ok, not including quacks, New Age crystal worshippers, Eckhart Tolle & David Icke devotees -
What’s the undiluted, purely medical latest proof for use of statins to prevent heart attacks? Just today, the FDA issued a warning about 1 in particular and all in general. It’s well-known that they cause muscle aches & pains, and the warning is about a rare but real & fatal muscle complication.
Is it really proven that lowering cholesterol will prevent heart attacks, or at least clear arteries (like, 50% blocked now, down to 30% 2 years later)? Or has the medical establishment simply stuck its head in the sand, figuring that the benefits outweigh the risks no matter what, better to try something rather than nothing?
Is there any other alternative to statins, such as Red yeast rice extract, which in the U.S. anyway is emasculated, since it ain’t allowed to contain lovastatin?
What I’m looking for is treatments and/or substances proven to prevent heart problems or clear arteries years down the road, backed up by controlled clinical studies, not anecdotal stories. Any medical pros out there care to settle this controversy?
The Cochrane Collaboration is conducting/has conducted a review into statins and their use in the prevention of cardiovascular disease. It lists the following in the abstract:
The Cochrane Collaboration is a pretty reliable source for EBM.
Thanks for including the Cochrane link and abstract. There are (at least) two things worth emphasizing. Note the phrase ‘at risk’ in the quoted text in your post: “statins were beneficial in reducing the risk of cardiovascular events in people at risk”. In other words, not everybody benefits from them or needs to take them. Only people at risk (eg. strong family history, diabetics, high blood pressure, etc.)
The other point that I’ll make is that although statins are effective in preventing heart attacks, etc., a lot of people must be treated with them for, say, one heart attack to be prevented. For example, in middle-aged men with high cholesterol but who have never had a heart attack, most of the studies get results along the lines of 50 to 100 men need to be treated with a statin for 5 years to prevent one heart attack. Phrased differently, if you treat 100 men with high cholesterol with a statin for five years, 99 out of the 100 will experience no benefit and will have taken the drug for almost 2000 days for ‘no reason’.
So, I’d emphasize that a) statins aren’t for everyone and b) they are far, far from a magic bullet. In fact, despite their good ability to lower cholesterol, they really don’t have much of an impact in preventing first heart attacks.
For men with known heart disease, the number of men needing to take a statin to prevent a recurrence is much lower than the above. That’s more like on the order of 10 to 15 men having to be treated for 5 years to prevent a recurrence of a heart attack.
Good answers & cites so far. Is there a specific statin recommended for someone who:
a) has coronary artery disease, but already low ldl (~ 50)
b) has had an m.i.
c) is active, exercise everyday
d) needs to raise hdl
and e) has tried some before, with unbearable muscle pain, tightness in chest?
volleyballer, I have most of the conditions you cite, except I haven’t had a heart attack yet. I’ve been on Zocor since my angioplasty in March. Even without the Zocor, my cholesterol wasn’t high, but my triglycerides are a bit high, so they put me on the lowest standard dose of Zocor in an attempt to lower my triglycerides. It hasn’t worked so far, so my cardiologist just added niacin to my extensive list of meds – niacin is supposed to change the hdl/ldl balance for the better. I only started it a week ago, so it’s a bit early to tell if it’ll work.
I don’t have much chest pain, but when I do (usually once or twice a month), I’ll take a nitroglycerin tablet and it goes right away. I also take Imdur daily – it’s a nitrate that expands blood vessels, which helps prevent the chest pain. Of course that means I can’t take Viagra or Cialis, which might be an issue if:
[list=a]
[li]I had ED, or[/li][li]If I actually had sex[/li][/list]
I was taking Lovastatin for my high cholesterol, but I began to have leg muscle pain and weakness, so the doctor took me off that about a year ago. My cholesterol has not been high since quitting the medicine, but my leg muscles have never regained strength and are now quite soft. Some pain still exists too.