to her possible ulterior motives. Ultimately I decided against taking the medications. I later learned she never entered her recommendations into my medical record
note: my mother does take them without obvious serious side effects
2
Read the Big Fat Surprise. Eat low carb. Avoid dementia, diabetes, depression, statins, insulin therapy, kidney failure, loss of sight, and loss of toes!
11
Most of these comments regarding “research” remind me of our supposed rocket scientist former President, William Clinton. He also did his own research and bagged the whole medication thing. Soon he had a heart attack that he likely would not have survived had he not been an ex-President. It is your choice. Vaya con Dios, and as we say in Texas, bless your heart.
How can people get upset, almost as upset as about the Electoral College, about some kind of contaminant that injures 10 people per 50,000 and blow off a medication, if you are in the group, that lowers your risk from 19 to 13% of having a heart attack in the next 10 years? I suspect our national commitment to Algebra in high school is not making much progress.
12
As a healthcare provider, I actually DO spend a good deal of time discussing a patients personal risk factors for heart disease and strokes, family history, and diet/exercise. I tell them that 80% of their cholesterol comes from their liver (not their diet) and is genetically determined. That not all LDL is the same -some have more "sticky" particles that increase their risk of plaque formation. I also discuss getting coronary calcification scores as a possible way to help with risk stratification. However, I do think statins are well studied and overall low risk, low cost and have value in health care. And if my patient hears all my rationales, and does not want to take it, that is their right - I have given them the best information I can and will discuss any other possible strategies to reduce their risk. I do not believe most healthcare providers are "in the pocket" of pharma - for one thing, most statins are now generic and not promoted by any company. We try and follow guidelines established by studies to reduce risk for adverse events. However, I also hear a lot of high risk patients who don't want to take "all these pills" and worry about side effects that are low risk/low incidence but aren't nearly concerned enough about the consequences of their uncontrolled diabetes, blood pressure, cholesterols, lack of exercise, obesity, smoking, poor sleep habits, family history, etc, etc.
27
"Treat the plaque, not the blood test". Non-invasive angiography - CT coronary angiogram - can help tremendously with people who are uncertain about whether to take primary prevention statin therapy. At 50, 50% of men will have some plaque and coronary calcification and treatment with statins should decrease risk over the coming decades. Conversely a normal CTCA suggests minimal benefit from statin treatment regardless of the cholesterol blood tests.
4
The use of statins to reduce risk (future rate or time to a cv event) is based on data collected in clinical trials, but is NOT an approved indication.
Rather, the drugs were approved to reduce LDL cholesterol levels.
Now, they are being recommended via the cv calculator, even for people with LOW LDL cholesterol levels. As noted, most men age 65 or older will qualify, just on the basis of age.
It remains a contentious issue amongst physicians.
Stephen Rinsler, MD
23
Statins help beyond cardiovascular health. At a recent visit to the eye doctor, he stressed the need to keep blood pressures normal and to continue statins. Retinal health depends on this as we age. What body organ doesn’t need good circulation? Answer is that they all do. So, don’t smoke, drink in moderation and wear sunscreen too.
7
We live in the age of the quick fix: statins are a prime example. Whatever happened to lifestyle changes, nutrition and alternative supplements (ie., krill oil)? Well, pass the pill and skip the hard work.
3
Very good at presenting the Pros:
All men 65 year old men with good healthy normal bp and chol should take statins. Will reduce their risk of stroke or heart attack from 9% to 6% within 10 yrs. Thanks for data, don't need "recommended.."
Misleading to just list those Pros and worse to say Cons in title and not list the percentage of those.
Drs generally spoke as one in the past, now the many opinions are meaningless (no more: trust me, I'm a doctor :)
Just the fact, ma'am.
1
My mother-in-law is 92 and has total cholesterol well under the average levels. But, she has a mild diabetes 2 condition controlled by diet. So, her doctor prescribed a statin! Rightly, she rejected it. This incident suggests that many doctors have been brainwashed by the drug industry and automatically write a prescription for statins.
22
My father-in-law, at 89, was prescribed Simvastatin for his slightly-high cholesterol. Days later, my husband (who isn't particularly intuitive but had excellent intuition that day) went to his father's home and found him lying at the side of his bed, unable to move his legs. He wasn't sure how long he had been lying there. When my father-in-law, who had never been in a hospital in his life, arrived at the emergency room, his urine was the color of dark tea. It took months for the feeling to come back in his feet. He had to move from his home to senior living, and his walking was never the same.
10
Discuss with your doctor..? Seems like a joke now-a-days. These doctors stay over booked and rush you through giving quick short responses or tell you to talk to the pharmacist who is just as busy/dismissive. The field has become less care and more greed than ever before.
21
As for diabetes and statins, I believe most think the Jupiter study is a good one, even many medical skeptics and pharmaphobes:
https://www.uptodate.com/contents/statins-actions-side-effects-and-admin...
2
Would it be too much to ask NY Times journalists to get up to speed on their reporting. How about speaking to functional and integrative medecine doctors and nutritionists. How about citing studies on lifestyle and diet Interventions related to lowered cardiac incident risk. How about something more progressive than perpetual fallback on "take a pill, get a vaccine, do a screening."
There is too much evidence that the body can and does heal itself without pharmaceuticals. Let's hear more about this!
36
This article did not pay off the title and provided zero new insights on statins. I would love for this article to be rewritten and actually articulate the Pro's and Cons.
17
It's quite possible the author didn't choose the title, but rather, an editor.
1
It's not the, "nocebo effect," that causes those miserable statin side effects such as muscle pain and weakness. It's the drugs. Statin drugs are mycotoxins that cause apoptosis, aka cell death. Statin drugs block an essential cellular pathway that needs to be open for cells to reproduce. When cells cannot replicate, they die. Read, "How Statin Drugs Really Lower Cholesterol And Kill You One Cell At A Time," by James B and Hannah Yoseph MD. Those aches, pains and myriad symptoms from statin drugs are real. Big Pharma knows the symptoms are real because they know the mechanism by which statin drugs work, yet they tell you it's all in your head.
When you finish reading it, share this valuable book with your doctor.
https://www.amazon.com/Statin-Drugs-Really-Lower-Cholesterol/dp/0615618170
16
I was diagnosed with “mild” plaque in my aorta. I have low cholesterol and a reasonable HDL/LDL ratio.
My physician recommended a statin “so that the plaque would not break off and clog the aorta.
The statin proved disastrous for me. Leg cramps, a couple of falls for which I had no explanation, and a general feeling of discomfort.
I gave up the statins and restored my sanity.
2
I started taking a statin, and an anvil fell on my head. I stopped the statins, and no more anvils!
7
The risk calculator cited in this article will never yield a risk lower than 7.5% for a 75 yr old male who is not African-American, no matter what values are entered. Check it out for yourselves, and if you are 75 or older, with no obvious risk factors, ask why you should be having a conversation about statins with anyone based on the calculators number.
7
Obviously, the solution to this conundrum is to die BEFORE you reach 75 if you are a non-African American male!
Soo antidepressants get a scare article but this gets a "nbd that you might be on it for a lifetime" pat on the back article? Srsly? Some weeks I wonder why I pay for the paper.
6
Jane,
Wow.
I agree with all calls for your retirement. Being an MD for 36 years has made me very cynical. Can you really trust the research of big pharma whose primary objective is to amass $$$$. Have you read “Big Fat Surprise”? Older women with high cholesterol live longer than those with low cholesterol. I personally would never take a statin.
28
Wow. This article makes it sound like there are lots of risks in taking statins. Turns out the article seems like it is trying to say the risks are minimal and over-stated.
Bad headline. Bad first paragraph.
3
This sure seems like a drug advertisement, not a well researched article.
30
It’s a bit irritating reading some of the somewhat flippant comments from those who don’t have heart disease & aren’t MD’s. Believe what you want when it comes to yourself, but don’t presume statins are bad for everyone. In 2016 at age 62, I had a massive heart attack, while traveling on business. It took 20 hours before receiving the stent that saved my life. I had a lot of damage to my heart & now have heart failure. As a young man, I was fit & in shape. At the time of my MI, I had foolishly become obese, sedentary, & was eating poorly. My total cholesterol was 180 & LDL 135, but there was no heart disease in my family. My MI scared the hell out of me. I immediately changed my diet, following Ornish & Esselstyn’s plant-based, low fat diets, & lost 55 lbs. With my heart failure, I needed an implanted defibrillator & must keep sodium intake to <1500 mg per day. I now exercise and do EVERYTHING my 3 cardiologists tell me to do. That includes following the drug regimen they prescribed, to the letter, & that includes 20 mg of Lipitor. I’m lucky; I’ve had no statin side effects. My cholesterol plunged. I’ve had no chest pain or angina. My heart failure drugs and lifestyle changes have helped strengthen my heart & my ejection fraction is up to 35%. I feel very good. With heart failure, I likely won’t live to 80, but I have few limitations now & I’m grateful to be alive. So far, what I’m doing is working, & one big part of that is my meds. I trust my doctors.
9
Brother ,I feel your pain but an ejection fraction of 35- man you are doing good.I was ten and now 40.
Tried statins three different times over the past ten years and the results were always the same–debilitating muscle aches and muscle atrophy. They may work for others, but they are poison to me.
I lowered my cholesterol by becoming a vegan, losing weight and exercising more.
11
Although neither my husband nor I needed statins, we once discussed the fact that my mother had severe muscle pain when she used them and didn't fully recover for almost a year. The doctor told us that statins always causes muscle degradation in research for everyone. A comment like Dr. Martin's that "A person's expectation of the effects of statins can result in the experience of symptoms and relating those symptoms to the drug." Come on. This is plainly implying that if you have side effects, they will be considered all in your mind. Women have been hearing this kind of comment from physicians for years. Now, apparently, it is being used for everyone. It is our right to be educated and conscious about our healthcare. We are not simply at the will of doctors or drug companies.
40
Ask your doctor about niacin (nicotinic acid, not nicotinamide) for reducing cholesterol.
4
The correct way to safeguard our health starts from eating right, exercise and sleep well along with daily meditation. Anything else is noise; and we fall into the over medicated feeble life. It's past time the society wakes up to the basics.
9
The one-third reduction in risk Jane Brody mentions means that out of 100 people with the same risk factors, 19% are likely to have a major heart event in 10 years. If all 19 of that group take a statin, only 6 will benefit from it. So the real question is: do you want to take a medication that has a 6% chance of helping you avoid a major heart event?
12
I do not tolerate statins, and recently learned that there is a genetic marker that indicates whether your body can absorb and use statin medication. My daughter and I have this mutation. I am controlling HDL through diet, and have CAD. I have had four stent procedures since 2005.
Has research looked into this genetic connection?
The Times should not be publishing pharmaceutical infomercials. The least the Times could do in recompense is publish an editorial on the benefits of living a rich, full life that is just long enough. The very latest research confirms that we are all going to die. When last I heard, what counts is how well you live, not how long.
24
No mention of alternate drugs such as Tricor? I have had success with it, and it's not a statin.
3
I developed a year long miserable cough so bad I thought I had throat cancer. Finally, after a year of visits to my PCP, a specialist told me a chronic cough is a side effect of high blood pressure medication and statins.
I went off those meds and the cough disappeared.
Just another example of BigPharm failing to inform primary care physicians and consumers. I hope this post spares someone else the misery.
11
Dry cough is a common side effect of ACE inhibitors like Lisinopril and enalapril, not statins. There are other similar blood pressure medications, such as angiotensin II receptor blockers, that your doctor could prescribe instead of ACE inhibitors that would not set off the cough. I would recommend seeing a doctor who is knowledgeable in treating blood pressure to find the best way to treat your high blood pressure with minimum side effects. I would also recommend discussing the benefits and risks of statin treatment with your doctor so that you can make an informed decision about whether to take statins.
3
I hope Jane Brody will share the results of her trial. This past January on my own initiative I reduced my Atorvastatin from 40 mg to 20 mg with spectacular results. The NYT Jan 5 article on statins and seniors resonated with me. The almost instant surge of mental and physical energy was astonishing. The recent article in the NYT about the industry sponsored tests in the UK concluding that this is all psychosomatic is nuts. In making my decision I was aware that my LDL was already at the low end and that there was a question whether I should be on 40mg. I would like to compare notes with Ms. Brody privately if she is interested. I have a hypothesis as to what is happening. For the record I am 80 and have been an active long distance recreational bicyclist and in the past few years have been experiencing repetitive stress strains especially in the pelvic area and was about to give up bicycling. Now I think there is hope. BTW, my CK level is normal. ANytime a person is experiencing musclw skeletal issues while on statins, the statins should be suspect.
6
A 2014 meta-analysis of studies which covered 500,000 noted that there was “insufficient evidence that statins reduce cardiovascular events “
15
Why is the minimum needed to treat (MNT) of these drugs discussed. It's 100 people for 10 years to maybe prevent a single heart attack.
This article is a passive-agressive sales pitch for statins.
22
My niece was put on a statin once and within a week or two started forgetting her dog. She'd bring the leash without the dog. After several weeks of this and other memory problems, I wrote a note to give to her doctor with my observations. One could call that anecdotal, but the correlation in time was tight enough to convince her doctor. The doctor took her off the statin and she's using lifestyle change instead.
Maybe this is a rare side effect, but I would recommend that any doctors handing out statins monitor their patients for any sudden changes in memory or cognitive ability.
7
I have elevated total cholesterol, elevated LDL (bad) and high HDL (good). I have no other risk factors other than being alive and over 60. Three doctors wanted me to immediately start statins and I declined because I thought my chest pain was due to esophageal spasms rather than angina. I had a hearth catheterization that showed my coronary arteries are "widely patent" and that no follow-up was necessary. I think we have largely debunked the whole high cholesterol thing. It's inflammation that's the root of heart disease, not one abnormal lab value.
16
Some statins / doses should be OTC. Many more people who would benefit would take them. Who wants to see a physician every 6 months and go through the pain and hassle of unnecessary blood work? We don’t really understand blood lipid chemistry and most physicians are clueless (still spouting drivel about good vs bad cholesterol). Lipo a is a CV ris factor not addressed by statins but the average physician has no clue what that is. Expensive and pointless.
The idea that statins work primarily by lowering LDL is an interesting assertion. Baking off Zocor vs Vytorin suggested that most of the benefit is from statins role as an anti inflammatory.
And can we please stop pretending that a 12 hour fast is required for bloodwork. It isn’t and never has been necessary.
And while we are at it, stop prescribing statins to women who have not had a CV event...no evidence they work. How many Type diabetics have we created by prescribing statins to this group?
It is a huge industry and I am not sure we are the customer any longer (if we ever were).
I want Control back where it belongs.... with me.
12
I don't take a statin any longer, but I've often wondered if it gave me an irreversible side effect of "gas". Any ideas on that?
2
Women in my family tend to have sky-high cholesterol, even those with reasonable diets and/or on statins--and those who have had the tests to check are consistently found to have arteries clean as a whistle. I'm not convinced that high cholesterol is causative of blocked coronary arteries, at least not without other factors.
13
On average, higher LDL cholesterol is associated with more heart disease and other arterial diseases but like most things in medicine (smoking and cancer, alcohol and liver disease) it is not deterministic. Also, women tend to develop heart disease later in life compared to men so effects can be delayed. If your family has a genetic syndrome of familial hyper cholesterolemia, worth getting checked out as these conditions raise your risk even more than the LDL number suggests
2
Any heart issues tend toward valve problems, not arterial blockages.
4
So what if I make the choice to die from heart disease rather than a myriad of other diseases. Not the worst choice perhaps?
5
But it is not either/or. There are other ways than taking a pill to prevent cardiovascular disease. Statins do not greatly reduce the risk of dying of cardiovascular disease.
"Could this otherwise valuable medication contribute to my back pain?"
- In my opinion, YES. I've been on statins for 15 years since I had open-heart surgery. However, with the advent of serious back problems, I went for a PET scan that informed me that my spine was degenerating. I stopped using statins and within a couple of months my back improved and I no longer had symptoms. However, more recently I had further heart problems and was told to take statins again. I suppose that I can decide whether to suffer serious heart problems or serious back problems - which seems like a LOSE/LOSE situation.
3
Back pain is typically highly variable in intensity and occurrence and very susceptible to placebo/nocibo effects. Everyone has signs of spine degeneration with age, in medical imaging, but it is highly problematic whether or not most findings of “degeneration” are the cause of the pain that triggered the study in the first place or merely an incidental finding. The concurrence of your symptoms and statin use is at best anecdotal. It certainly suggests the importance of understanding the relationship between statin use and muscle pain, but it is hardly evidence for a recommendation regarding medication use. As the statisticians say, “association does not prove causality.”
About 12 years ago I stopped taking Lipitor after experiencing severe muscle pain and a general feeling of lethargy and weakness. My cardiologist prescribed Simvastatin 10mg. after an echo stress test, (stellar results,) and 2 detailed blood tests, (total cholesterol 287.) Yesterday, after 5 weeks of irritability, acute muscle pain in my upper extremities, and a stiff neck so severe I called in sick today, I have decided this drug is not worth the side effects. I know I MUST exercise regularly and that is the ONLY thing I don't do as recommended, (I eat organically and follow a Mediterranean diet that I was raised on.) My daughter told me she was happy I decided to stop taking the statin because I "have been nasty for the past few weeks," not the way my kid usually describes me. Am I taking a risk? Yes, but my quality of life was seriously compromised. I'm willing to take the chance.
9
The article is misleading by suggesting that only people with high cholesterol are being prescribed statins. This is not the case. My cholesterol is normal (as well as my BP and heart rate), but a CT scan with contrast of arteries and heart shows a little soft calcium. My calcium score is 1, which is the lowest score except for 0. Two of my doctors insisted that I take the lowest dose of generic Lipitor. I hesitated but gave in a week later. I think the NY Times should have someone research statins prescribed for the presence of soft calcium.
8
I recommend the documentary "Widowmaker" on netflix. It is about scans of the arteries to determine the likelihood of heart attack. If there is calcium present in the arteries (soft or hard), statins are prescribed to prevent a heart attack. Unfortunately it does not cover much about statins, but it is a worthwhile documentary. I did not realize until watching this that scans were not available for a very long time. Doctors who make enormous amounts of money inserting stents in already sick people, the AHA and insurance companies were against the use of scans.
4
One more thing is that when you take statins, even a low-dose that I take, you have to go back to the doctor in 2 months to have blood tested for liver function. I do not think the article mentioned this.
In the three weeks I have been taking 10 mg. Avorastatin, I have joint aches, particularly when I am out walking. I am conflicted about the benefit of taking this drug and the down side of joint aches. The only relief I have gotten is from swimming, using jacuzzi and steam room. Since I am taking anti-coagulant, I cannot take Advil, which was always the best pain reliever for me (Tylenol is useless and not an anti-inflammatory). Everyone here is talking about muscle aches. I am feeling it in the joints.
1
I tried several Statins and all produced such fatigue I needed help getting out of bed and suffered miserable cramp-like pains in various parts of my body. I tried Red Yeast Rice and had similar, though less severe, symptoms. Every single immediate family member has/had high cholesterol; my father lived to be 97 and my mother, a very heavy smoker, died aged 88. I've have decided to rely on genes and not Statins.
23
Lipitor deteriorated the muscles in my elderly mother's legs, and put her in a wheel chair. It says that muscle deterioration is a possible side effect in the fine print right on the label. You never think these side effects may happen to you. But muscles do not grow back. Being wheel chair bound with poisonous Lipitor, or have lower cholesterol? Great choice.
24
Statins are a part of "optimal medication"(along with 81mg aspirin, beta blocker and angiotensin blocking drug) for those with coronary artery disease, as well as any other atherosclerotic disease. This combination, along with not smoking, eating heart healthy and regular exercise decreases the incidence of a cardiovascular event and probably a whole slew of other medical conditions, including dementia. They can also be used as primary prevention in those who have 10% risk for a cardiac event in the next ten years. That is the recommendation of the US Preventative Services Task Force based on evidence from high quality studies. But 10-20% of patients can not tolerate statins. And probably just as many can not tolerate 81mg aspirin, beta-blockers and angiotensin blocking medicines. That is just the way it is. The studies supporting statins (and other optimal medications) are population studies, the side effects are individual. Medical care needs to be individualized. If you can tolerate the medications, then great. If you can not, then stop that medication and work harder on healthier diet, exercise and smoking cessation.
14
I am a medical and science historian. After my doctor recommended I start a statin (risk slightly above 7.5%) I spent way too much time researching the issue. Factors that helped me say no to statins are not mentioned here: Growing evidence of a link between long-term statin use and diabetes; failure to call out drug companies for pushing statins with highly selective statistics (the author falls for the "reducing risk by a third" line, a favorite of drug makers, which refers to a reduction in relative risk, not absolute risk; I hope she does a followup emphasizing the more relevant "number needed to treat" and "number needed to harm" figures); and more generally the increasing medicalization of our lives (a troubling trend in which things that we once simply dealt with – like lifestyle choices and low-risk health conditions – are now being turned into treatable medical conditions); etc. Statins are a huge business built on what I found to be questionable assumptions, mass marketing, and wonky numbers. That said, very high-risk patients -- those who have already had a heart attack, or who have very high cholesterol that does not respond adequately to changes in diet and exercise -- should definitely consider statins.
48
I have mixed feelings on this issue. I am currently on a low dose statin 10mg. I exercise and eat healthy and my numbers look good. However; both of my grandfathers died of strokes and my father died of a heart attack. Meanwhile my Mom is 90 years old and has refused to take a statin for years despite high cholesterol levels and she is still sharp and quite active. So there is the dilemma I face. Do these drugs really work? Or are we being sold another used car by the medical profession?
32
This article appears courtesy of Big Pharma.
77
The death rate is stable at one per. Take a walk, plant some peas, read a good book. Enjoy yourself, and rember, the reason they put screws in coffins is to keep the doctors out.
25
You made me laugh out loud!
4
I have found it possible to control my cholesterol through diet. Looking at my numbers over the years of annual physicals it is clear that when I am adhering to a mostly vegan diet my numbers are way lower than when I go off the rails and chow down on dairy and other fatty foods. I am 48 and have several friends my age or slightly over who have gone on statins in recent years. They poo-poo the idea of changing their diet, insisting that their high cholesterol is "genetic." I guess people would rather be in denial and eat whatever they want and go on harmful drugs.
10
Cholesterol readings going haywire is a reflection of Metabolic disorder.It is a sign that the body’s inherent preset ranges have given way to an free range in which the desired range in which the total Cholesterol is no more applicable.
Usually for those who have a working metabolic system,eating cholesterol is not an issue,excess is efficiently removed by the body.
Not so with the vast majority having high total Cholesterol.
Why the high cholesterol:It’s usually Adrenal Stress.You are stressed & result cholesterol goes upwards.So reduce Stress levels.
Again your diet,High in Sugars,Fructose Sugars(fruit juices),Refined Carbohydrates.
This spikes up Triglycerides which are blood fats and very tiny,they enter the damaged tissues...causing cholesterol build up.
Sugars also triggers upwards LDL.
Not all LDL’s are bad,the large size LDL are not an issue.
Having Low Cholesterol is also dangerous,it portends premature death.
Cholesterol is very essential for making Hormones,specially Sex hormones,Testosterones,Estrogens...
For making Bile.For Brain(DHA),Skin & most important the walls of the cells in the body.
Statins have ramifications that effects the body in myriad ways.
Egg Cholesterol does not cause build up of Cholesterol as egg contains Lecithin which is a natural cholesterol breaker.
Cholesterol does not make cholesterol,
Sugar and stress does.
Be away from Sugar,Stress & Statins.
Be positive & be Joyous
9
For big pharma statins are the ultimate expression of their dream business model, a costly lifelong pill that is prescribed for healthy people to prevent a natural condition that may or may not contribute to a medical event that hasn't happened yet, side effects be damned. Of course they also control the studies that determine what the cutoff point is for "high" cholesterol. In other-words they just tell us when it is time to start taking the expensive pill their high profits are based on. No, thank you.
21
Statins are actually very cheap. A low-dose generic statin is $3/month. I am not defending the use of statins, but you are misleading readers by saying they are expensive. I wish they would come up with something better, but all new drugs are expensive. Statins have been around for years.
7
My monthly statins cost $2. I dont even get why Cvs is willing to bother.
2
I'm glad the generics are so cheap. Bon appetite!
1
Correction -
Ms. Brody writes: "Let’s say your risk is 19 percent. That means among 100 people with similar risk factors, 19 are likely to have a heart attack or stroke within the next decade."
No.
Risk calculators provide ABSOLUTE risk numbers.
"[P]eople with similar risk factors" have nothing to do with it.
The 19% means 19%. It was calculated just for you.
(Also, clarification on -
"[Statin therapy] also helps to stabilize existing plaque, lowering the chances that a chunk will break loose...":
Yes, statins stabilize vulnerable plaques, partially by increasing calcification, the bagaboo of a recent Brody piece, not decreasing calcification. But it is rare that plaque "chunks break loose." In heart attack (myocardial infarction) situations, vulnerable plaques simply rupture or abrade, whereupon a blood clot forms, cutting off blood, and so oxygen, to coronary arteries. Please don't continue to promote the erroneous story that "chunks" of plaque "clog" arteries. This is one reason why we ended up with all of those worthless angioplasties and stents (PCIs) in patients with stable ischemic heart disease...)
11
If you have ever suffered a statin’s side effects you would not question why people stop taking the drug. There is no quality of life if statins affect you badly so do not act as if the side effects are just a nuisance.
32
This article cold have included "This a newspaper infomercial"... To be
honest.
31
The risk calculator is a total fraud. I am 67 years old with very low cholesterol, low blood pressure, and I am in very good physical shape. The calculator tells me to go on a statin regimen, and no matter what cholesterol or blood pressure readings I enter, the risk calculator always tells me to start buying statins. This is nothing but a Big Pharma scam.
The medical profession should be embarrassed by allowing such unethical behavior to continue.
69
I played with the calculator, first entered my OK, not great cholesterol numbers and my controlled blood pressure numbers of 125/70. Risk 10.8. Then I modified numbers, had to get total cholesterol down to 150 and blood pressure down to 110/65 before the calculator said no statins needed. Reducing the blood pressure numbers had way more affect on risk than changing the cholesterol numbers. I am 69 and female. The calculator doesn't ask your weight, your exercise or diet habits. I believe in science with a passion, but really am finding it hard to buy this.
17
people correctly regard risk as a possibility, not a probability?? uh, perhaps the learned Dr Brody can clarify this non existent distinction. this statement manages to be both inaccurate and non sensical. but at least she's not shilling for her daughter-in-law or demonstrating how to cause SIDS like other recent Times medical articles. if you have any editors left perhaps they should focus on Dr Brody 's meandering n of 1 approach to medical advice (eg I tried this and it worked for me and my son sells it too...).
3
This sounds like an article paid by Lipitor or Crestor.
20
Ugggh. 73 million people should be on statins! How about no one should be on statins. Genetically high cholesterol? Virtually everyone can exercise regularly and vigorously, eat a reasonable diet, and ignore all of this "guidance". The same goes for BP meds. If your doctor isn't lean and fit he/she doesn't understand what health is. Ans this applies well into old age. Move, move, move.
11
yes, yet another case of overdiagnosis.
2
Why should I believe your “expert” opinion is the right one? My grandfather died of strokes, my dad did too and my sister had a stroke (from which she fully recovered) when she was 51. Only my sister (of the three) was unhealthy and overweight. I am in good shape, exercise, never smoked, don’t drink and eat fairly well (lots of veggies, not too many refined carbs). I have low BP but genetic high triglycerides plus hyperlipidemia and low HDL. I’m taking my statins thanks all the same. One size does not fit all.
5
@Jzzy55: Look for large studies that investigate the metabolic indices of truly fit people (those that exercise VIGOROUSLY). You won't find much. Most doctors don't know squat about fit people, and most people who claim they exercise are doing so in a very mild fashion. If you aren't sweating heavily and breathing hard, you aren't doing it. Regular hard exercise is darn near magical in that it transforms your metabolism and chemistry. Unless you have a genuine metabolic disorder, you will see your triglycerides drop and your HDL/LDL ratio improve. You'll also feel better, be mentally sharper, have better sex, and enjoy life more. The alternative is to take drugs that harm your muscles and have numerous other side effects for the rest of your life. Perhaps you are already doing everything that you can to maximize your health and well being. If so, you are the exception relative to the rest of America.
Imagine if it were allowed for people to play a game of Russian roulette (revolver - 6 chambers - one bullet - spin and 'win', or lose), where the prize if you win (stay alive) is 100 million dollars, and your life. If you lose, well, you die, obviously (although there is a chance you don't die; you're just quite debilitated for the rest of your life).
What a great game!
Who's up for it?
That's Big Pharma, and it's pet, Health Care, in a nutshell. It can make your life better! well, if you're lucky. But in no way are we responsible if you hit that chamber with the live round.
Why are they not responsible? Because ultimately, a person's health is his or her own responsibility (true; I believe this). Yet, health care, and Big Pharma, claim to know what's best...presuming you do not want them to guarantee this "fact" much less hold them responsible for being wrong.
It is just like the lottery in that respect, just like going to Vegas and rolling the dice. If you win, you win large; if you lose, well, too bad! Vegas ain't responsible.
Big Pharma ain't responsible either. Your physician(s) ain't responsible either. But take this pill. It will help you! Promise! (sorta. not really. but we really hope you survive and become a Customer For Life!)
Criminal.
4
About 10 years ago, at age 70 for both of us, I started my wife and myself on red yeast rice, figuring that lovastatin, a "natural" statin, would be cheap insurance against clogged arteries later on......almost immediatdely, she developed leg cramps and serious mental fogginess, this in a woman who had always been mentally very sharp......it was alarming to both of us and so we both stopped the red yeast rice after several months of use......her symptoms didn't improve, and within the next year, she couldn't remember how to go anywhere, said she'd "lost the maps in my head"....she quit driving, was diagnosed with Alzheimer's, and has been sliding mentally downhill ever since.....she moved into a memory care facility in 2016.....was the Alzheimer's just coincidental? I guess we'll never know......I was put on atorvastatin a couple of years ago because of serum cholesterol levels just outside the guidlines, but after reading these reader comments, I'm dumping my bottle.....I'm now 80, have terrible leg cramps in the morning, backaches that limit my walking, and balance problems.....don't know if the atorvastatin is implicated, but we'll see if there's any spontaneous improvement.....
8
I'm not a medical person, but I cured my mild vertigo with "repositional exercises," (probably not the correct term for them, but you can Google the subject and find the right thing.) You do it while sitting; it is simple. Please look it up and get it right. For backaches, try lots stretching when you get out of bed. For leg cramps, try eating a banana every day and taking a simple one-a-day type vitamin every day. Put your feet up while watching TV and buy a good recliner. Don't be too proud to get one. Don't give up. Drink lots of water during the daytime and walk inside your residence from room to room until you feel safer walking outside. It's the old "use it or lose it."
3
Thank very much, Jane! My reservation regarding statins has to do with loss of libido (quite unlikely for most folks). As an alternative I take over 700 mgs of Fish Oil every other day. At 79 I cannot do without sex!
2
I’ve been taking statins since the late 80s. In the early 90s I got a mysterious sequence of ever increasing leg pains that resulted in me having to use a cane for a while. The rheumatologist I went to thought it might be Lyme disease but test showed that it wasn’t. It was never determined what caused the pain. I took a drug called Vioxx (which turned out to be very dangerous and was removed from the market ) for a while and the discomfort eventually ceased. Couple of years after that I developed arm pains that seem to be caused by tendinitis and received acupuncture treatments that cured. After a while the therapist quietly mentioned that I should speak to my doctor because he had several patients taking statins that had similar symptoms. My prescription was changed to another variety. Sometime after that I got severe leg pains and went to a physical therapist who eventually asked me the same question about statins and said I should speak to my doctor. There was more but eventually my doctor conceded that it might be statins and at this point I need to go to a cardiologist to see what shape my circulatory system is in. Point being that this was all based on numbers and even my well respected MD never really checked that I needed to be taking statins in terms of circulatory blockage. I should point out that I learned about the side effects was from reading the materials that came with the medicine which mainly was pooh-poohed by two different physicians.
8
According to Edward A. Gill Jr, MD Division of Cardiology, Department of Medicine, University of Washington School of Medicine, Seattle, as of the year 2010 there had been five randomized controlled studies showing that reducing cholesterol with statin drug treatment does not reduce or slow progression of coronary calcium score. Dr Gill says statin drug treated patients had progression of coronary calcium score indistinguishable from the non-treated placebo group. This is a huge problem of monumental proportions, since Dr Paoli Raggi from Tulane reported in 2004 that progressive increase in calcium score above 15% per year is predictive of myocardial infraction within 6 years. One might then suggest the paradigm shift in Cardiology involves annual calcium score to measure risk, with adoption of strategies and interventions which truly slow progression of calcium score below 15% per year. For more see:
http://jeffreydachmd.com/2018/03/calcium-score-paradigm-shift-in-cardiol...
jeffrey dach md
7
Even this RN finds that it's awfully hard to trust the "evidence" when we find out that oops, transfats, which were supposed to be the miracle replacement for real animal fats like butter and cure our heart disease, was actually causing problems, and oops, it's actually inflammation that causes heart disease, not fat and cholesterol (yet they still sell cholesterol lowering drugs to us by the millions of dollars per year), oops,HRT isn't a panacea, it's deadly........or maybe not that deadly. Most readers probably don't remember back to DES and Thalidomide, wonder drugs prescribed for women that turned out to cause hideous birth defects. More whoops. Now Zofran too. Cox 2 inhibitors. What are we supposed to believe? And now we have the National Institute of Health soliciting funding from the alcohol industry for research into the health benefits of daily alcohol consumption. https://www.nytimes.com/2018/03/17/health/nih-alcohol-study-liquor-indus...
Is it any wonder we don't trust the medical "research"?
This is anecdotal but I watched my mother in law go on statins, develop Type 2 diabetes, eat only those fats and sugars that were fake, and go on to develop dementia by her mid 70s. But her cholesterol came down! She died of Alzheimer's, not stroke or heart attack.
Perhaps all this would have happened anyway but knowing that the brain is mainly made of cholesterol, I can't help but wonder.
Check out westonaprice.org and see if their science is any better.
39
This is great advertising for statins while minimizing their risks. The pharmaceuticals are popping corks doing high-fives reading this.
13
Unfortunately the nub of the problem is the unholy alliance between Big Pharma, the medical industrial complex and government. In other countries the efficacy of medications is undertaken by independent bodies: in America it’s undertaken by overpaid experts from this troika, whose opinions are for sale to the highest bidder. Really, it’s just another example of how corrupt our society had become over the last quarter century.
11
Statins are Exhibit A for "Big Pharma seeks customers, not cures."
14
Amidst all the verbiage on the unarguable fact that statins reduce the likelihood of cardiovascular events is this unarguable fact: “it has not yet been proven that the drugs help such people live longer.” Why should I, for the rest of my days, take (and pay for) a medication that can only claim to maybe change the cause of my death, but not prolong my life?
11
Ms. Brody, I enjoy your column. It is quite informative.
Um, how do I tell you this? Family history of premature heart attacks? Please take the statin. We'd miss you.
As you know, you and your doctor can work out the lowest effective dose.
2
Ms. Brody fails to describe the disturbing evidence about the cognitive side effects of statins that reverse when they are stopped. Could this have something to do with the rising number of people with dementia?
10
How many of these studies are done on women alone? The use of statins pushing women into Type 2 diabetes? I was put on statins and almost immediately developed episodes of unprovoked rage. Stopped taking them. Doctor tells me that was "anecdotal". Tried again at a lower dose. Same thing. I will take my chances without the drug. Having a debate inside my head as to the urge to crash into the car in front of me at a stop sign, no thanks.
5
The MNT - minimum needed to treat - for statins is 100 for 10 years to MAYBE prevent one heart attack, and the side effects are real. Why is the MNT for this drug not discussed in this article? It reads as a velvet-covered pushback against resistance to these drugs, which are pushed vigorously by drug companies via doctors as a cash cow.
7
This is a very interesting article on what happens with some people on Statins.
"Mood, Personality, and Behavior Changes During Treatment with Statins: A Case Series" in the journal Drug Safety Case Reports.
http://link.springer.com/article/10.1007/s40800-015-0024-2
1
Don't listen to your cardiologist who trained for 10 years after college to learn cardiology , listen to your Facebook Friends and Google experts.
7
@John Reynolds:
Except that the cardiologists in general were (and are) atrociously wrong about fat and cholesterol, generally missed the boat on refined carbs until quite recently, and the AHA is still pushing margarines and soybean oil as "healthy fats."
Respect for expertise, yes, but pay attention to previous track records and caveat emptor.
11
There is another side of the "evidence-based" recommendations that Ms J Brody and most doctors fail to mention. That is: in the most cited clinical study on the primary prevention of cardiovascular events (CVD), the risk is 3/100 for patients treated with statins, vs 4/100 for patients on placebo. That means: to prevent 1 CVD event, 99 individuals would be taking statins without benefit. The study was also only had a 2-4 year follow-up, let's not even speculate on a 10-year projectory of benefits and harms. Imagine the costs to the individuals and to society for that kind of Russian roulette. Imagine how special interests want to turn our society into a bunch of pill takers...Beware of medical statistics when used as science-based evidence. Whose evidence is it?
Chinh Le, MD. Corvallis, OR
5
Dr. Le, it's not just the pharmaceutical company profiting off the drug sale, it's my local drug store, too. Every time I walk into that store to renew a RX, I am likely to buy cookies and junk food, etc. And by the way, my 85 year old friend's young M.D. is NOT prescribing him statins, contrary to the advice of my male friend's M.D. at the Veteran's Outpatient center. My friend exercises at a gym for free with his Silver Sneakers benefit, rarely eats beef, and tries to eat his veggies and fruit and chicken. He'll live long and has no intention of taking statins at this time.
What they don't tell you is that your chances of a stroke or heart attack go up if you go off a statin or the dangers of massive bleeding in surgery or accident. Nuerosurgeons hate them as the can cause uncontrolled bleeding weeks after going off them. Do they really work better then an 80mg aspirin?
2
So how did you wind up? Did you stop taking temporarily and resolve the muscle issues? Were you too scared to even try? What were the results of your experiment? If your own "test" results are included in this article, I missed them.
2
i do everything right - diet, tons of cardio and weights etc and still have borderline high Ch. its very discouraging. Ive heard fish oil helps so will try that next. I dont want statins as im serious weightlifter.
1
The jury is still out on statins and this article could have used a little bit of research outside of that provided to the writer from the pharmaceutical industry.
7
If cholesterol is the key to heart attack risk, why did evacetrapib fail its clinical trials? I have never seen an explanation offered. It was highly successful in lowering LDL and raising HDL, and yet had no demonstrable cardiovascular benefit in massive double-blind clinical trials. All evidence points to heart disease caused by inflammation, and the small benefits of statins coming from their reduction in inflammation rather than cholesterol. What drugs would reduce inflammation?
5
Aspirin?
1
A full spectrum of antioxidants will reduce inflammation.Read Dr.Lester Packer, "The Antioxidant Miracle".
Let's consider that some doctors prescribe statin drugs, or any preventive drug for that matter, to avoid getting sued at a later date.
And, since we Americans are over-medicated already, how can you possibly assess the possible side effects of Statin drugs when they can interact with other drugs in the patient's system?
3
Of major importance here and with any drug is that over 90% is now funded by the drug companies producing the drugs. How can you possibly get reliable and honest data from them?
I totally agree with Working Mama - the side effects are minimized by doctors who prescribe the drugs and of far more relevance to anyone seriously considering them.
Of importance also is that doctors do not look for the cause in the rise of cholesterol, nor understand the basic operations of the sympathetic nervous system, which actually controls the functions of much of the body. Cholesterol is necessary for a number of those functions and an extreme rise in its production is not a symptom to be controlled, but an indicator of a issue needing to be addressed.
2
I'm actually more concerned that the side effects and risks of statins are minimized by doctors. For example, they reportedly increase the risk of diabetes. I have a strong family history of diabetes. They are known to cause certain muscle disorders. I have a history of certain orthopedic issues. Studies suggest statins may be more effective for men than women, and in fact normal cholesterol may be different for women (even though most doctors use the male norms to gauge everyone). However, many doctors offer a scrip sight unseen based on cholesterol numbers alone.
10
This is one area of public health where government funded "fasting" studies would probably be very useful. The hypothesis tested would be that people simply eat too much and all the time which results in not only weight gain but metabolic abnormalities such as high cholesterol.
A simple one-meal-a-day protocol could be developed with the participants required to water-fast until the early afternoon. Independent observers would be needed- expensive but necessary in any long-term study of dietary habits.
The reader can guess what I think the results would be, but let's wait for the study.
The food and pharmaceutical industries will not fund this- it will HAVE to be the government. Or maybe one of these mega-billionaires can get their heads out of space and back to earth long enough to make it happen.
2
Many NIH Researchers are paid consultants to the pharmaceutical industry. The FDA collects large user fees from the pharmaceutical industry. Thus funding for studies regarding natural means of preventing and treating diseases of all kinds, go begging.
1
I doubt the true numbers of patients negatively affected by statins is accurately reported, given the experiences of my friends. Most older people will be told to take a statin by their physician since the recommendations for prescribing this drug have changed. Why am I suspicious?
6
Recently advised to begin statin, I refused, for the following reasons:
10 years ago I was on a statin and, through diet and exercise, was able to reduce my levels to the "safe" area, at which point my MD agreed that I could stop. (I was moving the SE Asia for two years, and would not be close to medical facilities for liver testing, etc)
Now, my level is back above acceptable. But I still refuse, because it is dead winter and my exercise level is far below my norms. My diet remains healthy, and as soon as the weather warms, I will be back to distance cycling on alternate days for 6 months. At the end of 3-4 months we will re-test levels to see if diet and exercise do the job.
I am 72 years old, athletic and healthy. Don't want to give in.
(I ski in winter, but don't consider downhill skiing "exercise" per se..
6
I have significant risk. Certainly try them, as quitting will usually solve things if you do run into problems. But the side effects are very real and frankly intolerable if they should affect you.
A big problem for older people is that pain in the legs can be caused by multiple things. I've got a rare, but troublesome spinal cord condition, plus significant spinal stenosis in my sacroiliac region. All kinds of pain, mostly barely managed.
I started on atorvastan 5 or 6 years ago. Looking back, my muscle pain symptoms started about 2 tears ago about the same time as my CK values were rising to eventually peak at well over 300. I was in agony and could hardly walk at times, although I have to be frank that my walking is always pretty iffy because of other issues.
My primary care doc got me to specialists, who observed the high CK levels, but it was his intern who suggested it might be the statin. I quit taking it immediately about 6 weeks ago and found some quick if limited initial relief. Things are still improving, but I think I've gained most I can. The rest is just the way it is due to my other issues. However, they are bearable. Add in the statin and I was well on my way to incapacitation.
Yes, they offer protection against heart disease for those unaffected by or able to tolerate the side effects. Discuss with your doctor if not.
7
Oxygen homeostasis is the foundation of the human biochemistry. Statin drugs attack that molecular foundation by lowering Co Enzyme Q10 which is essential for oxygen metabolism. Co Q10 is also a major antioxidant.
Agree that patients should discuss individual risks and benefits with their provider regarding use of statins, BUT if they are so fraught, why does every male cardiologist that I know take them themselves?!? Because the accumulated scientific evidence from RANDOMIZED trials is as follows: 18 randomized controlled trials with 56,934 patients from 1994 to 2008 showed that all-cause mortality and fatal and non-fatal cardiac (CVD)events were reduced with the use of statins. (Cochrane Review). As much as I espouse a whole food/mostly plant based diet-frankly very few patients can really follow this AND all of the trials are observational-meaning if you CHOSE a plant based diet you had less risk of CVD not necessarily that eating a plant based diet prevents CVD.
3
Actually I know a trauma surgeon who was on them, had an severe adverse reaction and stopped. If our acquaintances are the only pool we are pulling our data from, we aren't being very scientific. If every male cardiologist is taking them and is convinced that everyone can safely take them, and should take them even at minimal risk levels, perhaps that is a problem in itself.
6
Groupthink is very powerful.
2
Something doesn't sound right when current guidelines dictate that 87% of a population is considered eligible for treatment by a drug. Who created the guidelines?
104
Pitch perfect comment! Uniform arbitrary guidelines insisting that you need to take Statins to prevent the possibility of heart attack is truly bizarre especially when you know it results in Pharmaceutical companies making billions of dollors off of the medicine.
1
I tried three different statins. All caused terrible back pain and weakness that prevented me from exercising. Not going that route again. On balance, being able to exercise is more important to me with my current low risk.
9
I put my 73 year old husband's data into the risk calculator. His blood pressure is ideal without treatment and his cholesterol levels are also excellent. He is not a smoker. Nor does he have diabetes. It recommended he take statins. I then entered ideal levels of cholesterol, the recommendation was to take statins. Why don't they just say that if you are a male above a certain age we recommend you take statins.
15
Jane Brody is rounding into 77 years old next month. I don't think she will be vulnerable to "succumb to a “premature heart attack" or any other premature thing.
11
Exactly! I was thinking that. It’s just part of her righteous image.
2
That's why she put the word "premature" in quotes.
3
This article neglects the need for personal experimentation. I have genetically induced hyperlipidemia with no other symptoms. I tried taking several statins, at different doses, in repeated trials over several years. I am well aware of the potential for confirmation bias, other age related influences, and that I’m a sample size of one. I wanted to be able to take statins. Yet repeating the experiment, over and over, produced the same result; muscle pain and weakness that significantly reduced exercise tolerance and made the best part of life miserable. Stopping the statin was consistently associated with a reduction of symptoms over time. Unfortunately, that can be a LONG time, in my case many months.
Projecting risk assessment downward to an individual from epidemiological data is not appropriate, unless that individual is “typical” in most critical factors. Physicians need to focus more on individual experimentation and quit pushing one-size-fits-all presumptions. I now have high confidence that for me, statins are toxic. The benefits are not worth the cost.
10
At 56 I received a stent to correct a rapidly worsening (over a month) angina and 95 percent blockage in a branch of the LAD. Afterwards the doc prescribed a statin. My cholesterol plummeted but I couldn't sleep. He sent me to a sleep clinic; that doc said I slept perfectly, an obvious error. I tried several different statins over nine months as well as other forms of cholesterol-reducing medication; still little sleep. Exasperated, I did what I (and the multiple doctors) should have initially done: read the package insert. It said the main neurological side effect was insomnia. On my own I stopped the statin and within three days was sleeping normally; my cardiologist burst out laughing in skepticism (I've changed doctors). Mild muscle pain I attributed to exercise also stopped. Since then I've adopted Dr. Esselstyn's extreme vegan diet; no further heart problems, very low LDL and I sleep well. Yes, it's hard to follow but as the published results show when compared with control groups it works incredibly well, much better than the Mediterranean diet.
17
There are many studies going on now that have not been able to establish a clear cause and effect of LDL and HDL cholesterol on heart attack predictions. Therefore statin use is at best a small player within the whole heart health picture. This may all turn out to just be another medical fad that over the long run proves of little use. Only more long term studies can confirm any of this. Stay tuned.
14
My husband suffered from the side effect of leg discomfort and pain until he couldn’t stand it anymore. He did his research about possible natural alternatives and discovered raw beets as a possible solution. He took a med. holiday and started blending beets with pomegranate juice. He only sips a half a cup of the blend each morning. Within a month his cholesterol lab results were normal. His MD was shocked with his first results and has continued to document his results for close to two years. Normal. Normal.
10
This article is disingenuous at best. The article linked to the sentence beginning, "There is no question that statins can protect the health..." states in the abstract that it was a study to test whether statins reduced all-cause mortality and found that they did not. It also talks about all side-effect symptoms being "reversible", but whereas myopathy and neuropathy co-occur as a side effect, especially in people who engage in "extreme" exercise, only the myopathy reverses. Statins push up the risk related to symptoms of rabdomyolysis, and situations in which muscles are being taxed over long periods of time in hot conditions can cause those myopathies and neuropathies, even if full blown rabdo doesn't occur.
It may seem completely weird that people who run and train for marathons are being prescribed statins in the first place, but there has been a worldwide epidemic of cult-like beliefs among doctors related solely to cholesterol numbers and little else. And those runners are very much at risk of permanent damage if they run in hot and extreme conditions while taking these drugs.
23
My doctor uses this risk assessment and has recommended statins for several years and each year my risk goes up because age is part of the risk formula, mine currently at 13%. So far I rely on a baby aspirin a day because the formula, as I understand it, does not take into account the LDL/HDL ratio at all. Yet it is not total cholesterol which is the problem but the lack of good cholesterol. My ratios have always been in the normal range. This article says nothing about the ratio. And nothing about the indicator of chronic inflammation which may be a more important indicator than total cholesterol too.
8
A number of years ago, I was on statins for three years. During that time I had severe problems with my short-term memory and my blood sugar level gradually increased until I was pre-diabetic. I went off statins on my own, and my short-term memory radically improved. However, my blood sugar level stabilized but never came back to normal, which is generally true and not as stated here. I have also read the results of an international study mentioned in JAMA involving over 68,000 people that for people over 70 (I'm 76) there is a negative correlation between taking statins and life expectancy. They also say that the risk is 5 out of 100, and that taking statins reduces that to 4 out of 100. They also say that this is a 20% reduction and that it is huge, when in fact it is miniscule. In the same group, they say that the risk of becoming diabetic is 74 out of 10,000, which they say is minuscule, when in fact that is 0.74%, about the same as the 1% it saved. These are shenanigans pharmaceutical companies pull with statistics to hide the negative effects of statins. Put this together with the fact that something over 50% of American doctors take money from pharmaceutical companies and you start to understand what is going on. JAMA has also reported that the doctors who write the procedures for prescribing medication take money from pharmaceutical companies and a good portion of them try to hide it. This is a really sad mark on the medical profession.
96
There are other, simple and cheap ways to reduce LDL (bad cholesterol) that are evidence based and shown in randomized control trials to have comparable effects to statins.
- Replace all saturated fat (fried food, icecream) with polyunsaturated fat (e.g. cook with Grapeseed oil)
- eat flaxseed meal daily (great with cereal) a rich source of lignans, omega-3 fatty acids, and fiber
- take/eat plant sterols/stanols daily a natural additive found in plants and prevent the absorption of cholesterols.
These are simple things that, when done daily, helped me to substantially lower my LDL without any side effects and without taking statins.
Sure, you can exercise every day and lose weight which also help greatly but that is too hard for most people to achieve and stick to.
6
@Gauguin:
Your recommend intervention has been tested for decades. It succeeds at "lowering cholesterol," but broadly fails at reducing heart disease mortality. In some cases, swapping out saturated fats for polyunsaturated oils _increased_ heart disease mortality, see DART, Minnesota Coronary.
https://www.nytimes.com/2016/04/16/upshot/a-study-on-fats-that-doesnt-fi...
https://www.bmj.com/content/353/bmj.i1246
Modern fried foods are fried in polyunsaturated vegetable oils, not saturated fats.
7
Agreed. The effect of eliminating saturated fats is the smallest of the three strategies I mentioned, eating flaxseed and plant sterols/stanols being the others which have bigger effects. We also have no evidence on what combing these approaches does.
Here is a scenario: you go to the doctor for a blood test and then she tells you that your LDL is above 160 and recommends starting you on statins (current guidelines is to consider it when LDL is above 160 in many cases and ages in the absence of other risk factors). Why not, as a first course of action follow the above three strategies, take another blood test three months later and see where you are at. (That is what I did and it worked for me.) If LDL is down that's great and does not involve major life-style changes (exercise, weight loss). If it fails talk to your doctor about other options.
That is because polyunsaturated fats are less stable and more likely to cause free radical stress. Free radical stress injures arteries and sets off cardiovascular disease.
1
I've taken the smallest doses of statins for the past 12 years for hypercholesterolemia. I exercise 5-6 days/week and follow a healthy eating plan high in fruits/vegetables, mostly whole grains, low fat dairy, mostly poultry, fish and beans (limited red meat), mostly healthy fats (very limited saturated fat) and minimal sweets. I've never smoked and rarely consume alcohol. Triglycerides, blood pressure, blood glucose and weight are normal. HDL is always 50 or higher. Prior to starting statins, I tried plant sterols/stanols, fiber supplements, red yeast rice, etc. with no positive results.
I've had 2 bouts of pancreatitis within the past 5 years, that have resulted in hospital stays. My pancreatic enzymes were 125 times higher than normal the 1st time and 60 times higher than normal the second time. Both bouts have been attributed to statins by physicians involved in my treatment. The type of statin was changed between the 1st and 2nd bouts.
The decision to take statins is definitely something that cannot be taken lightly. As much information as possible should be shared with the patient to insure positive outcomes.
My intent is not to scare anyone, but to share my experience and the fact that this is a possibility. I am officially done with statins. I am seeking further medical options to treat hypercholesterolemia and will continue with healthy lifestyle habits.
7
Wait a minute. "... well-established risk factors ... and in some cases, family history." It seems to me, through many years of observation and no real scientific exploration, that family history - genetics - is by far the most well-established risk factor.
2
The others are "well established risk factors" too, even if less important.
1
The discoveries of epigenetics are teaching us that how our genes actually behave is determined by their biochemical micro-environment. Oxygen and antioxidants manipulate the switches on genes. Genes have interactions as a sort of society. It is sort of like if you put a person into bar on Saturday night he is likely to behave differently than if you put the same person in church on Sunday morning.
While I appreciate the comments about eating a healthy diet, perhaps a totally plant-based diet, and getting plenty of exercise, statins do have their place. There is no history of cardiovascular disease in my family, my cholesterol and blood pressure are well within the normal range, and I have a very healthy diet. Despite the good numbers and good habits, I had a stroke less than 1 year ago, at the age of 53. I currently take a statin medication to protect my heart and to make sure my cholesterol levels remain healthy all in the hopes of avoiding another possibly more major stroke. For those of us who are fortunate to have access to healthcare, which should be a right, not a privilege, do your homework, have the conversation with your doctor, and be open to the fact that a medication can be a lifesaver.
12
The stroke may have had absolutely nothing to do with cholesterol levels. Lack of antioxidants in the blood increase a tendency for the blood to clot. Hormonal imbalances could be the culprit.It is important to check for hypothyroid or functional hypothyroid, and low cortisol,or functional low cortisol. Fubntional hormone deficiencies can occur when a hormone is secreted but for some reason is not fully functioning in the system. One important factor can be gut inflammation, and leaky gut syndrome which allows bacteria to go through the gut wall into the bloodstream. Some bacteria then secrete acids into the blood, causing micro clotting which increases the risk of forming blood clots. Maintaining a good gut culture can be important. In adequate thyroid function and adrenal function can cause gut inflammation. Sodium EDTA manipulates all blood unclotting mechanisms, yet very few doctors know this or use it. Many substances such as 120 mg of ginkgo per day,or ginger are natural blood thinners. Just taking a statin drug in the hopes it will prevent another stroke instead of tracking down what imbalance caused the first stroke, is not adequate.
The author conveniently ignores the fact that statins increase the likelihood of type II diabetes - at a statistically significant rate of increase. Meaning, lots of people on statins who previously did not have type II diabetes now do have it. Now you have a population that is taking BOTH statins and diabetic medication. The pharmaceutical industry is happy, the doctors getting money for recommending these medications are happy, and the patient is worse off.
67
I have a sister-in-law with this problem. When her doctor put her on statins, her blood sugar was normal and her cholesterol was not elevated. Her doctor prescribed statins anyway, and now she is diabetic and medicated for that new condition as well as continuing the statins. I realize that this is just anecdotal evidence; however, I don't believe the pharmaceutical companies are being honest about the risks of statins. Much of the research has been paid for by pharmaceutical companies. Truly independent studies have been less kind to statins. I advise reading the articles in JAMA concerning statins.
15
Statin drugs not only lower Co Q10, which is essential for metabolizing oxygen, they also attack the "lipid rafts" which make up cell walls. Cholesterol is the substance from which a number of hormones, including cortisol which is essential for life, are made. Taking statin drugs is about as safe as throwing a handful of salt in every load of cement you make for the foundation of a house. The damage will not be immediately apparent, but long term the drug eats away at the molecular foundation of the biochemistry.
3
When my friends start on statins their appearance changes dramatically. Their skin becomes pasty and color is very uneven. They suddenly look much older within months. Pores seem to double in size, especially on the face, which is most visible to others.
Wouldn't it be easier to walk a LOT more and eat a LOT less than be at the mercy of these drugs? Apparently it is not.
9
If someone told you that you have a 1 in 5 chance of having a heart attack or stroke in the next ten years, and that the most effective way of reducing the risk is taking a statin, what would you do?
6
If my doctor told me I have an 80% (that is, a 4 in 5) chance of NOT having a heart attack or stroke in the next 10 years, I’m not sure I’d be eager to improve my chances by adding statins, given the potential adverse effects. My 1st action would be to evaluate lifestyle and make some changes regarding diet and exercise. Perhaps if that did not help then I might consider statins as a plan B.
1
Quite simply, I'd take the chance. Taking statins made my life tired and miserable. I'd rather live well and die younger.
2
Discussions of statin use that do not include descriptions of absolute risk and “number needed to treat” (NNT) are of little use.
16
Statins are anti-inflammatory and anti-coagulant drugs. "Cholesterol-lowering" is just an unfortunate side-effect.
Statins do have a small positive effect for middle-aged men with previous history of heart disease. For other populations, negative side-effects outweigh possible benefits.
Statins have been wrapped up for decades in the now-failed "lipid hypothesis", which incorrectly guessed that fat and cholesterol cause heart disease. As part of the lipid hypothesis, fat and cholesterol were demonized as "bad" nutrients, and this was used by association to sell statins - "get rid of your 'bad' cholesterol."
Now that statins are coming off-patent, we will see much more honesty about the limitations and side-effects of statins, and much more hype about the next round of "wonder drugs."
33
"For other populations, negative side-effects outweigh possible benefits." This is the core of the matter and appears to be incorrect. In my case I have had zero side effects.
3
Many side effects of stain drugs are insidious because they are happening at the molecular level first.
1
This type of article about statins has been appearing in the NYT for a while now and it makes me seriously question the independence of the source. The author mentions that there is no evidence of reduction of the risk in mortality but ends with the fear mongering "would this be a risk you're willing to take?". What risk? You just acknowledged that the drug doesn't help.
Ditching sugar and engaging in moderate exercise, on the other hand, have shown actual benefits in risk reduction, while not inducing muscle issue or Alzheimer. It may be a harder prescription to swallow for some people, but that doesn't mean that it shouldn't be prescibed in the vast majority of cases.
17
You are going to die. Nothing can reduce the risk of mortality.
Good article. Many statins do have side effects, but there are several options to try with a doctor's supervision. Although I exercise 6 days a week and eat healthfully for the most part, I have naturally high LDL levels. I tried Lipitor (muscle aches) and Crestor (loss of concentration and other odd mental side effects), before taking Pravastatin. That caused severe muscle aches and stiffness until my doctor's PA recommended taking Ubiquinol, which apparently supplements or replaces an amino acid that is affected by statins. Within days, the muscle problems disappeared, and since that time I've had low LDL and total cholesterol levels thanks to the statin, with no muscle stiffness thanks to the Ubiquinol. It took a while to get to the right solution but I did find one.
4
Ubiquinol is Co Q10--the reduced form, which is the most potent form. It is an important co-enzyme for the metabolism of oxygen in the mitochondria. Statin drugs destroy Co Q10.
Thank you Jane Brody for this article. Wanted to express that the language we use in medicine these days is very important and helps define the public's notions about the professions that provide health care in this country. In this article, there were several mentions of Doctors as prescribers of statins. It's 2018. Health care providers who prescribe medications include Doctors, yes, but this group also includes Nurse Practitioners and Physician Assistants. Many patients in primary health care have encountered NPs and PAs in addition to Doctors. New York Times should be using a more inclusive language in medicine so the public is more aware of the types of providers they may encounter when they go to a clinic or hospital.
7
I took Lipitor for several years and had no noticeable side effects. My insurance then insisted I had to change to generics and that's when I started having memory loss, stiff joints and sore muscles. I even starting using the wrong names for close friends. It was scary and caused me serious concern. I later read a report that explained statins could be the cause of my issues. I called the insurance company and they agreed to let me change back to Lipitor and the symptoms subsided. However, a little later, my employer changed our medical insurance forcing us back on generics. Within a short time, the problems started again. I discussed it with my doctor and she agreed I should stop taking statins and maybe try an alternative strategy. Within days of stoppings statins, I felt like I was walking on air. I had forgotten what it was like to be pain free! I started taking fish oil as an alternative, my cholesterol dropped and is mostly with acceptable levels again.
12
I don't know if I should take statins or not. I tried to take the risk assessment but it won't evaluate anyone older than 79. Interestingly there is another article this week about how us old people are left out when it comes to evaluating and treating our medical problems. Since I don't take any other medications I guess I will skip statins also and stick with my beef and pork diet that has gotten me to age 82.
19
I can't live without that BBQ. I have a low cholesterol level despite eating meat and especially cold cut sandwiches. One thing I am fanatical about is cutting off every bit of fat. Prime rib is wasted on me, I leave 2/3 of it on the plate. I make my own meatballs with a minimum 94% lean ground meat. I eat lots of fresh vegetables. I eat out less than once a month. I consider most restaurant food to be unhealthy, too much sugar and salt and fats. My wife and I split a steak and eat less than 4 ounces each.
I've gained weight over the last 20 years regardless thanks to my spinal stenosis which has damaged both sciatic nerves and left me unable to walk for more than two hours.
My father and his brothers and sister all have or had heart problems. My father had a bypass in his early 40s. The generation before had no heart problems and neither do I or my 3 brothers.
Before I would take these statin drugs I would try diet first.
3
@ Rich: your wisdom is showing. Glad to see it :)
I developed shooting pains in both of my feet and ankles. For over two years, I suffered with the pain. My primary doctor sent me to a podiatrist, an orthopedic , a chiropractor. I wore custom othotics, and then I wore a custom medical boot on one leg. Nothing worked. One day my primary said "Gee, maybe it's the Lipitor". I stopped taking the Lipitor and within six weeks the pain had vanished. I never took Lipitor again.
40
Similar result. Was taking simvastatin for about 2 years and had chronic pain in feet and legs. Stopped taking the statin and the pain went away. (Also increased exercise level significantly so that too may be a factor). My new philosophy of life is the eat healthily, get plenty of sleep and exercise, reduce stress and hope for the best. I am tired of supporting big Pharma.
2
Can't take statins or anything analogous to them like red yeast rice or CoQ10. The side effects – muscle pain, weakness and overall debility, are severe. I certainly don't agree with the doctor Ms. Brody quoted, saying in effect that these side effects are rare. Of those I've spoken to about the side effects caused by statins, many of them experienced the same to a lesser degree. Furthermore, I'm disgusted by doctors who attribute reports of side effects to imagination. Try limping around on crutches for a few weeks! We're not children.
I have been going to physical therapy for back pain. My doctor chose this time to try out yet another statin - Zetia. For 10 days I made no progress in PT, and in fact I felt worse. Was hobbling around on crutches and was only able to do a minimal amount of work. Guess what was causing the pain? One day after discontinuing the statin I felt the progress the drug had been masking. GRRRRRRRRRR!
16
Zetia is not a statin, nor is CoQ10.
Zetia (ezetimibe) works by reducing the amount of cholesterol your body absorbs from your diet. It is sometimes used in combination with statins.
CoQ10 is a supplement sometimes use with statins to try to lessen the muscle pain. Coenzyme Q10 occurs naturally on the body and is depleted by statins.
2
Zeta is not a statin.
2
Not only do patients lack the knowledge regarding probabilities and relative risks, many physicians do not as well. My mother, who is 79, was prescribed a statin because of a modestly elevated LDL. There is absolutely zero reason to put someone that old on a statin, especially with a minor risk for heart disease. Physicians often do not think about the implications of prescribing another drug let alone have the time to discuss the side effects.
87
I am always reminded most GP's practice what they were taught in med school. They are simply too over worked to keep up with many issues. Most have regular office hours work 5 days, and I can't imagine in their spare time they are on the internet or reading the latest advancements pros and cons. That is why a good doctor refers you to a specialist.
4
I have a hereditary pre-disposition to high cholesterol, and have been urged over the years by doctors to take a statin. Then I heard from a friend (with the same condition) that her doctor had put her on a "low and slow" dosage of Crestor (2.5 mg once a week!) and she was seeing results. I decided to go on 5mg per day and have seen remarkable results! So . . . it seems there is a way to get results and perhaps mitigate damage. Maybe we don't need as much as they normally prescribe after all!
7
Maureen
I also have a family history, both father and grand father had strokes in mid 60's. I've been on statins for quite a while.
What results did you experience with the low dosage?
1
The answer to heart attack prevention isn’t a statin; it’s a plant-based diet.
Let’s embrace public health prevention over medicine for a healthier world.
23
Over? Why is this a competition? Maybe in some people’s minds.
Evidence please. Otherwise I will write this off as wishful thinking.
2
If a plant-based diet were the answer, then we would expect that studies would show that vegetarians and vegans live a lot longer than omnivores, right?
But when we actually look at this, they don’t.
What are all of the epidemiological datasets that we have? Well, there is the Health Food Shoppers Study, the Oxford vegetarianism study, the separate EPIC-Oxford study, and the UK follow-up studies. Search for PMID 12936946, 19297458, & 26657045. And there is the Adventist Health Study 2 and the 45-and-Up Study. See PMID 23836264 & 28040519. Am I missing any?
And, comparing omnivores to vegetarians or vegans, what were the comparative all-cause mortality results? Were the hazard rates around 0.80, indicating a beneficial 20% relative reduction in death for the vegetarians/vegans, or were they more like 1.20, indicating a 20% relative increase in death?
Read each of the studies and compile them. The hazard rates were: Health Food Shoppers, 1.01; Oxford, 1.03; EPIC-Oxford, 1.03; UK-follow-up, 1.00 (vegetarians) & 1.14 (vegans); Adventist 2, (M/F avg.) 0.88; 45-and-Up (huge, with over 240,000 participants), 1.13.
Overall, the relative all-cause mortality rates were roughly 1.00, indicating that while vegetarian diets are not particularly harmful on average, neither are they any more healthy than omnivore diets. Sorry.
The data burden is now on anyone claiming anything different.
4
I guess I'm the contrarian here.
I'm a physician who was diagnosed with CADz a year ago, found to have elevated LDL and started on 20 mg per day of atorvastatin. My LDL was cut to almost a third of what it was prior to meds. No muscle aches or memory loss or other side effects.
I have made dietary changes as well and am exercising more, but I was always pretty good with my diet. I think some on here do not understand that many/most patients will not adopt a completely plant-based diet. And, even among those who start such a diet, not all will stick with it. Also, although there are some good long-term observational studies of folks who've adopted plant based diets, there are few studies looking at this intervention over multiple years in intention to treat analyses.
All that said, statins are not the silver bullet against heart disease that many clinicians and patients seek. Nor the monstrous medication others claim. Heart disease is much more complicated than the cartoon-like 2D concepts most people (including most physicians) use to conceptualize it. Statins have their place in the treatment of CADz. The most shrill comments here and fear mongering elsewhere nearly echoes anti-vaxxer conspiracy theories.
Although I don't agree with folks who rail against statins, I would urge them to contact senators and reps and ask them to focus NIH research grants on more plant-based compounds (for CADz and other), not just lay the groundwork for Pharma's next round of patents.
47
Well said and by a physician. As I aged like most seniors I tried and have paid more attention to my health. As I approached older age I practiced what I call preventative medicine co-ordinated with a front line GP and test or referrals he would prescribe. So far knock on wood have done well. Only take two low dose B/P pills, and Avodart to shrink an enlarged prostate. I recently read a book by two notable physicians called ending medical reversals. Basically so much of what is considered best practice gets reversed over time. kind of a minefield for patients.
3
OK, so you cut your LDL without side effects. But the essential question remains: does elevated cholesterol cause cardiovascular disease, or is it only correlated to it?
18
@Michael:
Any diet that cuts sugars and refined carbs tends to correct lipid profiles, regardless of whether or not it is "plant-based".
3
I took statins for years before realizing that indeed I had muscle myopathy. I had complained to my doctor about having to sit down after walking 50 feet but no connection was made. Finally, my Achilles’ tendon ruptured so badly I needed surgery. The surgeon said it looked like a window shade that had rolled up. The consensus was that this was a direct result of statins. I’m off them now, feeling much better. However, my cholesterol is still high and we are on the never ending quest of finding a drug which works. Just sayin...
18
"that taking a statin be a fact-based, collaborative and personalized decision between doctor and patient, following one or more discussions of the individual’s medical and personal concerns."
Uh-huh - when in the 15 minutes allotted to see the doctor is this supposed to happen?
152
15 minutes ?? wow you have a good doctor / i'm lucky to get 5
6
2 comments on this good analysis:
* ‘premature heart attack like my father and grandfather had’. Most studies show that lifestyle, including diet, exercise, smoking status and stress levels, are key risk factors. How did your father and grandfather rate on these? I generally discount family history unless these factors are known.
* statins recommended at a 7.5% risk factor or higher. The AHA / ACC risk analysis has a 5% margin of error ‘at least’ according to some footnotes. Be careful about assigning credibility about any individual’s actual risk chance with such rough risk estimates.
5
confused... i had taken a statin for at least 15 years .... i am in my early 50's, but stopped with support and sign off from my new doctor (about 9 months) ... i haven't been back yet to double check my stats. I eat oatmeal every work day morning and have cut the bacon to a minimum ....
1
Aside from the fact that high overall cholesterol is not in fact associated with increased all-cause mortality and in fact seems to have a protective effect especially in the elderly (i.e., the higher your cholesterol, the longer you live), and that half of heart attacks occur in people with so-called normal cholesterol, the statistics on the effectiveness of statins do not remotely recommend them to me. They produce a very small reduction in absolute risk in those who have already suffered a heart attack, though advertisers use relative risk to amplify the supposed benefits - and other than that, they don't have much benefit. Cholesterol is vital to all bodily structures - is it really a good idea for us to be interfering with our bodies' own metabolic processes in this willy-nilly fashion?
147
None of what you say has any basis in science or medicine.
But if you have actual proof that any of it is true then I will gladly nominate you for the Nobel for proving every bit of medical research in the past 40 years as false.
3
@SteveRR:
Lack of high total cholesterol association with all-cause mortality or heart disease mortality - known since Framingham, but ignored in order to sell more statins.
Incidence of heart attacks in those with "normal" total cholesterol - well-replicated finding, again ignored in order to sell more statins.
Small reduction in real risk, over-hyped reduction in relative risk -- standard marketing procedure in almost every drug, _especially_ statins.
Cholesterol vital to all body cells - yep again, basic biochemistry.
Looks like pretty much everything Mimi posted is well-grounded in science and medicine, it just happens to disagree with your pro-statin agenda.
3
One of the things that caught my attention was a recent study where the percentage of people taking the placebo who reported muscle pain was the same as those taking the statin. Even some cholesterol skeptics see the value of a low dose statin for those of us with risk factors. I take 5mg 3 times a week and so far so good.
4
Ms. Brody, you are too good to fall for this statin scheme. Big pharma uses relative risk for results, absolute risk for side effects; start studies after a 30-day "run-in" to eliminate problematic subjects; stop studies early when people start dying, thus there are NO long-term studies despite prescribing this for life-time use; break side effects into dozens of categories to minimize perceived risk; and will not release study data for independent review! It is the biggest pharmaceutical fraud of our lifetimes.
Studies show post-menopausal women's life expectancy is correlated to cholesterol level. Lowering cholesterol lowers life expectancy! Apples have proven better for cholesterol control and heart health. See this article and the study it discusses: http://preventdisease.com/news/12/073012_Two-Apples-a-Day-More-Effective...
Here are the apples to eat: https://www.healthambition.com/healthiest-apple/
You have the platform to expose this nightmare.
21
No one believes that substituting an apple for a statin will improve health outcomes.
However, there is research that combining the two actually produces results as good as taking a statin alone.
7
"Lowering Cholesterol lowers life expectancy" Wow, That's real news. Bring on the bacon and steaks. I'll stop eating all those pesky fruits and veggies.
1
@mabeans:
Like most things in the body, cholesterol is a homeostasis. Too low can be just as dangerous as too high, and there is a "sweet spot" in the middle. Risks of some cancers, infectious disease, and mental disorders all increase at the low end of cholesterol.
Regardless of that, _dietary_ cholesterol has little to no effect on blood serum cholesterol. This has been known for decades, even Ancel Keys admitted this.
Lots of us eat the steak and the fruits and veggies on the same plate. They're not mutually exclusive.
Jane Brody does not present balanced information. Last week she was pushing a shingles drug, this week it's statins. There is evidence that high cholesterol in the elderly may even be beneficial, but where are the profits for Big Pharma? Good nutrition, exercise, and sleep are the best prescription for everything, but where are the profits for Big Pharma? I have questioned Ms Brody's information ever since she wrote in a cookbook decades ago that "salsa" is the Spanish word for salad.
25
I read the shingles article and while (right or wrong) I’ve stayed away from the flu shot, I found the reader comments on the horrors of shingles very persuasive and I’m considering that vaccine. I agree that Ms. Brody jumps on the for-profit health industry bandwagon too frequently to follow her lead without more research but that doesn’t mean she’s wrong on this one. Currently I’m trying to do that research and better understand the ingredients in the vaccine and their effects, the prevalence of side effects from the vaccine, and the true efficacy of the vaccine. Would love to see some more from the times on these issues.
I really like Jane Brody’s writing and have learned much from her but I think the frustration comes from the feeling that she places more unquestioning trust in medical industry recommendations than many of her readers do. They have their reasons and I’m glad they share them.
Not one mention of diet in this article. Basic human need- a decent diet. I was put on statins, disagreed, but was scared into it. After sleep problems, muscle pains, tiredness I stopped them. Went cold turkey on a whole food plant based diet after watching What the Health and my cholesterol dropped about 90 points after 5 months. JHC! I don’t need any more proof than that that statins are not necessary for most people IF they change their diet. Also same thing with my husband. These pharma oligarchs really have us going!
37
No one denies that a diet can replace the need for statins in many folks - but then again - no one denies the horrible success rates of typical people trying to successfully maintain a restrictive diet.
11
By trotting our the old trope “No one can stick to a restrictive diet,” we, in reality, just pretend a plant-based diet is just not a viable option.
Watching my cholesterol drop from 225 to 150 on such a diet is incentive enough to keep doing it.
What we also know is people don’t stick to taking pills.
9
@Tibett:
If that is your _total_ cholesterol, then you had perfectly normal cholesterol and dropped it into an unusually low range. Cholesterol is a homeostasis, too low can be just as dangerous as too high. Risks of some cancers, infectious disease, and mental disorders all increase at the low range of cholesterol.
Perhaps it is time to admit that the widespread use of statins was a fad that lacked a strong scientific basis. Correlations between cholesterol and heart disease exist, but they were never were backed up with causative studies regarding cardio-vascular outcomes. In addition, the negatives associated with statins, including increased diabetes risk, began to mount.
As years pass, it is becoming common for ordinary people to observe a rising number of friends and family who claim overall health improvements as a result of conscientiously coming off of statins in a controlled manner.
21
They never were and never are a 'fad' - they have been studied as a group in massive follow-ups for more than 20 years - arguably one of the most studied group of drugs in history.
You can't prove the efficacy of most medicines, medical treatments are probabilistic. You don't want to take statins and you are at risk, then you are simply adding to the proby of a bad outcome at some point in the future - it is not guaranteed.
5
I think you are confusing marketing statistics -- which we hear daily on drug and supplement ads -- with medical and scientific statistics. Studying something for 20 years is not in and of itself proof of anything, particularly when it fails to produce a statistically-valid cause and effect result.
8
You can never prove a "statistically valid" cause and effect - there is / or there is not a cause and effect - it is binary. Medical research uses a Hypothetico-Deductive model that yields a probabilistic model of success.... just like every other scientific endeavor in the world.
If you want to see a recent example - look at the Higgs-Boson 'discovery'
I have slightly elevated cholesterol and my dr. pushed me to take statins. I tried 3 different ones plus red yeast rice and got leg pains with all of them so bad that I couldn't sleep at night. The dr. seemed incredulous that anyone would get leg pain on statins. My son also got them when he tried a statin. Recently, the dr. admitted admitted that statins would only lower my already low risk of a heart attack by about 5%. If dr.s and pharmaceutical manufacturers want everyone on cholesterol lowering drugs they need to develop ones without nasty side effects. Until then they can keep them!
6
How can diet not be mentioned? A plant based Whole Foods diet has been shown to have improved results tremendously.
36
If only we could show objective results from studies that diet came close to the effectiveness of statins! So get on a good diet already! If you can't tolerate a statin get off it. If I prescribe statins to 100 patients with a 15% risk of heart attach and stroke and only save 5, what's wrong with that?
4
What’s wrong is the thousands of dollars people have to spend on these medicines and the very real side effects of medicines.
Doctors are trained to believe medicine is the answer for everything, which is why patients on tons of medicines is a very common occurrence
6
@Mike Higgins:
Any diet that cuts sugars and refined carbs improves lipid profiles and CVD risk, regardless of whether or not it is plant-based.
6
I was on Atorvastation (20mg) for a year or so with elevated cholesterol and I began to read about the research, not just what the clinical trials said but who controls the data - I was also diagnosed with osteoarthritis in both knees and hips, and the combination of the OA, Atorvastatin and Citalopram, which I was also on was quite devastating, given my marathon time used to be 3 hours 20..
My libido collapsed and I also had muscular pains and stiffness and general fatigue quite outside what the OA caused by itself. I switched to plant sterols, stopped the Citalopram and the improvement has been really something. The sterols aren't as fast-acting as the statins and have taken a longer time to lower the cholesterol, which I hope will continue, but I'm not in the hiighest-risk classes and I believe in working on and understanding your own condition, to take control of your body.
Next step, medicinal cannabis for the OA as an experiment...
4
Brody once again shows why she needs to retire. Statins should only be taken by those who have clinically diagnosed disease and not for prevention of that which may not materialize until one is well in to their 80's or above.
173
A bit harsh, but sadly true. I was a huge Brody fan back in the day but her columns today seem to be influenced by less than rigorous investigation or even worse, outdated conclusions.
Statins are not for anyone who just happens to be over 60. That's ridiculous on its face. In the past 10 years we have learned more about cholesterol levels and how they relate and don't relate to heart attacks. Over that same time we've learned about osteoporosis drugs as another example. Don't see any of those Boniva commercials anymore, do you? Same deal, different pill.
So many can be added to this list. My mantra: Just say no. Unless you know you have no other choice.
3
I have been on three different statins over the course of 20 years. Every time I had horrible memory loss and mental disorientation. I understand the need to push these drugs, but still some of us cannot tolerate them.
14
How about a 'fact-based' discussion regarding the cvriskcalculator ? If you are a 69 year male with a blood pressure of 115/75 with no medical problems, it is impossible to enter an HDL high enough or a cholesterol low enough to not be labelled 'moderate to high risk'. Is not the purpose of statins to raise HDL and lower cholesterol ? Are you now supporting ageism and sexism ?
7
Employee,
I think you are confusing what the available data show with ageism and sexism. The fact is, older males have a relatively high frequency of cardiovascular events.
You are certainly to be congratulated about the good BP and good general health.
Your complaint does highlight one issue with statins, though - use of this medication in the elderly. Statin benefit accrues over the long term. It's less clear that statins are beneficial in people over 70 or 75.
The studies show fewer heart attack and stroke, the purpose of the drug is to reverse that for some of the patients treated. Getting a cholesterol level lower is traditionally, "a physician-centered endpoint." Getting fewer strokes and heart attacks is traditionally "a patient-centered" endpoint. But these days the patients focus on their levels frustrating the H out of doctors who focus on the patient-centered outcome of heart attack and stroke.
1
I have taken statins for over a dozen years, not for any cholesterol-related reason, but to avoid another stroke.
This article doesn't take into account those who cannot take statins due to previous liver disease such as hepatitis. There is never a one size fits all medication even if on the surface of it, symptoms look the same.
3
Why didn't you look at the NNT (number needed to treat) for statins? It easily shows effectiveness (lack of) for most populations. Need to do more homework. Just Google NNT.
21
This article is misleading about the risks of taking statins. Six percent of people who take statins develop diabetes as a "side effect". They would not have gotten diabetes if they had not taken statins. I went over the risks with my own doctor and had her look up the risks. She was surprised at how high the risk for diabetes is from statins. I carry a strong gene for diabetes, so my blood sugar level is monitored regularly while take these drugs.
43
NNT is and underused concept but I think that is what Jane Brody alludes to when promoting a discussion with one's doctor. Yes the doctor has no time and some have not developed the skill to have the discussion, so we have the NY Times from which to learn. So if the NNT for you taking a statin is 20 is that an up vote or a down vote? After your stroke do you feel smart not even trying the statin when the NNT was 20? The point is the doctor can't make this decision alone; it's a value question. Would you pay more for a car with twice as many airbags if studies showed 1/3 fewer deaths? Would you pay $10 more? Would you pay $10,000 more. Can't leave that decision to the car salesman can we?
5
Oh, dear, sometimes I wonder about Jane Brody health articles in terms of examining a topic critically. For entertainment sake, for example, use the heart attack calculator and put your age in at 72 and see if by any combination of the additional data requested you can get a predicted heart attack rate less than 7.5%. I have an unmedicated total cholesterol of 130, a high LDL, low b.p., no risk factors, etc, from 40 years of jogging and still should be taking a statin, according to the calculator. Why not just ask my age and answer "take a statin"?
228
If the lowest risk quintile of 72 year olds have a NNT of 30 meaning you need to treat 30 to save one (over x number of years of treatment) and you are the guideline writer, do you feel it would be right to NOT offer statins to that low risk quintile? Who gave you that right. Leave the decision to the patient. A 7.5% risk is the chosen threshold..
1
I also have good numbers, a good family history, and I exercise, but at 72 the risk calculator and my doctor both say take a statin. So I do, because who wants a stroke? But this article, and particularly the comments, are making me question that choice. Kaiser, my provider, is very data driven, and promotes statins based on broad data and the risk calculator, not on personal history. No side effects so far, but now I'm wondering...
3
On the other hand at 56 years of age with an overall cholesterol of 298 and hdl 55, low BP and no other risk factors, I had only a 2% chance of heart disease. Does this mean I should have waited on taking the statin? When will there be a more refined diagnostic of each individual's risk for heart disease?
A new review article concludes that a small number of patients who take statins may have cognitive impairment (reversible, not necessarily causing discontinuing them) and at the same time the role of statins in preventing or causing dementia as in Parkinson's Disease or Alzheimer's Disease needs further investigation. The paper reviews evidence for and against claims and might help older people and their personal physicians considering whether or not to continue or start taking statins, especially if risk of cognitive effects is considered more than cardiac. https://doi.org/10.1186/s40035-018-0110-3
2
Statins make me feel like I've already got heart disease.
Muscle pain, cramps, weakness, nay, exhaustion.
The only mental effect is always being on the lookout for a place to stop walking and sit down, which was precisely what my father used to do when I was young, only he'd had an enlarged heart, valves replaced, the works.
I've tried three different statins over the years.
I'm done.
118
It is only an attempt to sell more drugs. My total cholesteral is 200 and HDL is 72 despite a plant based diet. My type 2 diabetes is controlled with diet and exercise as indicated by my 5'2" ,115 lb frame. My BP is borderline, controlled with CCB's. But my liver is already mildly damaged by isoniazid for latent TB exposure, and metastatic breast cancer runs in my family so I don't really need to take more chances here. But my dr's PA, and her automated health records program, is pushing hard for me to take statins and has me marked down as "non-compliant" when I push back and say no. Really?
64
I am willing to bet your waist circumference at the level of your umbilicus or the top of your hip bone (if you have dunlop) is well over 40. Lose the waist and your risk will drop much more than with statin treatment. Type II diabetes is due to insulin resistance due to excessive central adipose. The issue is not whether you are labeled as non-compliant, this issue is whether you die earlier than necessary. When you have tried 100 ways to lose weight, try one more time.
1
You do not know what of you speak. I do not need to lose weight at 115 lbs. I wear a size 4. I have no central andipose fat. My stomach is flat and my abs are visible. My waist is 27 inches. My hips are 35. I have never weighed more than this. I can lift 80 lbs, I walk 3 to 4 miles a day, but I have a demanding, high stress job, and bad genetics.
3
Of course I can't see your contour but my comments are accurate for most cases of type 2 diabetes. I think you are very likely to be an adult with type I diabetes. Have you had a c peptide level? If low it would suggest you are not making enough insulin. Type 2 patients have elevated levels of insulin. This is very important for you to know.
Take the statin
3
My cholesterol shot sky high for no discernible reason 30 years ago while still in my 20s concurrent with the emergence of a whole slew of other health issues. For 30 years I said no to statins without any heart attack or stroke. I figured my liver was doing this for a reason.
Finally figured out it was the fluoride in my water that was causing my misery, including bothering my liver and bumping my cholesterol which interestingly combats fluoride poisoning. My cholesterol is normal now and I am so happy I never opted into that dangerous drug.
6
I will patiently await the results of another major study that confirms the many life enhancing effects of statins.
8
It was previously thought that statins increased diabetes risk by 10-20%, then the large Finland population based study estimated increased risk of 46%. As this article is titled Pros and Cons, it could have mentioned this finding instead of just stating statins can increase blood sugar levels.
151
Wow--I didn't know that. It's hard to imagine how, given its marginal benefit, any Dr. could recommend a statin to anyone that wasn't suffering heart disease.
>>There is no question that statins can protect the health of people who have already had a heart attack or stroke (or even angina) << with a link to https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2... (the ALLHAT-LLT randomized clinical trial)
but that article is about PRIMARY not SECONDARY prevention, and concludes "No benefit was found when pravastatin was given for primary prevention to older adults with moderate hyperlipidemia and hypertension, and a nonsignificant direction toward increased all-cause mortality with pravastatin was observed among adults 75 years and older."
Benefits of statins in SECONDARY prevention (for those who have already had a heart attack or stroke) were seen in a 2007 study at https://doi.org/10.1016/j.jacc.2007.06.063 ("Statins for Secondary Prevention in Elderly Patients: A Hierarchical Bayesian Meta-Analysis"): "Conclusions:
Statins reduce all-cause mortality in elderly patients and the magnitude of this effect is substantially larger than had been previously estimated."
6
"Thousands of breast cancer cases included [in a study], and “long-term statin users”—women taking statins for ten years or more, “had more than double the risk of both types” of breast cancer: invasive ductal carcinoma and invasive lobular carcinoma.
Now, the #1 killer of women is heart disease, not breast cancer, so, we still need to bring down cholesterol levels. But might there be a way to get the benefits without the risks? Plant-based diets have been shown to lower LDL cholesterol “by over 30%” within just a couple weeks, equivalent to most of the standard cholesterol-lowering statin drugs—without potential side effects, such as increased breast cancer risk."
https://nutritionfacts.org/video/statin-cholesterol-drugs-and-invasive-b...
6
@Dr. J:
Cholesterol has _never_ been demonstrated to _cause_ heart disease. Not dietary cholesterol, and not blood serum cholesterol. Your vegan group-think tells us that "cholesterol must be bad because it's in animal foods".
Any diet that cuts sugars and refined carbs improves lipid profiles, regardless of whether or not it is plant-based.
4
Not all doctors are enamored of statins. Listen the talk by cardiologist Dr. Aseem Malhotra that he gave to the European Parliament. What are the actual chances you will die of a heart attack if you don't take a statin? Will statin drugs extend your life? If your doctor told you that taking a statin drug every day for the next 5 years will not extend your life by a single day would you take it anyway?
I hope that Jane Brody will listen to this valuable presentation by Dr. Malhotra. Maybe she will finally write a piece on statin drugs that is not simply an advertisement for Big Pharma.
The tide is turning even if, "science," writers at the New York Times's have not yet noticed.
I https://www.youtube.com/watch?v=H4uVNywg848
87
Bottom line: there are no guarantees in life. Educate yourself, make informed decisions, take responsibility for your own health...and hope for the best.
30
I cannot believe people still fall for the “cholesterol is bad” myth and allow big pharma to abuse them.
35
Javier, why can't you believe people still fall for the myth?
Pick up any issue of any top medical journal (JAMA, etc) and you'll find it filled with advertising from Big Pharma. Do you think Big Pharma would spend money on this if it didn't influence what physicians believe?
Watch TV for more advertising, this time directly to the public. Such direct advertising of prescription medications is illegal in almost all developed countries. Do you think Big Pharma would spend such vast amounts of money if it didn't influence us and make them profit?
The guidelines that doctors follow for drugs like statins are written by "experts", 59% of whom have "relationships with companies whose drugs were considered in the guideline they authorized." (from Overdo$ed America, authored by Harvard MD John Abramson).
We're talking about the corrupting effect of money, not about science. Big Pharma has the money to make themselves believed. They spend vast amounts of money to make their truth THE truth.
We need to change laws and regulations that make this so easy for them. I could list a dozen big things without breaking a sweat, and I bet you could too.
do yOu knoe what works even better than statins to lower cholesterol. A WHOLE FOOD PLANT BASED DIET. yes i am shouting it from the rooftops. It drops your cholesterol effortlessly. Stay away from dairy, meats and the everkiller EGGS. This diet is also not likely to cause muscle pain and damage.
As for back pain, when the elevated cholesterol cause damage to the vessels of the spine and causes back pain....All fixed by a WHOLE FOOD PLANT BASED diet.....a safe drug free, side effect free treatment.
11
@lola4md:
Vegan nonsense. Humans are omnivores, for literally millions of years. Don't blame new diseases on old foods.
Any diet that cuts out sugars, refined carbs, and highly processed foods improves blood lipids. Regardless of whether or not it is plant-based.
2
I gave them a determined try. They made me achy and stupid. Moreover, they produced only a one percent decline in the probability of my having a heart attack over the next ten years. So I discontinued them.
42
Soft sell to support big pharma profits. In the Times. Amazing
40
This article would be more helpful if it outlined the current treatment recommendations. All the links are to lengthy articles, which are fine and may have the current guidelines buried in them somewhere, but I don't care to go delving for the info. Why not add this to the article?
2
Our brain needs cholesterol badly. Statin use can lead to a significant higher incidence of ALS, MS and Alzheimer.
https://drmalcolmkendrick.org/2018/04/09/statins-and-amyotrophic-lateral...
About the only medicines Trump is taking are a statin and aspirin.
2
Trump eats garbage, is obese, sedentary, and takes a statin because he is too lazy to lower his heart attack through diet and exercise. In short, Trump is Big Pharmas poster child.
1
The idea of taking a pill to stop our liver from doing what it does naturally makes no sense. Saturated fat is turned into cholesterol that our bodies require. Instead of a life long “magic” pill, how about limiting eating cholesterol loaded foods and limiting foods with a lot of saturated fat. You know what doesn’t have any cholesterol? ALL plant based foods!!! Cholesterol is only found in animal products!
5
And animal fats which are solid at room temperature are loaded with saturated fatty acids -- which is what makes them solid at room temperature. Most plant oils are liquid at room temperature -- because they contain high levels of mono- and polyunsaturated fats. Except for coconut oil, which is full of saturated fatty acids -- which is why it is solid at room temperature.
Saturated fat isn’t, and can’t be, “turned into cholesterol”. They are entirely different molecules. However, cholesterol, whether synthesized by our own bodies or derived from the diet, can be esterified with saturated fats to increase circulating blood cholesterol. Hence the connection with saturated fat intake in epidemiological studies. Eating plant foods high in saturated fat, like coconut oil, will be similarly detrimental.
7
@Brandon & Dr J:
The idea that saturated fat consumption causes heart disease has been refuted about as thoroughly as anything can be in nutritional science, through multiple meta-analyses of observational studies and through experimental trials. "Sat fat is bad" hangs on due to vegan ideology, institutional inertia, and financial conflict of interest.
@Dr. J:
What temperature is it inside the body, compared to room temperature?
1
"reversible side effects: confusion and memory loss, liver problems, increases in blood sugar and muscle weakness, as well as interactions with certain other medications." It's only reversible if you go off them, and you are told you'll need to be on them for the rest of your life.
21
I am 67. I exercise a lot, eat reasonably well, don’t smoke but my cholesterol levels have been high for a number of years. Two years ago my doctor and I agreed I should go on Atorvastatin and low-dose aspirin therapy. All my numbers are now well within the normal range and I’ve experienced no side effects. I worry that people sometimes rail against the evils of so-called big pharma, arguing that taking natural remedies is better. Statins have been proven to reduce substantially the occurrence of cardiac events. Why wouldn’t you take them if you need to?And oh yes, they are all generic now and cost very little.
13
As an healthy 62 year old who takes no medications, I have no faith in "Big Pharma". Excercise, a mostly green diet and limited alcohol will yield better results than anything out of a pill vile. Best advice, research any medication thoroughly, then do it again.
31
Medical science still has a long way to go. I am a heart patient with two stents in my arteries with the second one just inserted three weeks ago. The first time I collapsed in the tennis court having problem to breath & sweat like crazy under the hot sun. The second time I felt severe chest discomfort (not pain) and had problem to walk even 0.5 mile in cold weather (~50F). I had to take Nitroglycerin to relax arteries before I can walk back home. Both times my cholesterol level were within the normal range at 166 & 122 before the procedure. I started taking Atovastatin(statin) 10mg after the first stent. I don't know the exact reason why I took it in the first place. I guess the dosage was so low that it will do no harm to my body. By the way, my LDL were also within the normal range. The only anomaly was my Triglyceride level that was in the marginal that barely above the normal range. I don't smoke and I don't drink. So you be the judge why statiin will help people's health.
1
Cholesterol is needed by the body to function and your body manufactures just the right amount. However, consuming foods high in cholesterol, then the body must store the extra cholesterol as artery plaque; where-else does it go?
Doctors seldom mention the alternative treatment of reducing cholesterol foods because they are trained either to prescribe drugs, or surgery, or devices. Medical schools are not known to teach nutrition.
23
This has been disproven long ago by major studies like the Framingham heart study. Dietary cholesterol does not cause heart attacks. However, an unbalanced diet can lead to unhealthy weight and poor injestion of important nutrients such as fiber and vitamins found in fruits and vegetables.
54
Medical schools don't teach doctors much about nutrition, but it has been proven now that the problem with a rise in cholesterol is not caused by dietary source cholesterol. The cholesterol rise is cause by events in the body which also cause cardiovascular disease. Cholesterol is like the tar they patch the roads with. The body uses cholesterol to patch arterial injuries which are classed by micro clotting in the blood and by excessive free radical stress. Cholesterol is the innocent bystander in the room, not the killer. The cholesterol theory of heart disease it totally bankrupt. Statin drugs are damaging as they reduce the body's production of Co Q10 up to 40 %. The Nobel Prize was awarded to the scientist who discovered its function in the body, because it is essential to life. The body cannot metabolize oxygen without Co Q10. The body's production lowers with age. In older people and those who do not metabolize oxygen as well,or who do not produce Co Q10 as well, the lower Co Q10 levels caused by the statin drugs could do a lot of damage of many different kinds--cancer risk could rise, viral risk could rise, aging could accelerate as Co Q10 is an important antioxidant which works in concert with vitamin E and vitamin C. Oxygen and free radical stress are both very important in adjudicating if the immune system wins in immune battles.
13
When you have an RCT demonstrating the benefits of CoQ10 on any of these diseases, get back to us.
6
I just started and quit after 2 days because of overpowering fatigue and dizziness. My risk is 7%. I'm going to re-evaluate when I speak to my MD. I wasn't expecting side effects. For the amount it would effect my personal risk (7% to 3%) I don't know if it is the right choice for now. Perhaps it was the dosage. We'll see.
3
There are many natural ways to lower cardiovascular risk.It is a myth that it has to be done by a drug.
6
Weeks after I made my comment, an MD told me I had to take the pill on a full stomach and try again. Then the fatigue was less but I noticed my legs hurt when I walked, they felt like they weighed 100 lbs each, and hurt like heck. I need to walk to drop a few lbs but I started to get miserable walked 2 blocks-very painful. So I stopped again. I'm not going to take pills which give me a 3% improvement on having a stroke or heart attack but make me miserable all my waking hours. It's spring in NY. I'm walking!
Good points, at least in the final few paragraphs, but how about an article addressing the rampant over prescription of statins to people who do not fall into a high risk or post-event category? I had a doctor tell me he thinks statins should be given to everyone and if he had his way, it would be added to the drinking water. Sure, some people need it but not all of us do. Some of us are not high risk and some weight gain and a mildly elevated cholesterol result does not mean we need to start taking a statin. And yet, that is exactly how this pill is being pushed in most medical offices.
And if you know one person who has had an adverse reaction (I know two - one took it as a teen and still deals with muscle pain from the side effects) you learn to trust more than just one doctor's opinion. My point is this : Statins are over prescribed in this country and are over sold as some sort of miracle drug. Downplaying the possible damage caused by medication you may not need does not serve the readers of this paper well.
75
I’m not willing to be a guinea pig for big-pharma. I tell my Dr I don’t believe in them for someone with no family or personal history of heart disease. A slightly high cholesterol may even be life saving. The incentive to heal has been over taken by profit motives. How about telling people to get off sugar and refined starches, and take a twenty minute walk every day. That’s much better medicine.
162
Good idea, and take out the trans fats,and add lots of antioxidant rich vegetables. Meditate or find other ways to lower stress. And take vitamin c, with lysine, and the other antioxidants in the Packer full network of antioxidants. Read Dr. Packer, "The Antioxidant Miracle". He has been the foremost antioxidant researcher in the world. Dr.Packer knows a lot more than the NYT about this subject. Also listen to the doctors who 'work like gardeners instead of like mechanics" (Dr. Majid Ali) --clean the liver and gut, balance the gut flora, raise oxygen metabolism, lower free radical stress-- the human body flies on the wings of oxygen,but its big challenge is tamping down free radical stress. That is the heart of the biochemical equation which has made us the form of life that we are through the millennia of evolution.
2
What about lifestyle changes? For about 80% of the population, eating a healthier diet (as well as exercising, not smoking, and not drinking alcohol) would prevent heart disease. In fact, for this group, these interventions are more effective than any statin.
And so far, the most effective diet is a whole foods, plant based diet, where whole foods = unprocessed, and plant based = no animal products.
For most of us, a statin prescription is a permission slip to continue with our unhealthy lifestyles.
No thank you. Count me out.
17
Basically right. Alcohol is a two edged sword. Whether it is poison or panacea is dose dependent.
3
fragilewing, actually alcohol is not safe at any dose. Sort of like radiation. Check out this article: https://www.motherjones.com/politics/2018/04/did-drinking-give-me-breast...
There are many other sources with the same conclusion. e.g. https://nutritionfacts.org/topics/alcohol/
2
@Dr. J:
Light-moderate alcohol drinking is broadly associated with lowered risk of heart disease. Whether it's the alcohol itself, or the stress relief, is unknown.
Keep your moral puritanism.
Radiation is not only safe but _necessary_ in certain doses on the skin for vitamin D and nitric oxide production.
2
At this point, statistics are meaningless to me. I already have a disease that is diagnosed each year in 1-5 people per million. Most doctors never see a single case during their career. A ‘small’ chance of serious side effects translates to ‘this could actually happen’. The muscle issues with statins is not always reversible by discontinuing them.
My cardiologist did suggest statins, but is working with me to lower my cholesterol by diet. It’s working. I’ve eaten oatmeal sporadically, but regularly consumed almonds and cut way back on sugar/carbs.
11
My biggest concern about Statin use is it will extend my physical life beyond my congnitive life. From the vantage point of my current age (early 50s) I'd rather live well and die quickly from a cardiac event than slowly decline and lose myself to Alzheimer's or dementia.
234
The statin can harm your cognitive life, and may well have more side effects long term than are now being admitted. Given how much it can lower Co Q10which is critical to oxygen metabolism, it is likely that it may have many side effects which have not yet been determined. But it is not either/or, it is total nonsense that the best way to lower cardiovascular risk is statin drugs.
10
You can have Alzheimer's or dementia early on. There are many that do not take stains, and live their long life without Alzheimer's or dementia.
It is all up to individuals and how they live.
1
"I'd rather live well and die quickly from a cardiac event than slowly decline and lose myself to Alzheimer's or dementia."
As I understand it, there is some evidence that statins reduce the chances of getting dementia. Although, like all current medical research, I wouldn't take that evidence as gospel. If you really want to "die quickly", move to state that allows people to choose "death with dignity".
2
Statins deplete the body of co-enzyme Q10, an antioxidant that is involved in the mitochondrial function of cells to make the energy they need to grow and stay healthy. CoQ10 is found in highest amounts in the heart, liver, kidneys, and pancreas. It is also found in muscle cells. When CoQ10 gets depleted, muscles weaken, and people experience fatigue and muscle aches. There is no systematic research that I can find about whether supplemental CoQ10 (capsules or gel tabs) can address this depletion, but there is some evidence that it helps congestive heart failure patients. The Mayo Clinic has a pretty good summary of research on co-Q10 here https://www.mayoclinic.org/drugs-supplements-coenzyme-q10/art-20362602, and about coQ10 and statins here https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/ex...
17
And note...the amount of depletion of Co Q10 by statin drugs can be major.
Read board certified cardiologist Dr. Stephen Sinatra, "The Sinatra Solution" to understand what miracles can be wrought in cardiovascular disease by using Co Q10 with a number of other substances. such as L-carnitine and D-ribose and magnesium, Omega 3 (high DHA Omega 3), etc. Co Q10 was a favorite substance of the former director of research at Merck pharmaceuticals, who later was head of Stanfor Research Institute, who managed to have some very small studies conducted on it. Co Q10 is a heart drug in Japan where the manufacturing patents are held, but since it is a natural substance which cannot be patented as a drug, there has been little interest in it in the USA. Big money turns the wheels of medicine,and if there are not the possible earnings of a drug which is patented --thus has no competition, no pharmaceutical company wants to pay for drug trials. Thus far from what the NYT is continually claiming, enormously valuable substances which are natural substances are not used in mainstream medicine.
4
Multiple doctors over the last 15 years have offered, pronounced the need, bullied, intimidated, and never once apologized for the symptoms I had with several of the pill-form statins. Muscle pains, extraordinary cramping in legs to disabling results; the restricting my lungs to breathe to the point of unable to get out of bed & rush to get my rescue inhaler some 7 feet away was the last straw.
I'll take death.
61
I take a low dose statin (zocor) to not only lower my cholesterol BUT also because of its inflammation reducing abilities. The later is by far the better property of statins. Inflammation from food, stress, age, exercise can wind up being be a killer. When first prescribed years ago i also said “cant i change my diet” to which my GP wisely said “everyone says they will but few make it 6 months and even fewer make changes needed for a life time.”
5
Your GP did not tell you that taking statins for the rest of your life will make bad changes for your life.
Your GP just wanted to get rid of you and move on to the next patient.
When you get older you have a better life from starting exercise and from starting a better diet and not taking statins.
When you take statins for life you have a poorer life from no exercise, and from a poor diet. You also may at one point having type 2 diabetes.
5
There are far more natural and less dangerous ways to lower inflammation than statin drugs. Remove the inflammatory food. ,including modern wheat, and trans fats,sugar and white flour.Antique wheat is far tastier anyway. Meditate, read poetry, take a walk in the park for stress.
All it takes to change your diet is to want what is good for you--to want health and well being and thus like the foods that bring you that and dislike the foods that bring illness, suffering and death.
My doctor has written a list of foods in six columns left to right . The chart starts on the left with the foods which contain," lifespan molecules" there are three columns, starting with the best foods on the far left, , then good foods, then ok foods. Then the chart continues with three more columns of foods which reduce life. The first column to the left is foods which are bad but not as bad as the next column to the right. The third column --the last one to the right, has the worst foods--the foods which are the worst, shorten life. My doctor then says, try to eat as much as possible to the left side of the chart. Really it is not such a sacrifice. Would you rather have asparagus or eat some sugar bomb which makes you feel ill afterward? Learn to treat yourself with the healthy foods that you enjoy. Soon your tastes will change and you will not regret the changes you have made. A pill cannot replace a healthy diet a healthy mind, a good attitude. The doctor who says otherwise is not wise.
6
Unmentioned in this article is the potential for interactions with other medications. Statins may make your other medications less effective.
It doesn't take a genius to recognize that a medication that interacts with grapefruit juice (!) may also interact with dozens of other substances, in unquantifiable ways.
29
Will my obese and out-of-shape doctor recommend life style changes?
When I complained of putting on 10 lb post menopause she responded by telling me not to worry she had put on 35 lb.
This doctor seems about average in my experience. I don't think there would be a reasonable conversation about lifestyle impacts with a lot of doctors, besides they don't have time to talk as they sit there, focused on clicking on their new medical records keyboard...documenting the patient's noncompliance not their own failures.
21
so true ...after surviving chemo treatment my Dr. ( younger and chubbier than I )
enters and tells me I look better than he ...tells me to lose weight and go on a statin because my good cholesterol is too low !
btw he advises " vigorous exercise " knowing I have terrible peripheral neuropathy as a result of chemo !
there you go
1
Get another doctor.
2
My mother has been on and off statins for a number of years. She has a healthy diet and cholesterol numbers that are good. I'm not sure why her physicians keep prescribing statins, but I think my mother is always willing to try them again. Each time within a few months she has had one of the more rare side effects - sleepwalking. After having had multiple accidents, including one where she badly cut her face when falling against a door hinge while sleepwalking we are done. At age 80 I think the danger of falling far outweighs whatever benefit statins might provide.
129
"Under current guidelines, among people 60 and older, 87 percent of men and 54 percent of women not already taking a statin would be considered eligible for treatment."
I find this factoid both frightening and suspicious. Statin makers have been funding studies for years to advocate lowering the threshold of acceptable cholesterol levels, knowing exactly how many more prescriptions they can count on for each lower benchmark. Furthermore, what many doctors don't tell patients is that what we eat just a few days before, and even the night before, we are tested impacts our cholesterol level the day we are tested. I.e., cholesterol is measured at a moment in time and it fluctuates over time. Eat right for a few days before each and every check-up and many people will find that their cholesterol levels are normal, but have a few slices of pizza and an ice cream cone the night before and you'll be prescribed a statin.
183
New guidelines almost always seem to indicate that more people need some medical or pharmaceutical intervention, preferably something therapeutic and never-ending (cholesterol, blood pressure, blood glucose/A1C, etc.)
34
My mother (82) had been on statins for 20 years. After a very active life spent golfing, skiing and daily multiple mile walks (year round!) she began a slow but steady decline in her physical activity that began at about 70.
Eventually at about 80 she was nearly housebound complaining of debilitating weakness and frailty and excruciating leg cramps and restless leg syndrome. Her cholesterol had been moderately controlled by Lipitor and she assumed her decline in vitality was the expected decline of old age.
After reading an article about Lipitor side effects she decided with her rheumatologist’s support to take a break from Lipitor. (Her cardiologist opposed it.) It’s been 2 years. Her strength has dramatically improved including her activity levels and her cholesterol is a little higher but not much. Unfortunately she gave up golf a decade ago and feels it’s been too long to go back.
She now regrets the quality of life she gave up for theoretically a longer life.
321
You describe exactly my father, now age 81. Unfortunately I haven't been able to convince him to reconsider his taking of statins. After a decline that started in his early 70's, he is now the shadow of himself, barely walks, and is terribly depressed and angry - what's the point then ?
7
Julie, never too late; get her out on a putting green or driving range.
5
She is s victim of medical malpractice. Her doctor allowed her to suffer unnecessarily for years. The horror!
I see this frequently in my practice. It's documented in my book, " The Doctor as Pathogen". We do such harm so often.
1
Very rarely, statins can cause life-threatening muscle damage called rhabdomyolysis. Rhabdomyolysis can cause severe muscle pain, liver damage, kidney failure and death.
https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in...
.............................................................
Why do articles about taking statins never mention the ways to lower cholesterol without drugs?
The risk of death from taking statins is low but why take the risk.
Simply eating oatmeal lowers cholesterol and you never have to worry about dying from eating oatmeal.
There are a number of "news" about why people should take stains and there are never any articles about how to lower cholesterol without drugs.
It takes time for a doctor to tell patients on ways to lower cholesterol without drugs. It takes no time for a doctor to prescribe stains and quickly move on to the next patient.
161
The size of the stain drug market couldn't have anything to do with the fact that we read articles like this one instead of articles on how to lower our cardiovascular risk naturally, could it?
Is it Science when the studies seem to support industry and not the solutions which do not hold a pharmaceutical pot of gold?
4
Exactly. When I read some years ago that virtually everyone 'of a certain age' should be taking a statin I howled.
Then I told my doc, "no thanks" - I'll try lifestyle changes first. I did. Unless you have high cholestrol due to your genetic makeup - if you were like me, nothing but rising cholesterol and being over 50, you might want to change your diet and get more exercise. It absolutely worked for me and I'm not talking about taking up marathon running.
I'm sure that these drugs work for those who truly need them but the tendendancy to push a pill instead of a lifestyle change on those who could easily benefit from one, is very troubling in my mind.
If you have not done everything you can to change how much and what you eat/drink, and how much you move... if you are still smoking... there is much you can do to improve your health before going on a drug. At least that's my way of thinking. So far, so good!
The problem is that many of us would rather just pop a pill. It's certainly easier in the short run.
1
Gotta prove oatmeal lowers your cholesterol with measurements before and after
Always known and preached, exercise more (less couch potato and more exercise), eat low fat more veggies and fruit, less meat more fish diet, loose weight but how many people unwilling,"unable", unmotivated to follow these time tested recommendations. Congratulations to those that can.
Is the science even settled behind the underlying premise; that higher cholesterol levels are causative, and not just correlated, with cardiovascular disease?
281
Exercise thins out the blood which probably would make it more difficult to have plaque builds up in the walls of the arteries.
My guess would be that the large majority of individuals that take statins do not exercise.
Three days a week taking baby aspirin with exercise would probably be better than taking statins.
2
Yeah, the science has been settled. The cholesterol theory of heart disease has been repeatedly disproven.
One has to understand the disease form the perspective of the molecular level. Free radical stress in the arteries is far more dangerous than unoxidized cholesterol. In fact it is known that higher levels of oxidized cholesterol correlate with higher cardiovascular risk. How does that cholesterol oxidize--free radical stress. So one of the functions of that test is that it is a marker for free radical stress in the arteries.
7
My reading of the research is that CHD is multifactorial and there may be a role of bacterial infections in inducing plaque formation and the associated local inflammation. It is even possible, based on outcomes with other cholesterol-lowering/CHD drugs developed recently, that the primary mode of action of statins is anti-inflammatory rather than via lowering of cholesterol per se. A lifestyle-based change incorporating unprocessed plant-based foods (and in particular, diverse and rich sources of dietary fibre) and moderately intense exercise is likely to be beneficial on multiple fronts, including in reducing CHD risk.
3
"One chance in 100 may be acceptable to one person, while another may regard one chance in 1,000 as too risky."
Most people have no real idea of what those actually mean in terms of their normal day to day risk. What is the risk that you will be in a car accident in the next ten years? What is the risk that you will lose your job. I doubt many people know whether those are 1/100 or 1/1000 risks. So giving them the odds is pretty meaningless.
For a random person age 65, the odds they will be dead in 20 years are better than 50-50. But none of us are random people. Those odds are meaningless for any individual since they include people with advanced cancer and those that have no health problems at all.
"The drug works primarily by lowering blood levels of harmful LDL cholesterol"
I don't think that is true. Other drugs that lower LDL have not shown any effect on the likelihood people will have heart attacks. It appears that statins lower the chances of the inflammations that cause the deposits of cholesterol in the arteries to burst and block the vein. As I understand it, its not even clear that increased blood cholesterol leads to plaque in the veins. It may be that the presence of the plaque causes the increased cholesterol levels, rather than the other way around.
56
I am certain that Mr. Williams is well intentioned. However, I have read extensively in this area (out of personal interest). I also have a formal background in mathematics, including statistics. I feel that I have to warn readers that Mr. Williams says a number of things that aren't well accepted in either community. I would caution acting on his recommendations until you get a wider range of data-driven opinions from experts.
On the topic of statistics, Mr. Williams is basically asserting that probabilities are totally useless for planning by individuals, since no individual is "random". Actually, any individual who lacks enough data to be certain about the future is "random" in that way.
I am reminded of a scene in an old Star Trek movie. The protagonists must attempt a risky "time jump" involving a situation that is extremely sensitive to small variations in conditions. Dr. Spock makes the calculation, but Captain Kirk can tell from his voice that Spock is not happy. Spock explains that he has only approximations for certain variables and therefore cannot be certain he can get to the right time and place. Captain Kirk replies that "some times you just have to take your best shot."
1
" any individual who lacks enough data to be certain about the future is "random" in that way."
That is plainly not true. Any information that might effect the outcome makes a person no longer random. If you know you are in the hospital with terminal cancer your chances of living 20 years are far less than if you are healthy. Likewise, if you are healthy, your chances of living 20 years are higher. Any uncertainty doesn't change the fact that the odds for the general population that includes both individuals no longer hold for either individual.
"I am reminded of a scene in an old Star Trek movie."
Which is part of our problem. People mistake entertainment for experience and its narratives for knowledge.
3
I agree with Ross Williams.
A side effect of statins is muscle pain.
How is a person that is having muscle pain to know that this is not serious problem of statin, and that instead the statins has caused a life-threatening muscle damage called rhabdomyolysis that will cause severe muscle pain, liver damage, kidney failure and death.
I doubt that there is any total of those individuals that died after being told to continue statins by doctors.
Doctors should tell patients to immediately stop taking statins when there are muscle pain, but they do not do this and want instead for patients to continue taking statins. The reality is that doctors are playing Russian roulette whether the patient will die or not die.
6
In general, side effects of medications are not studied as thoroughly in women or are dismissed as irrelevant when they appear in women. At my doctor's urging, I took a statin for a period of time but complained that I could not get up the stairs from muscle weakness. Fortunately, he listened and tried me on red yeast rice which did the trick without either side effects or blowing a hole in my budget.
45
Oatmeal contains soluble fiber, which reduces your low-density lipoprotein (LDL), the "bad" cholesterol. Soluble fiber is also found in such foods as kidney beans, apples, pears, barley and prunes. Soluble fiber can reduce the absorption of cholesterol into your bloodstream.
Cholesterol: Top foods to improve your numbers - Mayo Clinic
https://www.mayoclinic.org/diseases-conditions/high-blood-cholesterol/in...
Oatmeal goes well with honey.
6
Sugar (honey) may not directly raise cholesterol, but it is inflammatory and raises free radical stress, thus is not going to be healthy for the arteries. Try milk and some chunks of apple and almonds in your oatmeal. The almonds will slow down the insulin response to the carbohydrates. Soak the almonds overnight before using them.
4
The active component in red yeast rice is.... statin.
I have hereditary high cholesterol (no amount of diet or exercise will get my cholesterol levels into the range considered normal or healthy, trust me, I tried), however, I also have no other risk factors. I do not have a family history of cardiovascular disease (despite the fact that on my Dad's side everyone has high cholesterol), I am not overweight, I do not smoke, I exercise approximately 500 minutes per week, I do not have diabetes or high blood pressure, I eat a healthy diet with plenty of fruits, veg, nuts, whole grains, fish, olive oil, etc. I am a woman turning 40 this year, so what am I do do? Over the last ten years I have seen multiple cardiologists and primary care physicians who had surprisingly different opinions on what I should do. One suggested aggressive treatment with a statin plus niacin and daily aspirin (I was 30 at the time and said yes to the statin, no to the rest), I encountered doctors who were unconcerned about my LDL because my HDL is also high (>75), I met doctors who said, they simply did not know. I am none the wiser as to what I should do. I also do not tolerate statins very well (same goes for red yeast rice) because I get muscle pain. I do believe, however, that side effects are more common than research claims they are. I also believe that statin do help people who already had a heart attack but again what is someone like me to do?
26
Doctors and medical persons sometimes simply create more fear and stress.
Must doctors and medical persons do not want to listen and think. Instead they want to get to the next "customer" as soon as possible.
People can only make their own decisions, and try to find a medical person that will actually listen and think.
4
For heaven's sake, don't take the statins,and keep doing all the good things you are doing!
4
As a healthy person who is not diabetic nor has a high cholesterol or blood pressure problem, I would be highly concerned about having a cardiac event versus a side effect of a statin drug. Some cannot grasp perspective.
3
Based upon your perspective you should immediately start taking a statin drug since at any day the food you might eat might be too high in cholesterol and create a cardiac event from plaque builds up in the walls of the arteries.
1
The damage of the statin drugs is bound to be hidden-unseen,and slow. Anything that can lower your Co Q10 level unto 40 percent has to be dangerous, as the whole foundation of the human biochemistry evolved around its main energy source-- oxygen. CoQ10is essential for metabolizing oxygen and is also an important antioxidant. Anything that lowers your ability to metabolize oxygen is tearing down the foundation of you biochemistry. That can't be benign, especially since Co Q10 levels lower with age, anyway.
2
YOU cannot grasp perspective. You have not experienced nightly severe muscle aches over a period of months. There are other medications and alternatives to statins.
1
I was prescribed statins to lower my high cholesterol levels, but the muscle aches and pains were intolerable. I felt like I was 100 years old, and told my doctor I stopped taking them because I would rather die younger, than to feel horrible for a longer life span. He sent me to a lipid specialist who prescribed Livalo, which worked like a charm. Lowered my numbers with no discernible side effects. My insurance company refused to pay for the drug because it was expensive and not on their formulary. I, and my specialist convinced my insurance company that it would be cheaper to pay for the drug than to care for me after I had a stroke or heart attack. Eventually they came around.
35
FYI - Livalo is the brand name of pitavastatin, which is a statin.
Still, if the first or second statin you and your doctor tries either does not appear to work well or you believe causes side effects in you, try a third...
1
Over three years ago my doctor told me, with a smile on his face, that I should start taking statins. When I declined his recommendation the smile disappeared and he tried to counter what he thought might be my negative views of statins. Instead of going along with his advice, I went on a vegan diet. Results of my blood work in the last three and a half years have been in the normal range, and statins are no longer mentioned. The route I chose will not work for everyone, but I suspect that many other people could reduce their risk factors by being more careful about what they eat and drink, and by becoming more active.
350
Actually, William, the route you chose would work for about 80% of us. And is more effective than any statin. Congratulations! My brother experienced the same results as you did: on the vegan diet (whole foods, plant based), off his statins.
"Dr. Kim A. Williams, the president-elect [in 2014] of the American College of Cardiology, often sees patients who are overweight and struggling with hypertension, Type 2 diabetes and high cholesterol. One of the things he advises them to do is to change their diets.
Specifically, he tells them to go vegan."
https://well.blogs.nytimes.com/2014/08/06/advice-from-a-vegan-cardiologist/
10
@Dr. J:
I'll bet he also tells them to reduce sugar and refined carbohydrates at the same time.
7
I have the same experience following a vegan diet for 1 year now. Drop of 45 points in my cholesterol. Simple! It works if you work it!
11
After an extended period of acute stress and failure to take adequate care of my health I had a mini-stroke some 18 months ago, briefly losing my speech and the use of my right arm. The doctor at the hospital wanted me to go on statins. I refused. I am hyper-sensitive to drugs, something I inherited from my mother, so I approach drugs with extreme caution. However in my fear and vulnerability at this point I might well have acquiesced had I not read some research from the University of Arizona about swellings in neurons after exposure to statins that it was theorised might be the cause of the memory loss that is sometimes reported by patients on statins: https://uanews.arizona.edu/story/research-reveals-possible-reason-for-ch...
Quite frankly it was frightening enough to lose my power of speech. I did not want to have some drug possibly messing with my bran. However by opting out of drugs I found that I had also opted out of the medical system because doctors are no longer educated in the alternatives to drug therapy. The weeks that followed were hard - head pains and memory lapses. However I was able to do extensive research on science studies on the causes of such episodes and possible natural treatments to support brain function, lower blood pressure etc. I exercised more, took control of my diet and took certain supplements. The result, blood pressure low, cholesterol under control, and I have never felt healthier. So other options exist.
105
I gave up all caffeine and that lowered my stress and also lowered my blood pressure.
6
Good for you Cathie, keep on that and keep an open mind. You don't want to have another stroke and end up like my mom!
While in the hospital following a massive stroke my mom was repeatedly pushed, by hospitalist after hospitalist, to take a statin. She had low total cholesterol. Also the study suggesting statins would reduce risk of another stroke (SPARCL) had been further analyzed. Mom was in a subgroup for which statins would not help or might even increase risk of a bad outcome. No hospitalist was aware of mom's total cholesterol or the latest findings. And guess which company funded the study and whose statin was being prescribed.
5