BobDVolunteer

The cynic in me says because doctors get paid more if their patients are on statins. It is one of the quality outcome frameworks (QOFs) brought in by the Blair administration here in UK. You are quite right in that AF related strokes are caused by clots forming in the pooling of the blood in the fibrillating heart rather than any plaque issues. After fifteen years on the things my GP and I had a full and frank discussion on the subject and I threw them away. We are still friends! This is a highly personal matter and each of us needs to make up our own minds as there are plenty out there who will promote these drugs.

Interstingly there seems to be a growing trend for people to take matters into their own hands and stop prescription medication, often with amazing and unexpected results.

emsling in reply to BobD

Thank you BobD. As always your reply is very much appreciated. I have been struggling with this problem for the last 3 years and I am coming to the conclusion now that I prefer quality more than quantity.

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seasider18 in reply to BobD

My wife's cholesterol was rather high last time it was tested and our GP said that the latest instruction is to tell the patient the pros and cons of taking them and to let them make their own decision based on that. Being very anti drug like me she said no to taking them. When he first prescribed them for me many years ago (2011) he was also taking them. I quite soon stopped taking them due to muscle pain. I asked how he was getting on with them and he said that he had stopped taking them. Running out of our time I did not ask why but he did have parents with a history of high cholesterol aortic aneurysms.

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BobDVolunteer in reply to seasider18

From CDreamer's post below it now seems that doctors get paid so long as they have had the conversation with their patients and not depending on them taking statins.

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CDreamer

The argument around statins is quite extensive and the trouble is that because the incidence of cardiovascular deaths declined in a population taking statins - it was thought and pushed by the pharmaceutical industry that statins would save thousands of lives a year - therefore everyone should take statins.

I have had the same conversation with my GP and declined the suggestion - which as far as the doctor was concerned was a tick box exercise - she had a red flag because my cholesterol levels exceeded 7 which means I should take a statin. Although she couldn’t say so, she indicated that in my position, she would also decline the offer - which rather makes a none sense of the whole exercise as far as I am concerned and like Bob - is solely so GP’s can secure income from the NHS.

They are paid for having the conversation with you, it is not dependant upon whether or not you take the drugs, I think it is important to make that clear as the powers that be who determine these protocols are concerned with population health - not individual health.

But we are individuals and important to remember that we need to be active agents in our own health and well-being and therefore I believe it incumbent upon us to understand the issues. It seems as though you may not have been well served by your doctors.

Best wishes CD.

seasider18 in reply to CDreamer

They could make a lot of money by saying they had the conversation.

Checking diabetics once a year is also a nice little earner. I had annual check ups since 2004 when my blood glucose was sky high from eating too much Manuka Honey and butterscotch. It dropped after stopping if but was then regarded as borderline. They soon moved the goalposts to put me into the T2 category. I tired of the annual reviews and ignored this years three reminders as all I got out of them was an early shower and a late breakfast

I then got a phone call from the practice to get me to comply. I refused but agreed to have a non fasting blood test and gave them some morning readings as I do occasional checks and also quoted my BP home readings. I've not asked for the results but assume if they were cause for concern they would have contacted me.

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Badger2021

Interesting comment in this review about most studies showing that muscle pains were just as common when patients were given placebo rather than statins

mayoclinic.org/diseases-con...

Auriculaire in reply to Badger2021

There is a statement in this article which is just not true-that having too much cholesterol in your blood leads to heart attacks and strokes. Study after study of cholesterol levels taken in hospital of patients presenting with heart attack and stroke show no such thing. It is a myth . Indeed in older people a higher level of cholesterol has been shown to protect in all cause mortality including cardiovascular. This is especially true for women. Even the statin pushers now admit that their efficacy has nothing to do with cholesterol reduction but their anti inflammatory properties. Given that their benefits are extremely modest I would prefer to hang on to my protective cholesterol and look at other anti inflammatory agents. If one looks at where statins act to reduce cholesterol in the mevalonate pathway in the liver it is clear that they also impair the production of co enzyme Q 10 which is essential for the production of energy in every cell of our body and especially in the muscles. And what is our heart? The most important muscle in our body. There is recent Japanese research showing that statins are contributing to CHF and artery calcification. To give an afib patient (who may be at risk of heart failure due to atrial enlargement ) statins is in my view ridiculous if not criminal. Co enzyme Q 10 is not the only casualty . They also prevent the manufacturer of other substances our bodies need such as dolichols and seleno proteins. In the 17th and 18th century the medical consensus encouraged doctors to "treat" their patients using mercury and arsenic. Today they do it with more subtle poisons.

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CDreamer in reply to Auriculaire

AGREED!

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CDreamer in reply to Badger2021

I have recently become interested in the nocebo effect - which seems not to be talked about - which makes me wonder if that is what this study is demonstrating? It would be interesting to add on a psychological profile to the participants.

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wilsond

This time last year I was on 80 mg of statins and 5 mg of bisoprolol. I had terrific muscle pain in my thighs,to the stage I could barely walk unaided. As part of my decision to overhaul my lifestyle ,through nutrition,stress relief( I left a stressful job etc) I insisted on a meds review and blood test after 3 months. My cholesterol had gone down by degrees,so we decided to cut the dose in half. Also dropped the bisoprolol except as pill in pocket. My muscles do not pain me at all now.

I agree with Bob and CDreamers,statins are lucrative for cash purposes and not really proven to be effective. I hope to reduce mine further,for the reason that if one day I do need to up the dose I have somewhere to go! Best wishes

AFCyclist

Interesting comment from Bob.

I have just had a blood test and my GP said that because my cholesterol was 5.6 I needed to be on statins to get it down to 4.5. I said that all my life it had been around 5.5, I do lots of exercise and have a healthy diet. I refused them.

Cyrtis

I was on statins and suffered quite uncomfortable muscle spasms. My GP changed me over to another statin and I have been fine ever since (a few years). My cholesterol is also fine also. It was over 7, now under 4 even on a low dose statin.

Badger2021

Do you know your 10 year risk of having a heart attack? NICE recommends this when considering statins

qrisk.org/three/index.php

CDreamer in reply to Badger2021

Well an interesting exercise - but still based on herd statistics rather than individual circumstances.

What about other lifestyle factors such as stress - biggest indicator for inflammation causing disease? What about sleep, nutrition or lack of? What about exercise? How come we are SO reluctant to do serious research and clinical studies into these factors? There is already good evidence that indicates health and well-being is directly related to education, financial and social status.

Written as I am listening to a radio programme on the impact on physical as well as emotional and psychological of stress. It is incumbent on society to change our ways and rely less on medical and pharmaceutical interventions and more on self care.

As it happens my risk factor, according to the survey was 10% in 10 years. I’ll take those odds over taking a statin any day as I find the benefits of taking a statin much less convincing.

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Badger2021 in reply to CDreamer

NICE does address some of these, and is careful to make it's recommendations evidence based.

nice.org.uk/guidance/cg181/...

If there is good evidence about sleep and stress in relation to heart disease, NICE will presumably reflect this eventally.

My score is 27% so I was happy to take Atorvastatin at maximum dose. I have had no side effects and have taken Statins for 20 years.

In my opinion Statins have saved, and will continue to save many millions of lives. There is also apparently hope that they will reduce the rate of ischaemic stroke and vascular dementia, independent of cholesterol levels, because of their suspected anti-inflammatory effect.

The NICE guidelines in this area seem very clear and reasonable when looked at as a whole.

If the 10 year risk of a heart attack is at a level with which the individual is uncomfortable, and all lifestyle issues have been addressed, then I think Statins should be discussed. The small number who develop side effects which persist can then reduce the dose or stop them.

It would in my opinion be unfortunate to demonise statins in the way that vaccinations have been with such catastrophic results.

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CDreamer in reply to Badger2021

I can see that and agree that it is the anti-inflammatory factors which seem to be more relevant than cholesterol but unfortunately it is only the cholesterol factor which seems to have stuck. Whilst I am sure that many people gain long term benefit, if you are one of the unfortunates who really do suffer the muscle pain affects then life can be be pretty miserable.

It is an individual decision and I can quite see that there is A place for statins - my concern is that it is often the first and sometimes the only option discussed, probably because of the pressure on doctors to complete the consult within 10 mins. Certainly the last time I saw my doctor last week she was very stressed (= inflammatory response) and spent 5 minutes telling me that she hadn’t had a ‘quick’ consult all morning.

I understand that it is a very personal decision, based on individual risk factors.

I think discussing the pros and cons is different to demonising as I can also see that looking through epidemiological lens it makes sense and from the pharmaceutical excellent profits. It is that tension again between individual experience and group health.

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Hidden in reply to Badger2021

Very interesting, my score was 18%

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seasider18 in reply to Badger2021

Do you take them yourself ?

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Badger2021 in reply to seasider18

Yes, as I said above, for 20 years with no problems. On Atorvastatin 80mgs for past 5 years.

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seasider18 in reply to Badger2021

Atorvastatin was the one that the professor I saw at Imperial College put me on when I saw him in 2011. My GP was not to happy as it was evidently the most expensive one at that time.

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BobDVolunteer

There is an excellent book who's author escapes me but I think the title is "Too many pills".

Badger2021 in reply to BobD

Is he still alive?

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CDreamer in reply to Badger2021

Sorry Le Fanu. polypharmacy.org.uk/blog/?p...

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CDreamer in reply to BobD

James Le Foey? - studied medicine at Cambridge. Excellent book, intelligently written.

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sleeksheep

From a personal perspective my thoughts on atorvastatin is it should never have been prescribed for me. I was pre diabetic and I was carrying numerous joint injuries which rely on muscle strength to remain fluid.

Statins are listed as a contra drug for all pre diabetics , it retards insulin production in the pancreas and has the same effect on CoQ10 which is your muscles building block.

My blood glucose rose till I was Diabetic 2 even thou I had reduced my atorvastatin to 5mg a day because of severe calf and thigh pain.

I suspect it also interferes with your metabolic rate as after I quit statins my blood glucose dropped from 8.4 to 5.9 , my weight dropped from 89kg to 80kg and my metabolic rate has returned to what I used to experience pre statins.

Unfortunately the muscle loss is not so easily recovered.

As a side note six months after stopping my eyesight has improved , no blurred vision any longer. It seems thats another " benefit" of statins !

I told my Dr. I will never take them again and she had no worries about my decision.

emsling

Thank you all very much for your response