Statins: Hi I’m a fit 57 year old (lots... - British Heart Fou...

British Heart Foundation

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Statins

Manishboy profile image

Hi I’m a fit 57 year old (lots of cycling) mild hypertensive , BP medicated and under control . BMI 21.6 only 10 stone ,Cholesterol 5.9 , Q risk 11.6 %. Doc wants me to take statins , my father had heart attack at 7O . On the surface seems like a silver bullet to ensure the same doesn’t happen to me but struggling with the decision as I read lots of posts on here about side effects, also read lots of benefits to what perhaps is a super drug ensuring heart health in the Autumn of your youth . Have I got anything to loose or everything to gain ???

38 Replies

You've got everything to gain.

There are a tiny percentage of patients (about one in ten thousand) who suffer serious muscle problems from statins, This percentage holds true for all doses up to and including 40mg, the risk suddenly grows tenfold to about one in a thousand for the maximum 80mg dose. That is why 80mg is only prescribed for the very highest risk patients and those with serious lipid problems.

Statins can virtually halve your heart attack risk, but in addition they also deliver two other very useful benefits. Firstly they reduce the background inflammation which can be the root cause for atherosclerosis or cardiac heart disease, and secondly they tend to stabilise the plaque that is almost certainly already present in your arteries (it doesn't matter how virtuous your lifestyle, as a middle aged western male the odds are overwhelming that you have at least minor plaque traces).

This plaque stabilising benefit may be even more important than cholesterol reduction. The fact is that over half of heart attacks happen to people with less than 50% arterial blockage, but there are plenty of people on this forum with arterial blockage well over 90%, who were virtually disabled by angina, but have never had a heart attack. The difference in these two groups is chiefly down to the relative stability of their arterial plaque.

Anyhow, follow your doctor's advice and give statins a try. Most people have no side effects, but if you're one of the unlucky minority you can always change the brand of statin, reduce the dose, or if the worst comes to the worst simply stop taking them...after all it's a free country, no one can medicate you with statins against your will!

Good luck!

Kristin1812 profile image
Kristin1812Heart Star in reply to Chappychap

Thanks Chappychap. I wondered why the incident figures were so low for leg pains with statins, when we get so many reports here.They were surely more than 1:10,000? I see why now.

Pollypuss profile image
Pollypuss in reply to Chappychap

One in ten thousand? I cannot agree with that statistic. I meet people all the time who have problems.

Chappychap profile image
Chappychap in reply to Pollypuss

The 1:10,000 statistic comes from the British Heart Foundation. I first heard it in one of their excellent "Alive & Ticking" on-line lectures that was streamed in August of this year. The subject of this particular lecture was Statins, and they assembled some of the most eminent cardiologists and researchers in the country to share their knowledge and wisdom.

If you want to learn more you can watch the BHF lecture here,

youtube.com/watch?v=om7PnTd...

Another interesting statistic from the same lecture was this. There was a large trial conducted to try and better understand statin side effects, Half the group were given statins, the other half were given placebos. About 8% of the statin group complained of muscle aches, but here's the fascinating part, the same 8% of the placebo group also complained of muscle aches. Maybe we're just all so suspicious of statins that we're overly vigilant in looking for muscle aches, or perhaps it's because statins are generally prescribed to the middle aged and elderly, where muscle aches are naturally more prevalent?

Pollypuss profile image
Pollypuss in reply to Chappychap

Please tell that to my stomach😃

Wot Chappychap says.

Keep in mind there's an inherent bias in what you see online because very few of the huge number of people who take them without problems go online and shout about it, but a large proportion of the very few who do have problems do exactly that.

But the benefits regarding heart health are beyond doubt. Not only for cholesterol lowering but also for stabilising any plaque there may already be (and, by your mid 50s, most people will have some regardless of their lifestyle!)

Incidentally, I've been on 80mg of atorvastatin for the past 3 (pretty active) years.

I'd found that recovery from runs / gym taking longer than it used to - no major pains but an almost continuous slight ache if I work hard mors than a couple of times a week.

Put that down to age (my body knows it's 54 but my mind still thinks it's 20...) but, about 5 weeks back, decided to try COQ10 (200mg/day) just to see. I'm naturally very sceptical about supplements and the studies on it are pretty ambiguous but a lot of places suggest it might be useful for people taking statins and it does seem to have made a difference.

A week ago I did the Anglesey half marathon on the Sunday and was recovered enough for a 60 minute gym session of treadmill and rowing on the Monday afternoon!

I don't have a problem with cholesterol but even so my cardiologist had me on 10mg for years. then an angiogram I had earlier this year showed 85% blockage in the main LAD artery and I was given elective surgery to have a couple of stents put in.Afterwards my dose of statin the best being atorvastatin or lipitor was increased to 80mg as you say it can actually remove plaque build up.

I was reluctant to take such a high dose I had read all about memory loss and muscle pain but my cardiologist assured me that this was a tiny risk and sent me a lot of information to reassure me that high dose statins were safe indeed he took the same dose himself.

If anyone wants to see the reports I'd be happy to send a copy just PM me.

Janet

Redcoco profile image
Redcoco in reply to fairgo45

Hi I would be very interested in seeing those reports as I don’t have high cholesterol and am unconvinced about taking statins. Gill33cannon@gmail.com. That’s very kind of you x

TRST profile image
TRST in reply to fairgo45

I knew about the muscle pain but not the (unlikely but possible) memory issues. I tend to steer clear of anything that might make my poor brain deteriorate quicker than it already is!

Kristin1812 profile image
Kristin1812Heart Star in reply to fairgo45

Have I missed something? I didnt think anyone has said statins can remove plaque build up? Just stabilise it. But correct me if I’m wrong.

fairgo45 profile image
fairgo45 in reply to Kristin1812

Yes it can help remove plaque build up in the arteries

There have been several clinical studies — many of them done at Cleveland Clinic — that show statins can reverse plaque buildup. Two statins in particular, atorvastatin, which is sold under the brand name Lipitor, and rosuvastatin, which is sold under the brand name Crestor, are the strongest statins

Milkfairy profile image
MilkfairyHeart Star in reply to fairgo45

Statins stabilise plaque and helps prevent further progression.

This BHF article clearly states that plaque , atherosclerosis cannot be reversed.

bhf.org.uk/informationsuppo...

The NHS information says

'There are not currently any treatments that can reverse atherosclerosis'

nhs.uk/conditions/atheroscl...

Kristin1812 profile image
Kristin1812Heart Star in reply to Milkfairy

I thought that was the case……tho’ of course I did want to be wrong! Thanks for confirming,

Several studies, including Jupiter, found that plaque volume is reduced when taking statins.This reduction is normally in the 1 - 2% range and is due to the statins reducing the amount of necrotic core of the plaque.

Is this reduction in volume actually reversal?

Maybe, maybe not but no studies have ever shown plaque to be completely removed once it is present.

Milkfairy profile image
MilkfairyHeart Star in reply to fergusthegreat

That is my understanding too.

Approx 10% of heart attacks occur without blockages due to non obstructive coronary artery disease.

Heart disease is complex.

Milkfairy profile image
MilkfairyHeart Star in reply to fairgo45

Can you please provide the research to support this view?

The information on the Cleveland website says

'Clinical studies using ultrasound in the coronary arteries have shown that when you are on high doses of these medicines, even if you have plaque buildup already, you can stabilize the plaque on statin therapy.'

The further build of plaque is prevented but not reversed.

fairgo45 profile image
fairgo45 in reply to Milkfairy

If you'd like to pm me I can send you my cardiologists data that he sent me regarding statins and how they can help absorb plaque. America is probably the leading country for heart disease prevention and they support this as well.

I live in New Zealand and that is also the information.

You read the evidence from all over the world not Google and make your choices.

I've had 2 stents and my cardiologist persuaded me that the right statin would help reduce the plaque in the arteries he lectures all over the world he knows what he's talking about I choose to believe in him.

Milkfairy profile image
MilkfairyHeart Star in reply to fairgo45

Can I ask you to share this information with the whole forum please?

Many of the forum members like to read research articles themselves so we often share research articles openly on the forum.

fairgo45 profile image
fairgo45 in reply to Milkfairy

Sure happy to share and I have already shared the knowledge i have with a couple of people on here

If you pm me i can send it to you or anyone who would like what I have to share there is too much to post on here so I'd need your email..

Milkfairy profile image
MilkfairyHeart Star in reply to fairgo45

I would prefer if it was openly shared on the forum.

fairgo45 profile image
fairgo45 in reply to Milkfairy

Too many pages to post sorry

Milkfairy profile image
MilkfairyHeart Star in reply to fairgo45

Has your Cardiologist published their data in a recognised peer reviewed medical journal ?

If not, it is difficult to confirm that this data is accurate.

fairgo45 profile image
fairgo45 in reply to Milkfairy

Well these are peer reviewed papers and excerpts from the US guidelines so the question is where are you getting your information from.

Milkfairy profile image
MilkfairyHeart Star in reply to fairgo45

Then please give the links to these peer reviewed articles.

I relay on the information on the BHF website. The British Heart Foundation is one of the biggest independent funders of cardiovascular research studies.

It is respected throughout the world.

I also refer to the information provided by the NHS, including the research provided by the Medical Reseatch Council, the National institute of Healthcare Research and the European Society of Cardiology.

I will also look to the American Heart Association and peer reviewed articles.

Kristin1812 profile image
Kristin1812Heart Star in reply to fairgo45

It’s a very significant change to the established view, so peer-reviewed refs are really important. I’m with Milkfairy. Best to put just these refs openly on the Forum here, it’s not necessary to post the full texts.

TRST profile image
TRST in reply to Kristin1812

I don't take statins and I'm not up for debating the whys and wherefores, but a cursory 'google' threw this up:

health.clevelandclinic.org/...

Q: Can statins actually reverse plaque buildup?

A: Yes. There have been several clinical studies — many of them done here at Cleveland Clinic — that show statins can reverse plaque buildup.

Two statins in particular, atorvastatin, which is sold under the brand name Lipitor, and rosuvastatin, which is sold under the brand name Crestor, are the strongest statins.

Clinical studies using ultrasound in the coronary arteries have shown that when you are on high doses of these medicines, even if you have plaque buildup already, you can stabilize the plaque on statin therapy.

If your LDL cholesterol is lowered below 70 mg/dL, you can even see a regression in the plaque by up to 24%. So having really a low LDL cholesterol level can help stabilize any plaque buildup you have, and prevent further plaque progression.

— Cardiologist Steven Nissen, MD

Milkfairy profile image
MilkfairyHeart Star in reply to TRST

What we need is independent peer reviewed research articles to support the information on the Cleveland website.

Dr Google's Consultanting room isn't always accurate.

There is some evidence that suggests that statins can combined with other life style changes and very controlled management of diabetes, weight, high blood pressure etc can ' reduce' plaque build up.

This reduction is difficult to measure. It is done by ultrasound, the measurement could be effected by the skill of the person performing the test, the equipment used and the analysis of the readings.

It maybe difficult to get consistent results.

What is important is how well the blood flows through the coronary arteries, not necessarily the severity of the blockage by plaque.

Approx 10% of heart attacks occur in people with unobstructed coronary arteries.

Perhaps a more effective way to evaluate the benefits of statins, is to see if they reduce the number of heart attacks, strokes and major cardiac events.

Which they appear to do.

Kristin1812 profile image
Kristin1812Heart Star in reply to Milkfairy

So is the issue in the wording? Reducing plaque, vs reducing build up of plaque?

Milkfairy profile image
MilkfairyHeart Star in reply to Kristin1812

I am not sure, there seems to be conflicting interpretations of the research.

It would be good to have some clarity on the issue, though.

I agree with Chappychap and Thatwasunexpected. My experience may be helpful. My cholesterol level was always at the high end of normal (ie 4.5-5.5). My diet has always been OK and no matter what I did with my diet my cholesterol level didn't change much. When I was 60 my QRisk was 9.9% ie. I had a 9.9% chance of a cardiovascular "event" in the next 10 years. This seemed rather high to me but my GP refused to put me on statins. 7 years later I got severe angina and couldn't walk more than a quarter of a mile on the flat. I needed a triple bypass (which was done last October). How I wish my GP had put me on statins 7 years previously!

Manishboy profile image
Manishboy in reply to Mart25

Wow yes your experience is very helpful indeed I’ve been the same for a while hovering as you say but occasionally low I’m convinced I could reduce my Cholesterol and probably already have loosing weight, reducing alcohol and cutting out junk food all of which I absolutely revelled in during Covid probably giving me my current reading but the damage may already be done /hereditary and this is what I’m afraid of if I don’t try statins that have been offered only to reduce my Q risk and Cholesterol, I don’t have any heart worries yet my health path may follow a similar story to yours .Regards Manishboy

Mart25 profile image
Mart25 in reply to Manishboy

Diet, exercise, lifestyle, stress and genes all play a part and there's no predicting what will happen. You may turn out to be a lucky one. Your BMI is certainly better than mine and your cycling has to be positive too. Like you, I had no heart worries at any time. I have had a blood pressure monitor for over 25 years and my BP was/is always in the normal range. But angina hit me suddenly and severely and an angiogram showed substantial blockages of my coronary arteries. If I were in your shoes I'd take the statins and see how you get on.

I've been on Atorvastatin since a totally unexpected NSTEMI in December followed by my CABGX2 in January. No discernible side effects - my memory was already shot to bits due to lockdown! I exercise at least 30 mins x 5 days a week plus walk up to 10 miles a day at weekends. As others have said, taking them is a no brainer, but reversible if you really really can't tolerate them.

So good to see the positive replies with regard to Statins now could we hope for the same for Bisoprolol !!!

Stay Well Stay Safe

080311 profile image
080311 in reply to Prada47

Morning,

Both my husband and I have Bisoprolol 2.5mg, he as had it prescribed for over 15 years and I have had it for 5 both of us don’t have any noticeable side effects.

Pauline

True story, my friend in his 70s decided not to take statins as his blood work etc was marginal. A few years later, whilst visiting family in Australia he kept getting indigestion when walking up gentle slopes. Off to the medical centre, then to hospital as an emergency for a stent...and statins.

Perhaps try them and see how you get on? There are different ones so if one doesn’t suit the chances are another one will.

Hi I’m 68 and had an AVR OHS in January this year and doing well.

At my 6 week check up my surgeon put me on Atrovastatin 20mg as my cholesterol was high at 6.3. Then at my 3 Month check up decided to stop them as I had stiff leg muscles in the mornings and bowel urgency at times.

GP telephoned for a medication review and suggested I try a lower dose of 10 mg Atrovastatin. She said it would be advisable to be on a statin.

My cholesterol is now 4.6 and I have no issues with legs aches. Memory? It’s always been pretty selective! Haha!

Full list of meds is Asprin 75mg disp, Bisoprolol 1.25, Omeprozole 20mg and Atrovastatin 10mg.

Chugging along nicely and doing the Anglesey Coastal Path Walk whenever I can get over there. 7-11 miles. Also walking at least three times a week at home here in West Yorkshire 2-5 miles.

Feeling now that I am protected against what I can’t see or feel that’s happening to my arteries or heart valves. I was a perfectly fit 66 yr old when I was diagnosed. Complete shock that I had a severe aortic valve stenosis.

I’m happy on my new level of statins.

❤️Maisie❤️

Not much I can add to this other than my personal experience with statins. I have been taking 40mg Atorvastatin daily for nearly 2 years now and never had any issues with them.

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