Statins: See comments on both this forum and... - AF Association

AF Association

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Statins

Hylda
Hylda

See comments on both this forum and the Thyroid one about the advisability or not of taking statins. I have a chadvasc score of 3, old lady! and high blood pressure.

I take Dabigatran along with various bp meds and because of the statins no-one bothers to re-test my cholesterol level. I half-heartedly stop taking the statins and then resume again. I know you are unable to give advice, but does anyone have any opinions?

Di

10 Replies

Very strong ones - anti statins even though GP had to have the ‘conversation’ with me so they can be paid. Talk about big pharma influence on doctor decisions! After the ‘talk’ we had a sensible conversation and my GP agreed it wouldn’t be a good idea for me to take them as I have a neuro-muscular condition. I was offered genetic testing but as I doubt whether I would have taken them anyway - we both thought it a waste of time and money.

I then consulted a nutritionist and since following their advice and taking a food supplement called Cholesterase my levels came down from 7.2 total to 5.5 which I’m happy with as the LDL/HDL is excellent and my neurologist believes that cholesterol and keeping up fat intake essential for good brain function. I do have my cholesterol tested regularly and I eat a low carb - high protein/fat diet. My GPpractice automatically test cholesterol every 6 months or so but maybe because I won’t take them?

I found this article helpful - webmd.com/cholesterol-manag... but I also read Malcom Kendrick - The Great Cholesterol Con.

Personal opinion only!

BobD
BobDVolunteer

I refuse. Don't forget GPs get paid for these pushes.

ILowe
ILowe in reply to BobD

How right! GPs get paid to push, which also means they are sidetracked from doing good. James Le Fanu's recent book, Too Many Pills: How Too Much Medicine is Endangering Our Health and What We Can Do About It, explains this in detail.

Gfern
Gfern in reply to ILowe

Can you please explain how GP's get paid for prescribing statins I find it hard to comprehend and would like to know more and if my trust is being abused.

Dadog
Dadog in reply to Gfern

Good question Gfern. It's sure to be a roundabout back door system - but approved and made official by whom?

ILowe
ILowe in reply to Gfern

That is a good question. I hope someone on this forum who has first hand experience will comment. My main support for my assertion is James Le Fanu. He is a writer I know and trust. Here are a couple of quotes from his book, chapter 6. It is part of the way a new financial contract has been negotiated between the government and the GPs.

"The solution arrived at was that GPs would be ‘paid for performance’ – for their success in achieving measurable targets of, for example, the proportion of their patients on medication to reduce their blood pressure or cholesterol levels.

And so was born the Quality and Outcomes Framework – a framework (or method) for monitoring – and hopefully improving – the quality and the outcomes of medical interventions. The QOF (pronounced ‘quoff’), as it became known, was calibrated according to a points system, whereby GPs could achieve a maximum of 1050 financially rewarded points, 550 of which would be for their endeavours in achieving 76 targets (or indicators) across ten different medical conditions (heart disease, hypertension, diabetes, etc.) – that would make up a quarter of their income. The more points achieved, the higher their earnings would be." ....

"Consider Mrs Smith, a new patient, middle-aged and a bit overweight. You have just taken her blood pressure, which is slightly raised at 160/100. What do you do? You could ensure it really is elevated by taking it several times and, if it is, discuss ‘lifestyle changes’ such as losing a few pounds and taking more exercise, which might help bring it down – and arrange to review the situation in a couple of months’ time. She may by then have heeded your advice, lost some weight so her blood pressure now falls within the normal range. It is however much more sensible, if the GP is to maximise his income, to start her on the pills immediately. These are guaranteed to bring her blood pressure down and take him one step nearer to his target of the proportion of patients with well-controlled hypertension. Thus good doctors end up practising bad medicine."

Apparently, GPs have a series of questions to ask patients, and measurements to make, and they are obliged to offer a statin when the inevitably 'alarming' cholesterol lab tests come through. There is little room for professional judgement. Going against the imposed consensus about best practice is difficult.

Gfern
Gfern in reply to ILowe

Thanks for that I can see now how the problem can occur, it’s very worrying that patients care is determined by financial incentives. It doesn’t seem like a good idea at all and must be a cause of a degree of cynicism and mistrust between doctor and patients. If we can’t totally trust in our doctors who we need to look out for our health where is it going ,it must also cause unnecessary stress if you are questioning the decisions of those who should be best qualified to look after you.

ILowe
ILowe in reply to Gfern

How right. I consider myself relatively well informed, but I did not know about it until I read Le Fanu. The core of good medicine is a relationship of trust, and a confidence that the doctor will always act in the best interests of the patients, without fear or favour, without bowing to pressures of prestige, monetary reward, or opposing opinions. At least in other countries with private medicine, the financial incentives are more public. Now, I am not blaming doctors, and no doubt there are many out there who resist these pressures. But, still, it is creepy, and puts the responsibility on the vulnerable (the patient) to stand firm. I hope you have and continue to have a good relationship of trust with your doctor.

seasider18
seasider18 in reply to ILowe

Classifying a patient as T2 diabetic is also a nice little earner for them with twice a year blood tests and a half hour session with a practice nurse.. I was originally said to be glucose intolerant but later had a letter saying that diagnosis no longer existed so I must be T2. I would say that my blood glucose it like my cholesterol just slightly high and of course they keep on moving the goal posts. Recent papers say that T2 now consists of five different grades.

Lash65
Lash65 in reply to BobD

I refuse too. Caused me high blood sugar. They keep trying to push them on me though.

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