I have paroxysmal afib and had a TIA 2 years ago. The afib is much improved after an ablation last year and I've been on DOACs since the TIA.My cholesterol and triglyceride levels have always been spot on and remain so but my GP surgery is desperate to get me on statins. This is because current NHS wisdom is that, because of the TIA and afib, my levels need to be aggressively brought down. I'm not convinced and my GP surgery just tells me that I need to hit the NHS targets without really telling my why.
I'm generally fit, healthy and active. I don't want to be taking any drugs unnecessarily.
Can anyone here convince me to take statins?
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MisterMagoo
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Up until 2007 ( aged 63 ) I always reckoned I had lived 'the good life' .... wine, women and song ! I had at that date recently returned to UK from many years, probably over half a lifetime, living in Australia. Had to visit my GP ( in Surrey ) for an unrelated matter and was asked if I was on statins .... no I replied, I was not on any drugs. I was then prescribed Simvastatin 40mg - good for my Cholesterol I was told. I've been on statins ever since. At this point I'd regarded myself as pretty damn healthy. Superman, almost.
January 2010 .... got mugged by AF .... no warning, thought I had flu, then BP dropped, long story short - into A & E I went. Diagnosed with AF at that point and still on statins. Had a brief flirtation with Atorvastatin but am now back on Simvastatin.
So, to your question ........... no I can't convince you to ... or indeed not to. All I can say taking them has done me no harm (I'm now 79 ) .... but I have to say back in the past my BP was always around 148/90 ( but in those days that wasn't considered to be a drama ). The GP who put me on statins didn't comment on my BP. However, about 12 months or so later he put me on Ramipril 10 mg. and around 2014 my GP here in Cornwall added to my party bag with Felodopine. Personally, in my heart of hearts that taking Statins on their own has no impact. It does ( I'm sure ) have a positive impact when taken alongside other blood pressure medications and also some beta blockers.
Probably no help to you but that's my personal take/experience.
Thanks, John. As far as I know the job of statins is to reduce cholesterol and thus prevent heart attacks and strokes caused by plaques in our arteries.
I think - from reading - it's not sufficiently known just what statins do in the round, but they are also now considered to have anti-inflammatory properties. The creation of plaque (i.e. calcium salts, cholesterol and other bits and pieces) is known to be highly complex not least since the "pre-plaque" arterial areas on which the plaque eventually adheres can be seen to exist in even young people (and, apparently, also in chimps that live in African jungles and eat what nature intended). Plaque stiffens arteries and increases blood pressure and can lead to strokes.
So, should you take statins? Well, if I were you, I would. And I do. I don't think the NHS want anything of people like us except to reduce the pressure on its services from cardiovascular disease - and statins have been shown to do just that. Whether they do other things that they shouldn't seems unlikely, or that would defeat their use. NICE exists to help the NHS reduce morbidity and not for all of the many conspiracy reasons a few people here suggest. It gets my vote.
Statins can not only help prevent heart attacks, but newer studies show statin users in the afib population have a lower incidence of stroke. With your TIA history this may at least play some part why your doctor is so eager to get you on statins..
Personally, I'm a big fan., for all the reasons mentioned, as well as their anti-inflammatory properties.
Of course not everyone needs them. but with naturally high LDL's and a family history of heart disease, I've been using them for years without any side effects or heart issues besides afib.. I'm sure statins are playing a role on that.
Just to balance things I am not a fan. I took them for nearly twenty years because I believed my doctor when he told me it was right to do but they proved about the only drug (apart from diltiezem) that gave me dreadful side effects and some twenty years ago I stopped them. Several angiograms later and my cadiologist tells me my coronary arteries are still fine! Here in UK I do believe that things are complicated by the QOF system where doctors pay can be affected by the points system. Statins are one of several matters they are encouraged so by to promote but my own GP was honest enough to tell me it made no difference to her if I accepted her advice or not since all that mattered was having the conversation.
I take statins and combined with dietary changes I have significantly lowered my marginally high cholesterol. I've never had a TIA but doubt that's because I'm taking statins as only started last year.
However, 15 minutes of Googling the subject of TIA and statins found info like this..."Statins lower LDL— our “bad cholesterol.” Over the last few years doctors have steadily lowered the ideal level for LDL in people who are at risk for stroke or have an elevated LDL. The latest goal is less than 70mg/dl. Most physicians now add statin therapy to the discharge instructions that you receive when you leave the hospital after a stroke. An exception may be hemorrhagic strokes, an event where the stroke is caused by bleeding in the brain."
Your questioning of taking statins is not unreasonable. The lack of proper justification/ explanation by your GP is poor IMO. They're the person who should be convincing you.
: A region-wide study in more than 50,000 patients with atrial fibrillation has found reduced risks of stroke and transient ischaemic attack in those who started statins within a year of diagnosis compared with those who did not. The findings are presented at EHRA 2023, a scientific congress of the European Society of Cardiology (ESC).1
Your 2nd para is interesting .......... now I've just had full range blood tests. Nowhere is listed any result for Cholesterol good, bad, apalling or indifferent. Why would Cholesterol not be part of "full range" - if you get my drift.
Any guesses why this should be so ? Unless they are using a medical term in the list of tests with which I'm unfamiliar. Not that it bothers me unduly because I'm quite content and am taking them - just changed back from Atorvastatin to Simvastatin though.
My results have been reported to me by the NHS App.
... Depends on what was tested. At my dr's a full blood count is merely to look at haemoglobin related parameters, cholesterol and diabetes are looked at under a separate heading. Though commonly all tested at the same time. These headings are from my last test 2 wks ago, NHS app...Pathology Request (Request Sent):; U/E (Requested), L.B.P (Requested), Cholesterol (Requested), HDL/LDL (Requested), HbA1c (Requested), Full Blood Count (Requested)
Do a different heading for each component. Each further broken down into individual tests.
That's interesting. Here in South Africa I have a full blood test annually. It always has to be done when you are 'starved' - No food after midnight, so you get yourself to the path lab blood taking depot promptly at 7.30am when they open! But it covers everything, blood, cholesterol, kidneys, liver, thyroid. sugar. Vit K - anything that the doctor ticks on the form you take with you. They phlebotomist usually takes 4 vials of blood (I feel a bit like Tony Hancock and his sketch about an empty arm) and the results are through in a couple of days. They seem to be measured against World Health criteria. As far as statins are concerned, I take 5mg a day (Atorvastatin) which keeps my cholesterol reading at 4 - my doctor does not want it any lower.
Suggest you look at Zoe latest info on cholesterol which says NHS lipid panel testing is so inadequate that it’s difficult for doctors, let alone lay people to make an informed decision. It will stay a NO from me.
Pharmacotherapy for lipid lowering should aim towards the following targets while balancing the risks/benefits: Total Cholesterol less than 4.0 mmol/L, HDL >=1.0, LDL <2.0, Non HDL <2.5, Triglyceride <2.0
Not me! I refused them and even my previous GP said in my position they wouldn’t either but then she didn’t go with the cholesterol theory anyway. There are many doctors who are not convinced about dietary cholesterol as a cause and some evidence that it is normal for lipid counts to rise as we age and that it can protect the brain. Pays your money to choose who you believe. 🤷♂️
What they DID say was that for some people with chronic, high inflammatory markers statins may well reduce chances of future stroke as they are good anti-inflammatories.
I chose Lifestyle measures - which are challenging at times. So far, so good.
Your body, your choice and therefore your decision.........these were the words spoken by my doctor, not to me but to my husband, so his decision was not to take them, I on the other hand, after several TIA's am on Statins and since taking them no more TIA's soooooo your decision!
I had terrible side effects when I was put on Statins when it was so popular a few years ago. I think I took them for a good while probably 18 months or so but had dreadful dizzy spells and at one time actually fainted when I took my son's father-in-law to the bank - he was nearly 101 when he died and didn't take any medication other than pain killers when he had a hip replacement at the age of 84! I'd offered to take him as neither he nor his wife could drive and then it was me who had the problems! This happened again when shopping a short while afterwards so I went back to my GP and we decided as my cholesterol was not that high anyway it really didn't matter if I took them or not. I am still amazed that my wife has never had her cholesterol checked by her GP surgery - even when she asked and then she had one done in the pharmacy and took to her GP and it was about the same levels as mine and he said no he really wouldn't bother prescribing them as it would make little difference. My brother who lives in South Africa had a CAC test which has meant he has been put on statins. If I was offered that and the result suggested my taking Statins I may then decide to take them.
No studies to cite..but personally I stopped taking Lipitor after I had an MI and a stroke some 22 years and 10 years ago. I developed afib 5 years ago and have been free of any arrhythmia since starting on Tikosyn.
I spoke to my cardiologist last November and discussed statins. He told me that statins protect you from a different stroke risk to that of AF he considered that I had no risk of any other form of/because my cholesterol levels were normal. All the other bloods were coming back okay? My weight was fine and I exercise regularly on my diet is relatively a healthy one so You may want to consider that what is your risk of stroke? Is it from AF or other factors that might be protecting you by taking statins
From my last round of tests over 5 years ago, I was asked of any family history of heart disease. On mentioning that my father had a quadruple bypass aged 71, they booked me in for an angiogram. Found an 80 to 90 percent blocked LAD. They didn't stent it because of the location at a junction but put me on 40mg of atorvastatin and to make sure my cholesterol got down to 4. I've never had any signs of angina nor high blood pressure so had I not known I may have been a walking heart attack candidate (possibly still am but ongoing symptom free).
No side affects and had I been offered a statin without knowing I would have taken the offer anyway for the simple reason that prevention is better than cure especially as we age.
I had exactly the same text message from my GP surgery a couple of months ago after a cholesterol blood test. My results for all cholesterol components were normal. I decided to speak to my private cardiologist and the upshot is that my absolute benefit of taking them is 1%. The manufacturers state you’ll get a benefit of 30% from having a heart attack or stroke but that is not an absolute figure. This BTW is over many years. All of my so called markers eg blood pressure etc are normal and in fact my cardio said the only way to really determine if you need statins is a CT angiogram which he could arrange. He did mention in his letter to the GP that statins will do nothing for AFIB and that my QRisk score (high percentage) was driven by the fact I have AFIB (and age of course). At present I am not of a mind to take statins but will get a CT angiogram within the next few years if anything changes.
Thank you so much for posting this very sensible advice from your cardiologist. It highlights how so many of these big moves toward a particular treatment are entirely driven by statistics and statistics can only take you so far. I too have a relatively low QRisk score - only my age and AFib causing it to be higher than the 10 that apparently is the 'trigger point' for recommending statins. I had an angiogram about a year ago and my arteries are fine but still, every time I speak to one of my GPs they beg me to consider statins.
Hadn't heard of QRisk, so Googled and tried it. It reckons my heart age is 7 years greater than my actual age of 62..... However, I had a Coronary angiogram 4 1/2 years ago (age 58) the result was a Coronary age of <45 and calcium score was 0. Obviously comparing "apples and oranges" as QRisk also considers stroke risk but my Coronary angiogram is presumably a better indicator of heart health, when combined with recent echo cardiogram (no issues) and associated stress test (high tolerance for exercise).
High cholesterol is not bad on its own, it is produced for many reasons. It in particular is a main material to restore many damages in the body. It is also a building material for hormones. Brain almost fully made of cholesterol. High cholesterol may be a sign of some inflammation in the body. Read about it: statins are the big cone of pharmacy industry invented in 70th - 80th. You surely know that pharma profits stand on the second place in the world just after narcos mafia. Not sure, maybe they are already the first, definitely ahead of human trafficking. Someone mentioned above that GPs are commercially connected to pharma mafia.Read, study and make your own judgement. All people are different. Some can live on a handful of drugs without obvious problems, some may suffer or even lose their kidneys pretty quick
You can always say no. I do, every time it comes up. which is regularly. I had an angiogram a year ago and my arteries are fine, my cholesterol is (just) within 'normal' range and my QRisk score is (from memory) 12.5 which is purely because of my age (68) and AFib. The target for QRisk used to be 20 , above which they would recommend statins but it's been lowered to 10 I believe, which is why this forum is full of UK folks saying their GP is desperate to get them on statins. Personally, I am deeply opposed to taking any medication for the rest of my life unless I am convinced of its' necessity. I do not believe that statins are as benign as they're presented to be.
On the other hand, plenty of people take them with no ill effect that they're aware of, as seen by the comments on here. My only personal experience is of one friend who took them for some years because of high cholesterol has stopped because he started having muscle pain in his legs. My 90 year old father, who is extraordinarily fit and healthy for his age, has been taking them for about 8 years because he had to have seven (yes, seven!) stents due to significant plaque build up in his arteries. He's now having trouble walking any distance because of pains in his legs, which is having a big impact on his quality of life. I fear the statins are contrbuting to this but haven't said anything to him because of his plaque problem.
At the end of the day, we have to make our own decisions and take responsibility for the outcomes. When I was a child it was very common to take out children's tonsils - I had mine removed as did many others. Now they don't do it because they discovered that that the tonsils actually performed an important function - fancy that! - so it wasn't such a good idea after all. These big 'fads' in medical treatment come and go. Every medical intervention has some impact other than the desired impact. Every single one. We just have to decide if it's worth the trade off.
No you don't have to hit the NHS targets. You don't have to do anything you don't want to do or take anything you don't want to take. You can say no politely but firmly and make it clear that you do not wish to have this conversation again. You could even ask your doctor if they get paid extra money for getting people to meet NHS targets.
we had a mate that had a Heart attack and died after a ski paddle. He didn’t know but had plaque in his arteries, so fast forward all the paddlers in our group went and had a Heart CT Calcium Score. Most of us had 0 scores which indicated no plaque. Whilst this is not absolutely definitive, calcium and plaque have a direct correlation. So no calcium build up is a good result. He said keep it up and we can do another in 5-7 years. We had to pay for this as an extra but well worth doing for peace of mind
I had a blood test a couple of months ago and the practice pharmacist rang me to say my cholesterol was slightly raised. I told her I was surprised as my diet hadn’t changed and my cholesterol had never been raised before. She said my levels were the same as before, but the ‘guidelines’ had changed and so my levels were now said to be raised. She advised Statins. When I looked at my test results, the HDL, LDL and Triglycerate levels were all in the good range, so I don’t know why my overall number was slightly raised ( 5.5 ). I asked if I could try and lower my cholesterol myself, which she agreed to. I have changed my diet and now eat a Benecol yoghurt daily, but haven’t yet had another blood test. I will shortly, and let you know the results. Of course I have now read that there are other benefits to taking Statins, so I might succumb eventually - perhaps if my GP recommends. My husband’s cholesterol was higher than mine and he is taking the Statins ( no Afib ), and he is merrily eating whatever he likes !
You need a MRI scan really to see if your brain's arteries are deteriorating. After I had one (even though my cholesterol levels are 3.8 ) the consultant recommended I take a small dose of statins. 5 mg 3 times a week. No side effects for me. My Doctor told me that my level of deterioration was very good for my age but still recommended the statins.
The problem comes from eating animal protein. If your a vegan or vegetarian you won't have the same degree of risk. There is a new research document on Medscape. medscape.com/viewarticle/10...
Arteriosclerosis can cause the following conditions:
Coronary artery disease: plaque deposits in coronary artery blocks the blood flow.
Carotid artery disease: carotid artery present in neck and the supply of blood to the brain get affected due to plaque buildup in the arteries.
Peripheral artery disease: narrowing of the arteries present in the lower body.
Kidney disease: plaque deposition in renal arteries. Arteriosclerosis of these arteries may lead to kidney failure.
Plaque build-up happens gradually. Mild arteriosclerosis may not have any symptoms. Symptoms of moderate to severe arteriosclerosis depend on the arteries affected; moderate to severe arteriosclerosis symptoms include: Chest pain or angina Pain in your leg, arm, and anywhere else that has a blocked artery Shortness of breath Fatigue Confusion, which occurs if the blockage affects circulation to your brain Muscle weakness in your legs from lack of blood circulation
1st- My elderly mother was having side effects while on 40 mg Rosuvastatin and her cholesterol was very high when she moved in with me. Her Dr. wanted to keep her on it despite all the side effects, claiming it wouldn't cause these (protein in urine, various leg pains, other misc, basically quality of life not good ....the medical pamphlet it comes with says it does cause these things for some people). She lowered her dose in half and I incorporated dietary choices for her. In just two months her cholesterol numbers dropped dramatically and all her markers improved. All of the side effects went away.
2nd-My husband and I went to new Dr when we moved recently. We expressed concern about his family's cardiac history and my husband's cholesterol. Drs. words, "Statins are a double edged sword, Are you willing to try other ways first?". He gave my husband some recommendations on life changes, dietary changes and supplements. Unfortunately, my husband has only done the supplements so far and it's been three months. He will likely need statins, but his doctor was forthcoming that statins shouldn't be the first in line recommendation in our particular situation although my husband is high risk in several other ways.
Everyone needs to make their own decisions based on their health, particular circumstances and experiences. Have you considered getting a second opinion from another health professional before making a decision? Best of luck! Whatever you do, always listen to your body's response. What works for many doesn't necessarily work for all.
I can only tell you that I had the exact same conversation with my cardiologist last December and he said explicitly that AF should not be factored unto the QRISK score as it is different than ischaemic heart disease. He was kind enough to put it in my notes, which I remind the GP of when I need to. Hope that helps.
Biggest scam ever,does not extend anyone's life but does make the pharmaceutical companies,lots & lots of money!I'm not going to back it up,you got Internet,go do your research!
I was asked also to take statins after ablation 2017. I tried for 1 wk, felt ill on them and refused to take more. My cholesterols have remained normal.
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