Not All Statins Are Equal : Many people... - British Heart Fou...

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Not All Statins Are Equal

MichaelJH profile image
MichaelJHHeart Star
80 Replies

Many people quote what dose of statin they are on but not which type. The table shows the reduction in LDL (bad cholesterol) for different statins and doses. Before you ask I am on 40mg Atorvastatin as my student liver (🍺🍺🍺🍺🍺🍺🍺🍺) couldn't cope with 80mg!

Fluvastatin:

20 mg/day, 21% reduction

40 mg/day, 27% reduction

80 mg/day, 33% reduction

Pravastatin:

10 mg/day, 20% reduction

20 mg/day, 24% reduction

40 mg/day, 29% reduction

Simvastatin:

10 mg/day, 27% reduction

20 mg/day, 32% reduction

40 mg/day, 37% reduction

80 mg/day, 42% reduction

Atorvastatin:

10 mg/day, 37% reduction

20 mg/day, 43% reduction

40 mg/day, 49% reduction

80 mg/day, 55% reduction

Rosuvastatin:

5 mg/day, 38% reduction

10 mg/day, 43% reduction

20 mg/day, 48% reduction

40 mg/day, 53% reduction

The data comes courtesy of NiCE :

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

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MichaelJH profile image
MichaelJH
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80 Replies

Hello :-)

Very interesting

I was on 80mg of Atorvastatin but could not cope

Now I take 40mg and so far so good :-) x

Andy_roo profile image
Andy_roo in reply to

Just out of interest, what was your experience on 80 mg? I'm on 80mg and am struggling with this new low blood pressure, light headedness etc.

in reply toAndy_roo

Hello :-)

I think the main problem was joint pain for me

80mg is quite a strong dose maybe you could see if they will reduce yours or try you on a different one :-) x

Auiron profile image
Auiron in reply to

Thousands with high cholesterol set to benefit from new treatment on the NHS

Thousands of people with high cholesterol will soon have access to a new treatment option on the NHS as a result of final NICE guidance published today (28 April 2021).

nice.org.uk/news/article/th...

in reply toAuiron

This is good news :-)

Shall have to watch out for when they start this and shall make a note to ask about it

Thank you for telling me and giving me the link :-) x

in reply toAndy_roo

For mr it was both joint pain and cramps dropped from 80 - 40 and much better but now cramps are starting to resurface two months on

Gazzer83 profile image
Gazzer83 in reply to

I am on 80mg atorvastatin and have been for many years. I suppose my body has gotten used to it. That and 6 HA's. I am on 14 meds a day and I suppose that any side effects would get lost with the rest of my meds. It can be very difficult to pin down a cause if you are on multiple meds. It could be a reaction with other meds rather than a direct effect of one.

Kind regards

Gazzer.

in reply toGazzer83

I 100% agree !

I am also on such a cocktail of meds all needed and something is upsetting me but I sit and think which one and it would be such a difficult task to find out

I know we need and have to take these meds but I have to be honest it is dragging me down feeling the way I do

Hopefully I will get there and get the right combination to suit me :-) x

MONIREN profile image
MONIREN in reply to

Just a side point, going over your medication with pharmacist, they could probably work out what is causing you problems. Mine came to my home and went over them for an hour. I had to book it through gp. I'm regional Australia. Not sure ,but you could ask. It's part of their expertise. They also have more time than gp. Take care. Moni

in reply toMONIREN

Hello :-)

O Australia what a nice place to live :-)

I think or pharmacists will do a review on the medications which will be worth asking but they will not come to us , that is a very good service you have :-)

Thank you for pointing this out I will have a look into it :-) x

Can you provide the source of this data? If not it should be removed.

MichaelJH profile image
MichaelJHHeart Star in reply to

When you fill in your bio properly?!

in reply toMichaelJH

Not sure why a bio has suddenly become essential! But reported your post any way, pretty sure you would if any one else posted this without any evidence :-)

Heythrop51 profile image
Heythrop51 in reply to

Sir, if I may say so you are a total idiot!Your bio says you have come to annoy people. Why? MichaelJH would only publish genuine numbers as there's no reason to do otherwise. People like yourself spoil forums. Go away!

Ramilia profile image
Ramilia in reply to

It is very simple to find the source of data like this. It took me less than 30 seconds, as I'm sure it did Milkfairy. It might have been more helpful if you had done the same and simply posted the link for people instead of berating MichaelJH.

WARNING

Without a link to the source data this is potentially a made up set of data which could be potentially misleading/dangerous and should be removed.

Lezzers profile image
Lezzers in reply to

Why would it be dangerous?

in reply toLezzers

I said 'potentially', as absolutely no idea as it is a random post without anything to back it up!

Lezzers profile image
Lezzers in reply to

But why could it be potentially dangerous?Ps: have you changed your name?

in reply toLezzers

Because someone may believe they are real numbers, when they are just random numbers posted by a random person on the internet!!!! Until the source is provided.

Lezzers profile image
Lezzers in reply to

I'm sorry but I still don't get why it would be dangerous? They're just numbers, random or otherwise, surely the worse that can happen is someone asking their GP/cardiologist to change their statin?

in reply toLezzers

So someone reading this thinks those numbers are accurate, without anything to substantiate them, so they waste their GP's time unnecessarily asking for a change, using an appointment that could be put to better use for someone who has an urgent need of an appointment.........

Lezzers profile image
Lezzers in reply to

So not really dangerous then! But potentially wasteful of a GP's time. Lets hope that if anyone is concerned they'll speak to a pharmacist, or the practice nurse at their meds review! I thought your original name was gaz_chops?

in reply toLezzers

Potentially dangerous as it is a waste of time that could be spent doing something useful!

Lezzers profile image
Lezzers in reply to

Hardly dangerous!! I'm sure Michael will post his source tomorrow, he's not one for just posting random comments! Good night!

in reply toLezzers

If I posted a set of random numbers would you just accept it?

Lezzers profile image
Lezzers in reply to

My question was why is it dangerous? I never said I believed it or disbelieved it, I just wondered why you consider it potentially dangerous?

in reply toLezzers

See above

in reply toLezzers

And I never said you did 😉

wischo profile image
wischo in reply to

Grow up please and stop your nonsense.

Heather1957 profile image
Heather1957

TBH not sure if this is dangerous as surely Statins are a prescription drug so it’s not like showing these figures to a Dr would be the deciding factor, the doctor would know if this was true or not.

Milkfairy profile image
MilkfairyHeart Star

This might help validate the figures.

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

in reply toMilkfairy

Thank you, Pity the OP didn’t practice what he preaches.

Milkfairy profile image
MilkfairyHeart Star in reply to

Just a thought, Michael is always known to give reliable, trustworthy advice and information.

Mountwood profile image
Mountwood in reply toMilkfairy

Thank you Milkfairy. As always, you are the calm voice of reason and commonsense.

Nettekin profile image
Nettekin in reply toMilkfairy

Thanks Milkfairy for the link. If read in conjunction with @mart25 reply it provides a lot of info regarding cholesterol. We need all the info we can get to push our GPs sometimes! Hope you are keeping well, haven't seen much of you lately. X

Milkfairy profile image
MilkfairyHeart Star in reply toNettekin

Thank you for your kind words.I am still hanging in there.

Winter is a tough time for me.

I haven't yet managed to avoid hospital, late winter or early spring, since my diagnosis nearly 10 years ago.

Keep your fingers crossed for a mild winter😊

Nettekin profile image
Nettekin in reply toMilkfairy

Fingers well and truly crossed. Living 1000feet + up a mountain it is always cold and windy here in West wales. I am always a little more nervous of cold air rather than the actual temp as it seems to cause throat pain similar to that pre ha. I do hope this year will be different for you. X

That is very interesting, where do those stats come from 😂

Milkfairy profile image
MilkfairyHeart Star in reply to

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

in reply toMilkfairy

Hi, yes I have seen the NICE guidance,I was trying to make a funny pun ! The replies were once again getting a bit nasty, as often happens on this forum. Totally unnecessary.🙏🏽

Heythrop51 profile image
Heythrop51

Milkfairy has posted the link to NICE a few posts above!

santino44 profile image
santino44

interesting, I'am on 80mg Atrovastatin to reduce LDL cholesterol given the figures medication could do the job on it's own but not so total serum cholesterol below 5 required with Tri glycerides kept in check also as this undo the the benefits of the role of Statins so consider the carbohydrates in your diet at the same time. My total serum cholesterol revealed Triglycerides too high so high fibre & low carb diet required.

firstlight40 profile image
firstlight40

Also, please do not forget that statins act as artery plaque stabilisers (reducing the chances of plaque breaking up and blocking an artery) as well as reducing ldl cholesterol. This explains why the standard 'go to' therapy of 80mg atorvastatin is prescribed after a heart attack even though the reduction in ldl cholesterol over 40mg dose looks small. I expect to be dropped from 80mg to 40mg as a matter of course 1 year after my HA.

in reply tofirstlight40

The stabalisation effect on the plaque is often overlooked, it's something that diet alone can not do.

Qualipop profile image
Qualipop in reply tofirstlight40

I wasn't prescribed anywhere near that dose after my HA.

firstlight40 profile image
firstlight40 in reply toQualipop

Maybe your Ldl level wasn't as high as mine or your arteries were in a better state :-)

Qualipop profile image
Qualipop in reply tofirstlight40

Maybe but 80 obviously isn't a standard dose they put everyone on.

Mart25 profile image
Mart25

The figures quoted by MichaelJH are widely available. Milkfairy gave us the NICE reference. Here's a link to a downloadable PDF of the NHS lipid management pathway, which contains a statin intensity table on page 2 : england.nhs.uk/aac/publicat.... This latter document shows what your GP should be doing to manage patients' cholesterol levels - but I'd be surprised if most GPs have the time and persistence to follow this guidance.

For me, the interesting thing about the numbers is that most of the reduction in LDL comes with the lowest available dose (usually 10 or 20mg). Then you get a relatively small change with every doubling of the dose (of any statin). So, for example, if your LDL level is too high on a dose of 40 mg atorvastatin, then doubling the dose to 80 mg will make only around a 6% reduction in LDL (ie. not a lot!). Therefore, if you cannot tolerate a large dose (like MichaelJH) then halving the dose isn't a big deal because it doesn't affect your LDL levels by much.

But I haven't seen any data about different statins and their doses on plaque stabilisation. Does anyone have any info on this?

Nettekin profile image
Nettekin in reply toMart25

Hi mart25. Thanks for that link - very interesting reading. As you say, whether your GP follows it is quite another matter. I finally managed to get an appointment with a lipid consultant after severe liver problems on 80mg atorvastatin, but still have to push for regular blood tests at the GP. I was eventually put on Ezetimibe and Colesevelam as a different approach, but cholesterol still too high.

Mart25 profile image
Mart25 in reply toNettekin

Hi Nettekin. I think it's important that patients understand all this information because GPs don't have enough time (this isn't a criticism - there are simply not enough GPs). I was on 80mg Atorvastatin with no liver problems but my LDL was still too high. So I persuaded my GP to try 40mg Atorvastatin and 10mg Ezetimibe and that did the trick. The reduced Atorvastatin dose was intended to limit the stress on my liver, even though there was no evidence of an adverse effect. I wonder whether you have tried a very low statin dose with ezetimibe. It might do the job without liver effects.

Newstart3 profile image
Newstart3 in reply toMart25

I like the colour coding on this, it makes it all interesting to process at a glance. Like you I'm curious to know how the different statins and doses impact on plaque stabilisation. If you do come across any info please post or message me 🙂

Wooodsie profile image
Wooodsie

Thanks Michael for removing the fog and sticking to the data. Very interesting. However, what your figures don't (and can't) address sadly, are the side effects. If only there was such a comparator 💁‍♂️ but we all react differently. Having just changed for reactive reasons, my choice was based simply on what wouldn't hurt. Not sure I succeeded 😫😂

in reply toWooodsie

Same here. Fired onto 80mg Atorvastatin and no GP follow up after leaving hospital. Result… I had swollen legs and weight rapidly climbed by almost two stone ( 28lbs) over a six month period. No cardiology help due to Covid so had to take matters into my hands and tried to at least speak to my own GP over the phone …. Far toooo busy so after being with the sane practice since I was born I changed practice and the difference was night and day. Found after trial and error my body can’t tolerate any statins …. Now on fortnightly injections and so far so good. FYI - High doses of statins made hardly a dent in my bad ldl levels …

kingsnorth profile image
kingsnorth in reply toWooodsie

l have changed from 40mg Atorvastatin which l couldn't tolerate to 5mg Rosuvastatin 5mg which l can tolerate l have normal range cholesterol and always have but plaques in my arteries unfortunately. l hope my Rosuvastatin does its job 🤞

Wooodsie profile image
Wooodsie in reply tokingsnorth

Same change here. I do feel a bit less pain, but now concentrated in my joints (that or the arthritis has got worse 😬😂😂)

kingsnorth profile image
kingsnorth in reply toWooodsie

Are you taking 5mg Rosuvastatin? Mine are being increased to 10mg at the end of the month. Who would have of thought that l would need statins when l have normal range cholesterol, eat healthily, good BMI and exercise. Unlike Mary Poppins I’m not perfectly perfect !!

Heather1957 profile image
Heather1957 in reply tokingsnorth

My 'readings' for cholesterol are within the normal and acceptable range but 4 years after having a bypass I needed 2 stents fitted in my RCA and they had to drill it clear first as surprisingly the plaque had built up and solidified.Who knows why our bodies react as they do. I am currently on 80 mg Atorvastatin to bring the 'bad' cholesterol down, had blood taken last week and seeing the Cardiac nurse on 9th Feb so fingers crossed there has been some changes.

kingsnorth profile image
kingsnorth in reply toHeather1957

Hope your appointment goes well keep me posted

Carealot profile image
Carealot in reply tokingsnorth

I too have low cholesterol, healthy weight and good BMI. Healthy diet and exercise too. However, the plaque in my arteries (triple vessel) require me to take 40 mg of Simvastatin (changed from Atorvastatin), since when have had burning legs 🤦‍♀️ Currently breaking Simvastatin in half until I see my GP for review in a couple of weeks

santino44 profile image
santino44 in reply toWooodsie

All good information from one and all, much to consider about the possible impact of Total Serum Cholesterol & quietly in the background Blood Pressure I have already had 3 heart attack back in the 90's and what follows was a quadruple CABG allowed well until 2019 when I had a out of hospital cardiac arrest and a new diagnosis of moderate to severe Heart Failure ( NYHA Class2) EF 30% now that was unexpected, was taking my medication as required taking exercise eating healthy food but last fasting blood test revealed was all other reading were in range except for Tri-glycerides my take I wish I was checked years/recent as the annual CVD review( similar to NHS Health Check every 5 years) at the GP did not reveal any changes but me required so better checks/scans etc would be useful

Emeralds55 profile image
Emeralds55

Thank you Michael, my cholesterol was 9.8 and I've been on 80mg Atorvastatin since my HA, I can now see why.

Katjen profile image
Katjen

Thanks Michael. So interesting and informative. I had a HA two years ago, only risk factor was family history, hence cholesterol 7.8. Started 80mg Atorvastatin but had to have it reduced to 40mg due to chronic diarrhoea. At yearly review in 2021 cholesterol down to 4.5 and this year it’s 3.6. So for me it is well worth taking alongside the other cardiac medication.

rizal profile image
rizal

Thanks for posting this. I have been on 80mg Atorvastatin for years, total cholesterol OK(ish) it's the LDL that doesn't behave itself

Hi Michael, I'm on rosuvastatin. How are you now? I've been thinking of you and sending you healing since your leg problems. 💕Clare

MichaelJH profile image
MichaelJHHeart Star in reply toclarehealsworldwide

As you ask I have been struggling the last few weeks. It's become a blend of phantom pain/loss of sleep/pain killers /constipation as each affects the other. It is quite bizarre as your eyes can tell your brain the leg is not there but your brain tells you you have cramp in the calf and the foot is burning. Eighteen months on I thought phantom pain would be a memory!

clarehealsworldwide profile image
clarehealsworldwide in reply toMichaelJH

I'm very sorry to read that, Michael. I'll make a crystal grid to send you healing 24/7. I really hope it will help.🤞 Have you tried any pain relief hypnotherapy or meditations?

Marco2764 profile image
Marco2764

Good enlightening article, thanks

XmasEve24 profile image
XmasEve24

Really interesting. My cholesterol was 9.6 at its highest and unable to tolerate all the usual statins (cramps). Lipid specialist put me on 5mg Rosuvastatin.l’m so pleased to see these comparison figures. Thank you to you and Milkfairy.

Radars profile image
Radars in reply toXmasEve24

I am on 10mgs atorvastatin which i get upper backache its worse after exercise and goes off with rest, anyone think i would be better off with rosuvastin .

XmasEve24 profile image
XmasEve24

Definitely worth asking. I’m also on 10mg Ezetimibe post CABG x2- as they like it even lower after one of those. Now 3.5. Good luck.

MichaelJH profile image
MichaelJHHeart Star

Good morning all...

I have never seen so many alerts before. Most refer to this thread though one was a response to a thread of well over two years ago.

Apologies for not including the source (NICE as Milkfairy and others have pointed out). When initially asked I felt the attitude was very aggressive, and when it was followed by a suggestion that I had made up the data and that it was danger ⚠️I had enough and went to bed. All I had intetended to show was that when people change statins they are not equivalent in action for the same dose. I tried to present it in an Excel table or even a pivot table bur sadly failed. With my background in Mechanical Engineering and Physics I would never invent data as that could genuinely be dangerous? ☢️

Lezzers profile image
Lezzers in reply toMichaelJH

Thanks for your explanation Michael, not really needed though as I think all but one person understood what you were saying. The aggressive approach was a bit surprising!!

Ps: I wasn't inferring that you was aggressive 🤣

Heather1957 profile image
Heather1957 in reply toMichaelJH

I don't think anyone (really) thought you had made the info up, why would you, or anyone for that matter! I need to do as you do though, if something is winding me up, go to bed! Very wise!!

isobelhannah18 profile image
isobelhannah18

thank-you for another informative post.

SaxBox profile image
SaxBox

Hi, A very interesting chart thankyou. I have angina with none of the classic symptoms and was put on 40mg/day of Atorvastatin but couldn't cope with it and ended with 10mg Pravastatin which is acceptable . Leg cramp does seem to be a problem. I've been checking my cholesterol regularly this past year and it has risen about 20% under Pravastatin. Recent Heath check was 4.9. The way I see it its a trade off between keeping cholesterol down and tolerating the strength of the statin. I had to abandon taking beta blockers.

BenThom-Wood profile image
BenThom-Wood

Aha, interesting. I’m on atorvastatin at 40mg. Nearly at the top level & I’ll keep en eye out for Roauvastatin! Thanks for sharing.

MichaelJH profile image
MichaelJHHeart Star in reply toBenThom-Wood

40mg Atorvastatin seems good. My liver could not hack 80mh but increased benefit is quite small...

BenThom-Wood profile image
BenThom-Wood in reply toMichaelJH

I’m now wondering if the pharmacist’s comment of cutting out alcohol (I’m convinced he said cut down…) was something to take a little more seriously; does alcohol impact of the efficacy of statins? All statins?

EndyII profile image
EndyII

Just to add to the thread on Atorvastatin based on some stress tests and CT-Angiogram I was put on 40mg, after a couple months my LDL was at 1.5 the day of my invasive Angiogram due to continuing issues. They increased it 80mg, and added the other usually cocktail of meds instead of stenting my 70% blocked distal LAD, and some other 30-50% areas. My LDL dropped to 0.8. I always had normal LDL, with tad high HDL, not sure how to translate it to UK scale, since i got most of my blood tests in the US before moving to Europe.

Curious if anyone else has nerve pain, light tingling etc on statins, nitrates, b-blockers, etc. I have been to the AE twice with left arm pain - pain in neck/should, tingling prickly in neck jaw , and bicep — and other abdominal discomfort. Both times troponin stable at 6 or 7, ECG fine and more comfortable with the nerve issue diagnosis from my last visit the lead Dr (black scrubs) of AE took time to look into. I am going to physiotherapist soon with referral, hopes it checks out.

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