Morning all - asking out of curiosity here, am currently on Bisoprolol 1.25mg (reduced Fromm 2.5mg about 9 months after NSTEMI) Dispersible Aspirin 75mg and Atorvastin 80mg.
Everything is well controlled and all relevant targets have been exceeded from weight to cholesterol etc - my question is does the Statin dosage get reviewed / decreased over time on the back of positive scores, or does it tend to stay at the current, post incident dose of 80mg.
Any input or insight welcomed from those further down the road. I'll be two years post NSTEMI this July.
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doktordru
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You should at least once a year if not more have blood tests and a medication review
Right from the start I was on 80mg of statin but could not tolerate it and so they dropped it to 40mg which I am much better on but I have regular blood tests and my levels are fine
If you are tolerating the 80mg there is no reason at this stage why they would change it if you are struggling then talk to them and they will decide if for you personally you would be alright on a lower dose but this is something you need to ask them x
yes I have annual set of blood tests which are showing everything fine. Terms of all cholesterol numbers. And all other measured function are ok given the potential negatives arising from statin usage. So that’s useful to know. If all cholesterol numbers look good along with good diet and exercise it’s possible to look at decreasing dosage over time. Luckily my side effects were/ are minimal so I guess I’ve got used to them.
This would be something to talk through with your Doctor as we are all different why they want us on a certain dosage so I would ask them if this would be possible if you would like to consider it
My husband has been on 80mg Statins for a very long time, probably 20 years, due to family history. As his cholesterol was ok he tried to drop his dosage down (with the ok from his doctor in Canada at the time). Then he had NSTEMI and quintuple bypass, so who knows if that would have happened any way, but now he sticks with the 80mg.
I started with 20mg Atorvastatin. With heavy side effects reduced to 10mg after 1 month. 2 months later my levels were fine. Still some inacceptable side effects, reduced to 5mg. Will see in 2 months what the test says.Cholesterol ist not the problem, the doctors know that very well. It's all about business! The diet is the key, no sugar, no grain and good fats.
NICE recently increased the starting dose for Atorvastatin from 10 to 20mg. As far as eating grains are concerned, this link suggests that there are heart benefits: heartuk.org.uk/low-choleste...
I asked about a reduction in medication at my last review as my results are fine. The reply I got was the dosage / medication is a preventative measure and therefore would not be changed 🙂
I was put on 80mg of statins a year ago. My cholesterol has gone from 6 to 2 and the consultant said that 'in March' she'd look at reducing the dose to 40mg. So I'm hoping she will! I tolerate it fine, fortunately.
My statin dose was reduced to 40mg a few months in as I was struggling with some of the meds, bisoprol was stopped at the same time, and the Cardiologist said we had some wiggle room due to my numbers. I'm currently on 20mg as I do seem to to have some sensitivity to statins. I had a blood test a few weeks ago and my cholesterol has gone up a bit so I've booked another review with the GP to discuss that and some other ongoing issues with being so flipping tired all the time. There has been some talk of adding ezetimibe to the mix.
I was started on 20mg atorvastatin. At my initial 3 month blood test, my cholesterol had reduced significantly so I think I will be staying at this level but will have an annual blood test to check.
As stated above, 20mg is new 10mg for a starting dose based on recent reports such as this:
Results: LDL-C levels were reduced more significantly by atorvastatin 20 mg than by 10 mg after 12 weeks (42.4% vs. 33.5%, p < 0.0001). Significantly more patients achieved target LDL-C levels (<100 mg/dL for high-risk patients, <70 mg/dL for very high-risk patients) with atorvastatin 20 mg than with 10 mg (40.3% vs. 25.6%, p < 0.05)
Hi doktordru, I had Nstemi and quadruple CABG July 2023, my numbers are also fab , cholesterol really great stats etc. I was on 90 mg arvovastatin and making great gains in my physical rehab until about 5 months post surgery when I started to get too many aches in my muscles , joints , tendons , cognitive impairments and other symptoms. GP agreed to trial stop the artovastatin. I felt great for a month , then I was started in 40mg Pravastatin. I was told that it was a preventative measure to be on a statin , and that our figures for cholesterol need to be lower than the norm as we are on secondary measures (statin). So even if our figures look amazing , that’s where they need to be and it’s the effect of the statin that’s helping to keep them there. I’m not sure I’ll be coming off a statin , but I will be keeping an eye on how the meds make me feel and be asking questions to have them changed . I can’t see the point in having great stats and feeling sh1te everyday . I’m currently trying to get my beta blocker dosage reviewed as I’m losing periods of the afternoon/day to fatigue and can barely stagger about.Having a challenge getting through the online GP system to reach my doctor . Been told it will be reviewed on the 25th March , an appointment I made on the 25th Feb! I can’t wait that long and told the surgery that my doctor needs to see my submission with my blood pressure results and that I will be stopping the Bisoprolol and ramipril without Gp authorisation. Oops .. sorry for the rant 🤦🏼 It felt good to get it off my chest 🤣🤣.
thanks for the note and good luck with the recovery. If it’s any help I was in a similar situation with Bisoprolol where my discharge dose of 2.5mg was giving me a resting heart rate if circa 40 and a sleeping heart rate into the low 30’s. After getting an Apple Watch I was able to collate a load of data which persuaded my GPs Practice Pharmacist to review and reduce the dosage to 1,25mg which is where I am. Much better outcomes in that resting heart rate in now typically 44 and the faint feelings have gone!
I had a similar conversation with my GP practice very recently regarding my atorvastatin and ramipril doses. Whilst they were receptive to reducing the ramipril (subject to regular BP checks), this wasn't the case with the statin despite my (now) low cholesterol and triglyceride levels. They explained that the benefits post-MI are not just related to reducing cholesterol and stabilising the existing fatty deposits in the coronary arteries. More specifically, recent research has suggested that statins help to increase the elasticity of the heart. So, I continue with 80mg!! I hope this and the other good advice here helps.
thank you - that's good to know and was new news to me! Always good to hear about the experiences of others - I'll pick this up at my next review - not pushing for a change as overall I feel good - more interested in understanding current thinking and how it applies to my situation.
If you change your diet to plant based low fat, there is a big chance, that your cholesterol goes down significanty and then you can reduce your statins. Interesting book about this topic: "Reverse Heart Disease ( Esselstyn ). Good luck, stay well!💐
Me cholesterol when from 5.3 pre HA to 2.7 pst CABG and reducing saturated fat in my diet. So I requested a review and they cut dose to 40 mg. I would suggest you do a fasting cholesterol test first, see where that is.
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