Statin drugs

[gu99]

I have battled high cholesterol for most of my adult life and am now at 170 (total) with the aid of a statin drug.  I have seen some reports that say that even though statins reduce cholesterol numbers there isn't the expected correlation with reduced incidence of heart disease. Is that true?  And if so, why should I continue taking a statins and risk liver damage?

[erijon]

Interesting story on the long term effects of statin use on all cause mortality numbers. An excerpt from the link below;

“The long-term benefit unexpectedly is not protection against heart disease and stroke, but against other illnesses that appear to be linked to infection,” said the lead author, Dr. Peter S. Sever, a professor of therapeutics at Imperial College London."

http://www.goupstate.com/article/20110905/znyt04/109053011

Also;

"The benefits of statins for preventing heart attacks and strokes are well-established, but after long-term follow-up the most significant effects seem to be on deaths from other causes. It's quite remarkable that there is still this difference between the two groups, eight years after the trial finished.

"Some studies have suggested that statins protect people against death from infectious diseases such as pneumonia. More research is needed to explain how these drugs might have unforeseen actions that prevent deaths from other illnesses."

http://www.sciencedaily.com/releases/2011/08/110828101912.htm

Very interesting!

Jon

[twopack]

It looks to me like that last study erjon cited reported a decrease in RELATIVE RISK but no significant decrease in cardiovascular DEATHS with statin use.  Yet it reports a reduction in deaths WAS found for other diseases.  

This IS interesting!  There’s finally a study that makes sense to me.  The anti-inflammatory effect of statins (natural OR synthetic) is well known.  It makes sense they would be beneficial to many body systems, including the CV system.  After all, it is also widely accepted today that inflammation is a leading factor in the development of heart disease and sudden adverse cardiac events.  

Inflammation causes the body to lay plaque down to 'repair' vessels that aren't actually damaged.  The plaque can sit there or it can collapse/break off in the future.  We all know what happens then.  If we can reduce the inflammation that triggers this process we can reduce the amount of useless plaque lining our blood vessels.  Less plaque means more patent blood vessels (little matter the cholesterol level) and reduces the risk of sudden cardiac events from plaque collapse/emboli at the same time.

It has actually been proposed by some that the anti-inflammatory nature of statins may be more important in improving CV health than their ability to lower cholesterol levels.  In addition, the anti-inflammatory benefits of statins are achieved with low dose administration.  Higher doses have not been shown to further decreases inflammation.  For me, it’s important to know I can choose a low dose statin therapy and receive important benefits while avoiding the side effects higher doses are likely to cause.  (I’ve been there.  Can’t go again.)  

IMO, Gymdandee gave some excellent direction about lifestyle changes that absolutely work.  Anyone who can’t take statins, or prefers not to, should go back to his remarks and take notes.  I’ve seen those very things make a huge difference as I’m able to work them into my changing lifestyle.

The other stats in this thread seemed meaningless to me.  How can anyone assume results on a study that was never finished?  Initial results looked terrific?  That’s wonderful!  But it doesn't mean anyone can project initial findings into results that MIGHT have resulted further into the study.  It seems to me when you abandon your own study protocol you have abandoned the study.   Studies should be, and are, stopped immediately if it becomes clear participants are being significantly harmed.  Otherwise, I say take them to the intended conclusion.  To do otherwise raises suspicion.  After all, this wasn’t a drug targeted for a disease that had no present treatment or for patients who were desperate for it to come to market.  Clearly, the motives came from elsewhere.  Perhaps someday drug trials will be performed by people other than the manufacturers.  Those trials might be a bit easier for me to trust.  But that’s me.

[erijon]

I understand your concern over studies funded by the drug manufactuers, however please remember that the study is not controlled by the manufactuer. The FDA places an Independent Data Monitoring Board in control of all data resulting from studies for the sole purpose of keeping it out of the hands of the manufactuer. The decision to stop the study was ultimately made by the FDA based on the recommendation of the IDMB for JUPITER, not the manufactuer.

If you want to look at true ARR and NNT numbers, you only need to look at studies for other statins. The one most commonly used is the 4S study for Simvastatin which showed a NNT of 11.7.

[maydaykay]

All I can say is, I have known several people who had very high cholesterol who lived into their 90's -- or in the case of my father-in-law's bride of 10 years -- STILL living at age 103(!), whose cholesterol has always been close to 300, and she has never taken ANY drugs! Then, there's my own history, which never included high cholesterol (has always measured below 155-160), but I had triple bypass surgery 10 years ago at age 51! I have been taking statin drugs ever since, my cholesterol hasn't changed. Recently, my doctor increased my dosage dramatically (trying to get my LDL under 70 - the highest it's ever been at in all these years), and I have definitely suffered from increased muscle pain, peripheral neuropathy, joint pain, and memory loss since the change. For years, I've been saying, "If it hurts this much to be 59...60...61, then I don't want to live to be 80 or 90!" With this most recent (3months) change, I realize that I have been suffering from the statins for a long time, and although I have a history of heart disease, I would rather take my chances with changes in diet, exercise, stress elimination, and NO STATINS!!

[gymdandee]

When you get your blood test for cholesterol do they do a particle size test? large is OK small isn't good!

[erijon]

How do you know it's the statins? Muscle pain only occurs in 5.3% of patients, your issue could something else. One thing that is known, an LDL over 70 for an individual with known heart disease is a risk. If you can do it with diet and exercise and some lifestyle changes, even better, but I would not stop the statin without discussing it with your cardiologist.