Do statins prevent heart disease, heart attacks and strokes

[Wesley Clark]

I cannot find a straight answer on this. I know statins will lower your LDL levels, but does that translate into a lower risk of death, disease and disability?

This article references several studies on statins saying that they really do not prevent health issues.

http://healthland.time.com/2011/01/2...y-individuals/

The implication I get is that unless you've had a heart attack or heart disease and/or are at very high risk of these things they really don't help. What is the consensus?

[vivalostwages]

I don't know about that part.

I do know quite a few folks who have sustained permanent muscle damage and pain from taking statins. (I do not know about the newer ones, though.)

[dataguy]

I did quite a bit of research on this topic a couple of years ago. Some of my conclusions:
1. If you've previously had a heart attack, statins can help prevent another one.

2. The reason they help has nothing to do with lowering your cholesterol. It's because of their anti-inflammatory properties.

3. For the average person, they offer no benefit and have potentially serious side effects. Especially women, for whom there is no clinical evidence that high cholesterol is any kind of health risk.

4. Consensus has nothing to do with facts. Facts are determined by supporting evidence, not my majority vote. There was so much conflicting opinion about the link of cholesterol to heart disease that a conference was convened in 1984 called the NIH Consensus Development Conference on Lowering Blood Cholesterol to Prevent Coronary Heart Disease. The purpose was to decide on the "official" medical position on this topic. In other words, a committee was going to decide what the "facts" are. This is not the normal scientific process.

5. All research in this area indicates that interfering with the normal production of cholesterol in your body is detrimental to your health. Cholesterol serves many useful and vital functions in your body. It is not a toxic substance.

[Fear Itself]

http://www.courses.ahc.umn.edu/pharm...Med%202010.pdf (PDF)

In conclusion, based on aggregate data on 65 229 men and women from 11 studies, yielding approximately 244 000 person-years of follow-up and 2793 deaths, we observed that statin therapy for an average period of 3.7 years had no benefit on all-cause mortality in a high-risk primary prevention population. Current prevention guidelines endorse statin therapy for subjects at high global risk of incident CVD as a means to reduce fatal and nonfatal vascular events. Due consideration is needed in applying statin therapy in lower-risk primary prevention populations.

[Dogzilla]

Originally Posted by dataguy

I did quite a bit of research on this topic a couple of years ago. Some of my conclusions:
1. If you've previously had a heart attack, statins can help prevent another one.

2. The reason they help has nothing to do with lowering your cholesterol. It's because of their anti-inflammatory properties.

3. For the average person, they offer no benefit and have potentially serious side effects. Especially women, for whom there is no clinical evidence that high cholesterol is any kind of health risk.

4. Consensus has nothing to do with facts. Facts are determined by supporting evidence, not my majority vote. There was so much conflicting opinion about the link of cholesterol to heart disease that a conference was convened in 1984 called the NIH Consensus Development Conference on Lowering Blood Cholesterol to Prevent Coronary Heart Disease. The purpose was to decide on the "official" medical position on this topic. In other words, a committee was going to decide what the "facts" are. This is not the normal scientific process.

5. All research in this area indicates that interfering with the normal production of cholesterol in your body is detrimental to your health. Cholesterol serves many useful and vital functions in your body. It is not a toxic substance.

Do you have cites for some of these, especially #3? I would like to have something to quote to my doctor the next time they start pushing statins on me. I have high cholesterol, but no other risk factors or co-morbidities. My theory is that my cholesterol levels are genetic and I probably won't die of a heart attack in my 40s. Maybe in my 80s. While heart disease is rampant in my family, most have lived into their 80s at least before it killed them. So I maintain that taking statins for 40 years will almost certainly do more harm than good. But I would like cites to back that up and it looks like you've done the research already.

[thatguyjeff]

Googling "statin myth" or "cholesterol myth" yields lots of results - some reputable.

[x-ray vision]

QtM on statins:

http://boards.straightdope.com/sdmb/...4#post14909084

[pkbites]

Originally Posted by vivalostwages

I do know quite a few folks who have sustained permanent muscle damage and pain from taking statins. (I do not know about the newer ones, though.)

My mother is in that camp. Statins really screwed her up. Severe, almost debilitating muscle aches and even some kidney problems.

I, on the other hand, have been taking them for years with no [noticeable] ill effects.

[DiamondNinja]

Originally Posted by vivalostwages

I don't know about that part.

I do know quite a few folks who have sustained permanent muscle damage and pain from taking statins. (I do not know about the newer ones, though.)

My mother had severe muscular weakness due to statins. I was irritated that her doctor even prescribed them in the first place; her LDL wasn't very high.

Anyway, I was the one who figured out why she was so weak and in so much distress; her doctor refused to believe it was the statins until I asked my mom to stop taking them for a few days and see what happens. She was back to normal within the week (well, relatively so).

It really didn't lower her LDL too much anyway, maybe just a few points.

[DiamondNinja]

Originally Posted by Dogzilla

Do you have cites for some of these, especially #3? I would like to have something to quote to my doctor the next time they start pushing statins on me. I have high cholesterol, but no other risk factors or co-morbidities. My theory is that my cholesterol levels are genetic and I probably won't die of a heart attack in my 40s. Maybe in my 80s. While heart disease is rampant in my family, most have lived into their 80s at least before it killed them. So I maintain that taking statins for 40 years will almost certainly do more harm than good. But I would like cites to back that up and it looks like you've done the research already.

I can't believe they are worried about heart attack for you when your family members were elderly when they had heart attacks. It's usually if the family member had a heart attack under 50 that the bells go off. Statins haven't been around long enough to know long term effects; I'd do my best to avoid them, and if needed, proceed with caution.

[dataguy]

Originally Posted by Dogzilla

Do you have cites for some of these, especially #3? I would like to have something to quote to my doctor the next time they start pushing statins on me. I have high cholesterol, but no other risk factors or co-morbidities. My theory is that my cholesterol levels are genetic and I probably won't die of a heart attack in my 40s. Maybe in my 80s. While heart disease is rampant in my family, most have lived into their 80s at least before it killed them. So I maintain that taking statins for 40 years will almost certainly do more harm than good. But I would like cites to back that up and it looks like you've done the research already.

I wrote a report on this topic and created a web site. The web site is still up. Here's a link to the report. It contains references for all the statements in my post.

http://themissingfacts.com/MissingFa...holesterol.pdf

[Kansas Beekeeper]

Originally Posted by DiamondNinja

My mother had severe muscular weakness due to statins. I was irritated that her doctor even prescribed them in the first place; her LDL wasn't very high.

Anyway, I was the one who figured out why she was so weak and in so much distress; her doctor refused to believe it was the statins until I asked my mom to stop taking them for a few days and see what happens. She was back to normal within the week (well, relatively so).

It really didn't lower her LDL too much anyway, maybe just a few points.

Same here. When I took them I was so week and ached so badly I couldn't function. I tried three different statins. My doctor still is pushing me to take them, but I refuse.

[Dogzilla]

Originally Posted by DiamondNinja

I can't believe they are worried about heart attack for you when your family members were elderly when they had heart attacks. It's usually if the family member had a heart attack under 50 that the bells go off. Statins haven't been around long enough to know long term effects; I'd do my best to avoid them, and if needed, proceed with caution.

I "fired" my primary doc for this, as a matter of fact. I went in because my wrist hurts, pretty much all the time. Trying to figure out if it was carpal tunnel, your basic arthritis, or a symptom of possible autoimmune disorder (to which I'm genetically predisposed). She did a blood draw (testing for autoimmune markers, which all came out negative) and instead of treating my hurty wrist, or referring me to an othopedic specialist, or to physical therapy, she remained steadfastly focused on my cholesterol, despite the fact that I was at a healthy weight and all other risk factors were right down the middle where they're supposed to be (blood pressure, heart rate, etc.). I'd go in for a follow up, complain about my wrist again, and be asked if I was taking the statins.

Finally, I just quit going to her, quit taking the statins, never had my cholesterol checked again to see if they'd done any good (or if the subsequent weight loss did anything to the numbers), and my wrist still hurts. I think that was about four years ago. I am not convinced that I "need" statin drugs and am not interested in taking them for the next 30-40 years even if I do. I'll do my best with diet and exercise and just take my chances.

Mental note: I really need to find a new primary doctor. For this hurty wrist.

[vivalostwages]

My doctor is always bugging my mom to take them again. She is nearly 86 and has never had any heart issues. High cholesterol is familial for her and for me.

Dogzilla, my doc could not do anything for my hurty thumb, so I went to the acupuncturist a couple of times already and it is significantly better.
Just an idea.

[Dogzilla]

Originally Posted by vivalostwages

My doctor is always bugging my mom to take them again. She is nearly 86 and has never had any heart issues. High cholesterol is familial for her and for me.

Dogzilla, my doc could not do anything for my hurty thumb, so I went to the acupuncturist a couple of times already and it is significantly better.
Just an idea.

Thanks. Tried that. Didn't work. Also tried yoga. Still hurts.

[shiftless]

Originally Posted by Dogzilla

I "fired" my primary doc for this, as a matter of fact. I went in because my wrist hurts, pretty much all the time. Trying to figure out if it was carpal tunnel, your basic arthritis, or a symptom of possible autoimmune disorder (to which I'm genetically predisposed). She did a blood draw (testing for autoimmune markers, which all came out negative) and instead of treating my hurty wrist, or referring me to an othopedic specialist, or to physical therapy, she remained steadfastly focused on my cholesterol, despite the fact that I was at a healthy weight and all other risk factors were right down the middle where they're supposed to be (blood pressure, heart rate, etc.). I'd go in for a follow up, complain about my wrist again, and be asked if I was taking the statins.

Wow. Almost the exact same thing for me. I went it for a possible torn knee ligament and I couldn't get my doctor to even look at my knee. After a long discussion about the dangers of high cholesterol and a lot of pressure to increase my dosage of Crestor I did get him to take a quick look. I should "call if the swelling didn't go down" was what I got for my trouble and expense, plus a new perscription for Crestor. He was "fired" and I found a real doctor rather than a drug pusher.

[Kinthalis]

Scary stuff. So what the hell DOES prevent heart diseases like this?

I think I know what people are going to say, but still...

[Wesley Clark]

FWIW, it was my understanding that part of the muscle damage was because the HMG-COA enzyme that statins block also manufactures CoQ10. So taking a CoQ10 supplement may help with that side effect.

http://archneur.ama-assn.org/cgi/con...ull/62/11/1709

However I do not know if Coq10 is the only thing you need, or if that is just one of many things you would need to do to counteract the muscle problems from statins.

[Wesley Clark]

Originally Posted by dataguy

I did quite a bit of research on this topic a couple of years ago. Some of my conclusions:
1. If you've previously had a heart attack, statins can help prevent another one.

2. The reason they help has nothing to do with lowering your cholesterol. It's because of their anti-inflammatory properties.

3. For the average person, they offer no benefit and have potentially serious side effects. Especially women, for whom there is no clinical evidence that high cholesterol is any kind of health risk.

4. Consensus has nothing to do with facts. Facts are determined by supporting evidence, not my majority vote. There was so much conflicting opinion about the link of cholesterol to heart disease that a conference was convened in 1984 called the NIH Consensus Development Conference on Lowering Blood Cholesterol to Prevent Coronary Heart Disease. The purpose was to decide on the "official" medical position on this topic. In other words, a committee was going to decide what the "facts" are. This is not the normal scientific process.

5. All research in this area indicates that interfering with the normal production of cholesterol in your body is detrimental to your health. Cholesterol serves many useful and vital functions in your body. It is not a toxic substance.

Your link was interesting, what have you found over the years on these issues.

1. What do you know about and think about the LDL-oxidation theory of arteriosclerosis? Instead of LDL levels themselves being the risk factor, it is the oxidation of LDL that is the risk and that a person needs to address.

2. How/where did you find that statins were anti-inflammatories? Would the benefit they show be tied into point 1, by reducing LDL oxidation?

3. Do other anti-inflammatories have similar health benefits? I have read up on anti-oxidants and anti-inflammatories for CVD. But I don't know how much of that research was done by people with a financial interest in the products being researched.

4. I believe Lipitor is the only statin shown in studies to help prevent heart attacks (I believe, I could be wrong). But those were for people with a history of heart attacks. Do you know if lipitor is somehow different than the other statins?

[Wesley Clark]

Originally Posted by Kinthalis

Scary stuff. So what the hell DOES prevent heart diseases like this?

I think I know what people are going to say, but still...

Aside from the 2 obvious lifestyle changes people give (well 3, quit smoking).

Keeping your stress low
Maintaining good social contacts
Getting good sleep


People really underestimate things like those because as a society we are so obsessed with obesity (and by proxy diet and exercise because they are seen as vehicles to combat obesity) that we overlook tons of other things people can do to get healthy. Even Dean ornish made addressing emotional problems a huge aspect of his reversing heart disease program.

Aside from that there are several supplements on the market, but as I said in my earlier reply I have no idea how valid the science is behind them. CoQ10, ALCAR/ALA, Vitamin K2, Pomegranate, grape seed extract, resveratrol, trimethylglycine, etc.

http://www.lef.org/protocols/heart_c...lerosis_01.htm

But obviously, supplements have pros and cons just like drugs. I don't think I can take pomegranate supplements because they interfere with the enzymes that break down some Rx drugs I take. If I take too much resveratrol and i get a nosebleed it can take an hour to stop. etc.

[dataguy]

Originally Posted by Wesley Clark

Your link was interesting, what have you found over the years on these issues.

1. What do you know about and think about the LDL-oxidation theory of arteriosclerosis? Instead of LDL levels themselves being the risk factor, it is the oxidation of LDL that is the risk and that a person needs to address.

2. How/where did you find that statins were anti-inflammatories? Would the benefit they show be tied into point 1, by reducing LDL oxidation?

3. Do other anti-inflammatories have similar health benefits? I have read up on anti-oxidants and anti-inflammatories for CVD. But I don't know how much of that research was done by people with a financial interest in the products being researched.

4. I believe Lipitor is the only statin shown in studies to help prevent heart attacks (I believe, I could be wrong). But those were for people with a history of heart attacks. Do you know if lipitor is somehow different than the other statins?

I haven't kept up with all the current research on this topic.
1. I'm aware of this theory. In my opinion, it has more supporting evidence than the simple high LDL=high CVD risk hypothesis.

2. The anti-inflammatory effect of statins has been noted in several studies as the explanation for reduction of cardiovascular events. Here's a link: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC59622/

3. I have no information on the effects of other anti-inflammatories.

4. I have no information on Lipitor compared to other statins in this regard.