Are statins essential if you are suff... - Atrial Fibrillati...

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Are statins essential if you are suffering from AF and/or past strokes? And how much is 'good'?

oscarfox49 profile image
66 Replies

Just seeking some views on what constitutes the 'correct' level of statins to take in various situations.

I have been taking 10 mg of simvastatine for six months and found this is no problem for me and it has marginally reduced what was a very low LDL cholesterol level in the first place.

But my doctor is saying that as I am listed in the 'existing heart condition' category, even though my LDL level is lower than it was six months ago, he would like me to double the statin to 20 mg. I started doing this a few days ago but feel a lot worse with muscle pains, indigestion and sleeping badly (which of course might be coincidence).

As my stroke three years ago came from a blood clot caused by AF rather than a particular heart condition or blocked artery, I rather suspect that he is just 'chasing the number' and wanting to hit the target of 0,7 g/L of LDL (calculated); mine is 0,97 g/L. He actually says his target is 0,55 g/L.

I wonder what others think about this? If I had high LDL I would of course agree with him, but I really don't want to take more drugs that will make me feel worse when life is back to a much more normal basis now. How do I assess the real risk level when 'heart conditions' are so variable and AF is not necessarily the same as other conditions caused by too much bad cholesterol.

Interested in your views.

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66 Replies
Vonnegut profile image
Vonnegut

I am occasionally told my cholesterol is high after a blood test so I take red yeast rice capsules until the follow up test when it has always gone down impressively and I have the Flora spread that is supposed to reduce cholesterol. Guess you have to find what works for you and doesn’t come with unpleasant side effects.

mjames1 profile image
mjames1

Not sure what your pre-statin LDL was, but my target is under .8 g/L. To that end I'm take 20mg/day of the Superstatin Crestor. I think these numbers come from trial data showing plaque regression at that point, but not 100% sure. Statins also have an anti-inflammatory effect in addition to their LDL lowering (and HDL raising) properties that can help certain conditions. Now whether you should increase your statin dose to reach .55g/L is another story. I'd simply ask him where he got that target from. He might (or might not) have a convincing argument. Statins as we know are a two-edged sword. Unfortunately no free lunch for many of us.

Jim

mav7 profile image
mav7

healthline.com/health/high-...

oscarfox49 As mjames states above, certainly best to discuss with your doctor.

Check the above article and scroll down to the chart. Below 70g is recommended if there is presence of heart disease. Seems his target of 55g/l is reasonable.

I have been taking 20mg of Lipitor for 13 years without side effects. My LDL is 51g/l.

CDreamer profile image
CDreamer

I’m afraid I refused to take them, for so many reasons. I believe the most useful purpose for AF are as anti-inflammatory agents but there are other natural aids and foods which work just as well.

BaileyC57 profile image
BaileyC57 in reply to CDreamer

Please name them !

CDreamer profile image
CDreamer in reply to BaileyC57

Very basic Article from Harvard health.harvard.edu/staying-...

I could give you a host of reliable websites saying the same thing. It’s remarkably easy to research on the web - use only verifiable websites and known names such as Dr Chatterjee, Dr Rupy thedoctorskitchen.com/podca... and then there is all the research from the Zoe study and Prof Tim Spectre - I could go on and on.

All say the same thing. Morning smoothie with pineapple, coconut, broccoli, spinach, water melon, green apples, olive oil. In addition I always take Resveratrol, plant sterol supplement and range of vitamin supplements. If nothing else, eat daily portion of mixed berries and purple food.

I stopped worrying about lipid levels as there is bunch of evidence that questions the usefulness of repressing lipid levels IF you are healthy weight, take exercise, have no genetic familial cholesterol issues and eat mainly plant based foods.

I have an autoimmune condition and systemic inflammation and this works for me.

There was a post a few weeks ago with an Infograph by someone, sorry cannot remember who, with some excellent information who also recommended Resveratrol.

Robfromwales profile image
Robfromwales

can the levels above be translated into Uk figures to get a better understanding of what is being asked?

Autumn_Leaves profile image
Autumn_Leaves in reply to Robfromwales

97mg/dL = 2.5mmol/L

70 mg/dL = 1.8mmol/L

55mg/dL = 1.4mmol/L

Robfromwales profile image
Robfromwales in reply to Autumn_Leaves

Thank you .

Gumbie_Cat profile image
Gumbie_Cat in reply to Autumn_Leaves

Goodness, thank you! Got worried there. I’ve never had statins suggested for me at all. Not sure if it’s just different in Scotland.

Autumn_Leaves profile image
Autumn_Leaves in reply to Gumbie_Cat

I’ve never been offered them either but my cholesterol is low to begin with, so it makes no sense.

Gumbie_Cat profile image
Gumbie_Cat in reply to Autumn_Leaves

Just realised this was an old post, so apologies. Last time it was checked it was 5.3 total, which seemed high - but they’re happy at the ratio, HDL ratio is good. Though I feel it could do with another check now I’m in permanent AF.

CDreamer profile image
CDreamer

I would add bitter herbs and many spices such as cinnamon - which are classed as foods.

Sunnyday2022 profile image
Sunnyday2022

Good morning. I am in a similar predicament re statins. My cholesterol is fine but my GP wants me to start statins due to my paraxysmol AF (which is controlled at the moment with low dose Flec).

My cardiologist had never mentioned statins but when I queried it directly with him said there may be some benefits but that if I get bad side effects to stop.

It is so hard to know what to do as I am unhappy just taking more and more meds!!

Vonnegut profile image
Vonnegut in reply to Sunnyday2022

So don’t take them! You are the best judge of how you feel and most drugs, even the ones that are helpful, like Flecainide, come with unpleasant side effects like constipation for me which I never had before and adds to the fatigue I have! Doctors just seem to have a tick box attitude to prescribing and we know we are all different.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Vonnegut

Hi

Fr constipation try COLOFAC 140mg. Take 1 pill with a large glass of water.

Before b/fasr wait 1 hour. It will work by relaxing colon and bowel. Repeat before each meal if necessary.

I take kiwifruit, figs, prunes, etc on porridge in morning as an alternative. Always constipated after/during hospital stay!

cheri JOY. 74. (NZ)

Vonnegut profile image
Vonnegut in reply to JOY2THEWORLD49

It’s ok now, a little after my regular 5 prunes with breakfast muesli and fruit and vegan yogurt and “milk”and a glass of prune juice, I usually have success, as I did today, or even before breakfast, but I am aware of a problem I never had before. I have used occasional lax tea or another pill at bedtime but all those things come with warnings that they should not be taken every day. I have never heard of the pills you suggest but manage ok though don’t like the bloating either ( and the flatulence that comes as a “side effect” of the drug that keeps my heart in order!

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Vonnegut

Hi

COLOFAC was prescribed by an Australian surgeon who did my colonscopy.

I need to go before orafter breakfast daily.

Cheese doesn't help!

He said I had the longest colon pushed int a small space tat he had seen.

I reckon I have long body and shorter legs!

I like prunes too.

cheri JOY

Autumn_Leaves profile image
Autumn_Leaves in reply to JOY2THEWORLD49

I have a “long and tortuous” colon but also I have long legs 😉

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Autumn_Leaves

Hi

Wow!

I get the 'obese' label whereas with the shorter legs and long body my weight should be OK.

I know that my legs are shorter as jumping over rivers and streams is

horrendous!

Others jump over and I hesitant exclaiming "I cant get over"!

JOY

Autumn_Leaves profile image
Autumn_Leaves in reply to JOY2THEWORLD49

I’m tall so I’ve got long arms too! I always have people asking me to reach for items from the top shelves in supermarkets 😂

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Autumn_Leaves

Hi

Hav you tried COLOFAC 140mg yet?

The Urologist has offered me a PILL IN POCKET for bladder. Apparently if I have to go somewhere where I may be caught with a overactive bladder I can use PILL IN POCKET which before going out will relax bladder until full with no surprises!

cheri JOY

Gumbie_Cat profile image
Gumbie_Cat in reply to JOY2THEWORLD49

I also have a long body and short legs. Inherited from my dad, who used to say ‘I’m tall sitting down!’.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Gumbie_Cat

Hi

You're the best!

Now what r u grumbling about?

Me, not now as Grandpa's (Dad's side) and my specs no longer required. I have my A1 distance sight back. And still read newspaper under light.

Gall Bladder removed like Grandpa (Dad's side)- disintegrated!

Mother's mole on cheek and missing 2 x2nd teeth. Unfortunately mine are together upper right. Hers and sister's upper 1 x each side.

Heart problems probably Dad's and brothers but different.

Thyroid - goitre Mum's sister.

We make up each of our parent's genes!

Living long 90s my Mum and Dad's both sisters. My Dad's smaller feet than Mum's.

Interesting to make a GENE'S FAMILY TREE! EH!

cheri JOY. 74. (NZ)

Autumn_Leaves profile image
Autumn_Leaves in reply to JOY2THEWORLD49

I might also try Colofac as I’ve not tried it yet. It’s available to buy OTC in the UK. I read that it’s an antispasmodic, as is peppermint oil which I found very helpful for IBS spasms in the past. I don’t get so much of the cramping these days but my colon is a bit sluggish. The last medication I tried (Linaclotide) gave me a lot of stinky gas, bloating and abdominal discomfort and after about 2 weeks when it became ineffective. It took several months at least for the stinky gas problem to diminish. The problem with these meds is that they have the potential to upset the gut microbiome and I don’t want to do that. At the moment I’m using adding ground flaxseed to my meals (also a good plant source of omega 3). I also have psyllium husk mixed with a full glass of lukewarm water first thing. I prefer the food first approach but appreciate that it doesn’t always do the trick for everyone.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Autumn_Leaves

Hi Autumn Leaves which have left NZ and June. July, August are our winter months.

I started turning on the towel rail until 2 days ago. 2 hrs 8pm-10pm. With timber sarking it radiates through the walls. 27m in this little Unit.

If I am in trouble with morning ablution 1 glass water with a Colofac bingo works.

From hospital I'm desperate and ask Dr for glycerine suppositories NOT ENEMAS.

Best on your journey. Apparently Diltazem can give you constipation.

I was weighed today. Lost 6kgs. Not sure why eat less?

cheri JOY

Sunnyday2022 profile image
Sunnyday2022 in reply to Vonnegut

I am absolutely fine on Flecainide and as it controls my AF I am happy to continue taking it. At the moment I am hanging fire on statins as I am about to start on an anticoagulant and want to see how that goes first.

I agree that all drugs have a downside which needs to be weighed against the potential downside of not taking them.

Vonnegut profile image
Vonnegut in reply to Sunnyday2022

If the flecainide stops you having episodes as it mostly does with me, why take the anticoagulants? I was told by an EP that unless an episode went on for a long time with a high heart rate one was not at risk of stroke. So I stopped taking them and still here! The flecainide causes enough side effects without adding to them innecesarily!

Goosebumps profile image
Goosebumps in reply to Vonnegut

That is most interesting what the EP said to you. I think myself and hundreds of other members of the forum would love to see the study data (or studies) that their statement is based on.

I have read that the size and configuration of the left atrial appendix is a critical factor in the stroke risk.

Vonnegut profile image
Vonnegut in reply to Sunnyday2022

And red yeast rice capsules will bring your cholesterol down if, like many people, you don’t get on with the side effects of statins.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Sunnyday2022

Hi

More important is the anti-coagulant.

cheri JOY. 74. (NZ)

Sunnyday2022 profile image
Sunnyday2022 in reply to JOY2THEWORLD49

yes indeed and I am just about to start on those.

Crumble2 profile image
Crumble2 in reply to Sunnyday2022

I was prescribed statins by the cardiologist as research has shown they can help with PAF. I have a ‘highly sensitive’ something in my heart (can’t remember which bit 😂) and the statins should help. I’ve been on them for 2 years now and I believe they have helped a lot.

pusillanimous profile image
pusillanimous

I take just 5mg of Aspavor per day,. It keeps my cholesterol around 4, has no side effects and is good for my anxiety as it makes me believe that together with the Eliquis and Biso I am doing my best to minimise the possibility of a stroke !!!!!!!

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to pusillanimous

Hi

ASPAVOR what is it?

cheri JOY

pusillanimous profile image
pusillanimous in reply to JOY2THEWORLD49

It's Pfizer's Brand name for atorvastatin. Sorry, I expect people take lots of different brands - I assumed this was a common one !

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to pusillanimous

Hi

Mine doesn't come in a. packet so I don't know what brand.

Thanx for that.

cheri JOY.

Murdy1 profile image
Murdy1 in reply to pusillanimous

That's interesting, thanks for sharing. Tom

Ppiman profile image
Ppiman

The science has convinced me to keep taking them after stopping for a while because of negative comments on forums. I was lucky not to have any side effects that I am aware of.

It seems that early deaths and morbidity are reduced by taking statins, and most evidently so in those who have suffered a previous cardiac or cardiovascular event. No one is forced to take them, of course, and there are likely other untested ways to achieve similar effects.

The cause of stroke in AF patients is still unclear and might yet be shown to be other than the actual fibrillation itself, perhaps being caused by an anomaly with the structures of the heart, with the finger pointing at a small and variably shaped structure called the left-atrial appendage.

Steve

Vonnegut profile image
Vonnegut in reply to Ppiman

I had an echocardiogram shortly after my paroxysmal atrial fibrillation diagnosis and there was nothing wrong with the structure of my heart. It’s just an intermittent electrical fault!

Ppiman profile image
Ppiman in reply to Vonnegut

That's the same as many of us, but that isn't the point I was making. I'm sorry if that wasn't clear - these threads can be long and points easily lost.

The atrial appendage is a part of all our hearts and it varies in shape. Some shapes ("cauliflower" shape being the worst) have been shown to give rise to small blood clots, which might be worsened by fibrillation going on, although the link is not 100% clear.

Also, I suppose it can be said that an "electrical fault" is still, essentially, a physical fault in the sense that the heart cells have physically changed the way they work and now pass electrical signals differently, often randomly, to cause arrhythmia. Drugs like beta-blockers work by altering the chemicals around and within the cells to allow the electrical currents to flow differently and more safely, for example.

Steve

Vonnegut profile image
Vonnegut in reply to Ppiman

And in my case the lowest dose of Bisoprolol brought my heart rate down too low! We are all different but I was told my heart structure was fine after the echocardiogram and guess the guy knew about such things so I believe that!

Ppiman profile image
Ppiman in reply to Vonnegut

It brings mine down pretty low, as well, but for now that seems to be okay and it keeps it calmer.

Steve

Vonnegut profile image
Vonnegut in reply to Ppiman

So not dangerously low as it did with me!!

Ppiman profile image
Ppiman in reply to Vonnegut

No, but I'm only on 1.25mg, so if I need more, I don't know what will happen.

Steve

Vonnegut profile image
Vonnegut in reply to Ppiman

Bisoprolol only slows the heart down but doesn’t do anything for the irregularity which is what Flecainide does! That’s what I was prescribed by an EP after 1.25 of the Bisoprolol lowered my heart rate too much! At first I took it as a PIP when I had an episode (checked with my Kardia) and I was only told to take a Bisoprolol if my heart rate exceeded 140 twenty minutes after taking the Flecainide which rarely occurred. That’s what I did until it was decided that I take the Flecainide daily morning and evening which has virtually put an end to episodes and the odd one can be soon ended with an extra one! Of course, it does come with side effects but I’m still alive at 79 and able to enjoy much of what life has to offer!

Ppiman profile image
Ppiman in reply to Vonnegut

I was told that I'm unable to take flecainide owing to my heart's electrical timings.

Steve

Vonnegut profile image
Vonnegut in reply to Ppiman

That’s interesting but sounds odd. Bisoprolol won’t be of any use over the irregularity but if you can cope with the far lower heart rate guess it might work for you in a way! Three days on the lowest dose and the pharmacist and doc took my pulse and told me to stop taking it immediately!! Of course we are all different so it might work for you! Hope it does!

Nugger profile image
Nugger

Checkout ( The clot thickens ) youtube

Silvasava profile image
Silvasava

I had a stroke in December 2019 and was put on 40mg of Atorvastatin in spite of my cholesterol levels being good. I developed pains in my wrist and hip and after a discussion with my doctor I reduced to 20mg as they also have anti inflammatory benefits. No issues since. Subsequent investigations showed Afib and DCM.

LaceyLady profile image
LaceyLady

my nurse said to me she ‘had’ to offer me a statin even though my cholesterol was only 4.8!! She knew my answer NO, why did she have to offer? ££??

Autumn_Leaves profile image
Autumn_Leaves in reply to LaceyLady

You were probably offered statins because of your overall cardiac risk as calculated by an algorithm, based on not only your cholesterol but also your other blood test readings along with your medical history. There is pressure from the NHS for GP practices to cut their prescription bills. This is not America, as the late David Bowie sang.

LaceyLady profile image
LaceyLady in reply to Autumn_Leaves

she was my diabetes nurse and she’d no idea either. It’s all to do with £££ I had a patient who worked in Drs surgery years ago and she said the drs get taken out for meals by the reps🙄

LaceyLady profile image
LaceyLady in reply to Autumn_Leaves

Statins are linked to T2D my ex nurse/midwife friend been on the for years suffered severe pains in her legs found they’re linked to diabetes 😵‍💫

Murdy1 profile image
Murdy1 in reply to LaceyLady

At 4.8 you're fine (my opinion) may you keep saying No. Good health to you LaceyLady. Tom

LaceyLady profile image
LaceyLady in reply to Murdy1

Thank you 💗 I’m on enough horrible medications with Side effects that I have to take without this.

Vonnegut profile image
Vonnegut in reply to LaceyLady

Whenever I am told my cholesterol is “borderline” or something like that, I take red yeast rice capsules until the next time test when it is always at an acceptable level. As I have never been overweight etc and an echocardiogram showed no structural problems with my heart and I am not keen to take lots of drugs regularly, that seems to work fine for me but we are all different and as you say 4.8 is not 5 or over!!!

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to LaceyLady

Hi

My National Heart Specialist said that he wanted me to be at 4. So if the thinking the same to bring you down more.

10mg Avorastatin would do that. Anything over 20mg will interfere with my Thyroxin and thyroid hormones.

I had a sore toe which was injured more than once on 10mg.

cheri jOY. 74. (NZ)

LaceyLady profile image
LaceyLady in reply to JOY2THEWORLD49

Check out statins and T2D

NZ rules May well be different from the UK. I personally do not like levels to be that low, all information and reasons need to looked at altogether t make an informed decision. Drs here NEVER look at the whole picture

localad profile image
localad

My total cholesterol was super high (13) back in 2010. I told the GP I ate low carb and was told "you are killing yourself'. I was sent to a consultant cardiologist who when asked how I ate (low carb) told me there was nothing wrong with me.

Haven't tested since.

Had a nuclear stress test in 2017 for a 4 month remote exped I was going on, Ejection fraction 68%. 'Normal', no indication of ischemic heart disease.

I did start paroxymal AF in Jan 2018. It became constant persistent by September 2018. That lasted till Jan 2021. On bisoprolol then sotalol then amiodarone (plus edoxaban throughout) but no statin. Ablation Jan 2021 sorted the AF (and a bit of flutter)

Now no caffeine and limited alcohol, which I've recently found my heart is sensitive to.

Back to zero medication, (not even an anticoagulant). Still no statin.

71. normal blood glucose. normal bp. normal weight. Still low carb. Still not tested statin since 2010.

Vonnegut profile image
Vonnegut in reply to localad

Congratulations!

Carew profile image
Carew

There are some known genetic variations which imply varied tolerability/likelihood of side effects of different statins. If you have had a suitable gene test, it might be interesting to look at this.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi Oscar

Statins.

You will have good and bad LDL. You subtract good from bad.

I was pushed into Statins at hospital post stroke. Mine too was caused by Af because of Thyroid Cancer.

I tried 10mg Avorstatin but it not only interferes with thyroxin but my big toe throbs. 2 accidents. Then a leg waking me up at night.

My doctor changed me to 10mg ezitimibre which I have found ou equal to 400mg avorstatin! Both legs hurt.

I will stop all statin and the ezitimibre.

My heart Specialist would like me at 4.0 when I am 6.2 less 1.4.

Statins keep cholesterol lower. But we all need cholesterol. Cases like a guy couldn't walk after taking Avorstatin for 2 years and a baby died when put on them..

Your choice but your level is measured different from NZ.

You can get high reading from high fat food or genes.

My carotid arteries were squeaky clean at the hospital. My stroke was called an embollic stroke another type of ischaemic.

Take care JOY. 74. (NZ)

Autumn_Leaves profile image
Autumn_Leaves

You have to look at the entire picture and not just cholesterol test results. Your cardiometabolic risks also need to be taken into account. If you have T2D and a history of stroke, your risk profile is different from someone who doesn’t have those conditions/medical history. I don’t know whether an LDL cholesterol result of 97 (2.5 in UK) is “very low” or not. You need to look at the situation from the perspective of all your risk factors and weigh those up with any side effects you might be experiencing. You could try dietary and lifestyle adjustments if you haven’t already done so, and see if that makes any appreciable difference but you might need a combination of meds and lifestyle.

skipthebeat profile image
skipthebeat

I was told the statin wasn't necessarily to lower cholesterol, but it works to stop existing plaques breaking off and causing a stroke. Speak to your doctor and ask for an explanation. Good luck.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

There is a combination to reach a conclusion of your Cholesterol.

Mine changes between 4.5 - 5.5 with the above done.

My stroke was caused by AF and 1 small clot to my left frontal lobe at 2am asleep. It awoke me.

On the 4th day it showed my 2 carotid arteries squeaky clear of plague, of blood clots etc.

But a shadow on my thyroid was biopsyed to show a carcinoma of 1.9mm Papilliary Cancer. 4 months later in February 2020 Thyroidectomy and 12 lymph nodes removed on right side. 2 were infected. I was lucky.

Now with 3 x yearly scans since I am all clear of that cancer.

I recall 2 studies of side effects of statins, 1 where a man after taking statins over 2 years could no longer walk and a baby born and kept on statins died.

Throw up a coin and see where it lands I say. Ha ha but above is not funny is it?

What did you decide?

cheri JOY. 74. (NZ)

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