To statin or not to statin - that is the question?

[Seahorse]

I have FH which means that either my mum or dad had FH (probably my dad but undiagnosed). Unfortunately they are both now dead but neither died from or had heart disease. One of their parents must have had FH but again no heart disease. All were heavy smokers, increasing their risk further. None of them took statins as they did not know they had the condition. My brother had FH (also a smoker) and he did take statins - died of a heart attack! Hmmm, makes you think eh?

[Hidden]

Yes, the studies do show that NNT (Number needed to treat) for statins is very poor e.g. at least 1 in 100. In other words, for every one hundred people with high risk taking statins, only one will benefit from taking statins. There are numerous studies showing this (feel free to search online for the exact figures). Compare this with antibiotics. Nearly everyone who takes antibiotics will be treated.

[Aliwally]

Isn't this why more accurate research into FH is needed. Please don't quote me, but I vaguely remember reading that the course of FH can be extremely variable and also once someone reaches middle age ,the risks are less. The main risk time is early adulthood, but again I am no expert.

Surely this becomes more important as children are now being diagnosed with FH.

[Hidden]

Agreed - more research is needed. It's clear people with FH have much higher cholesterol levels but not everybody with FH (by a long shot) will develop heart disease. Unfortunately I don't have any figures as I can't get them e.g. what percentage of people, with diagnosed FH go on to develop heart disease and at what age. Perhaps more importantly - what percentage of people diagnosed with FH DON'T develop heart disease and why not ( obviously we're assuming high cholesterol causes heart disease). It's apparent people with FH have more risk of developing heart disease but by how much compared to those without FH in absolute value terms e.g. 10-year risk based on studies. I also hate the relative stats they give e.g. (and this is made up) - you have 50% more chance of developing xyz if you have FH than if you don't. Absolute value would be 2% without FH and 3% with - hence 50% more chance! Unfortunately I guess it's unethical to study people with FH not on a statin compared to those without FH not on a statin so I guess we'll never know.

[Aliwally]

The article I vaguely remembered was published in the BMJ in 2001 when they traced mortality over two centuries in a large pedigree of FH families.

I could only access the abstract, but the gist was that 40% had a normal life span.... but I suppose you could argue that 60% didn't.

Mortality was normal in the 19th century which they surmised could have been due to high cholesterol protecting them against infectious disease when all the poor souls with normal cholesterol were dying of infected scratches before anti biotics.

Death rates peaked between 1930 and 1960. Fascinating, but not sure how relevant!

[Hidden]

Yes, found that article in the BMJ. Turns out our own Heart UK owns the Simon Broome Register now and ...'The on-going core costs of the Register have been generously supported by a number of unrestricted educational grants from major pharmaceutical companies' - which is nice.

Reading from here:

primarycare.ox.ac.uk/resear...

based on the study as published in the BMJ in 1991, 'a roughly nine-fold higher risk of fatal coronary heart disease (CHD) in FH patients aged less than 60 years before the introduction of effective treatment with HMG Co-A reductase inhibitors (statins).'

Now I've read the paper in the BMJ and from it's figures: In the age group 20-39 there were 6/216 deaths from CHD, 40-59 there were 8/237 deaths and in the 60-74 there was 1/75 from CHD. Again, these are all people with diagnosed FH and not on statins.

And in the conclusion - I quote: A striking finding was the reduced relative risk of death from coronary heart disease with increasing age. Patients who survived through middle age seemed no longer to be at a substantially increased risk of coronary heart disease. In both men and women aged over 60 at registration there was no increase in the standardised mortality ratio for coronary heart disease or all cause mortality.

[Aliwally]

Just been looking up a couple of studies about cholesterol levels in the very elderly, a Dutch one was called in the oldest old! In people over 85 high TC is associated with longevity due to reduced cancer rates and infection.

In a smaller French study mortality was lowest at a TC of 7.

My husband's aunt aged 90 threw away her statins a few years ago,she is off to Ibithia in a couple of weeks. Good for her!

[suki65]

Hi seahorse that is very interesting was your brother not very old ?

[Seahorse]

Age 52 but he was a life long heavy smoker.

[suki65 in reply to Seahorse]

Hi Seahorse That is one to prove a point ,im only 48 never been poorly told i had to go on statins as genetic high cholesterol very ill after taking 3 different statins ,keep telling every health proffession but dont listen .

no statins just intermittent fasting i will do it this way with or without my doc

Are you on statins seahorse ?

[Seahorse in reply to suki65]

Yes. I'm on rosuvastatin 20mg at the minute.

[Silversurfer4739]

Today's Mail on Sunday page 49 mentions that Sir Magdi Yacoub told BBC'S Radio 4's Today programme that everyone over 40 should be taking Statins..(Sir Magdi is a famous Heart Surgeon)

he said this after other people said they should be stopped..

Sir Magdi said:"Not to take statins is a disaster.

The risk benefit ratio is massively in favour.

Doctors don't even have to prescribe them,there is move that that people can buy them themselves.

do I go back on them after stopping them 18 months ago?

My joints are still in agony.

my Heart has got worse.

I am about to use a Powerchair officially on the 21st of May.....

I hope it helps my pain.

Good Luck....

[sandybrown in reply to Silversurfer4739]

All,

The article in in the mail today. Millions are on Station and many more to go on this. Satins has been around for 25 years and has been proved it has benefits!

Only a few people on this site are giving views on statin bad effect, including me.

The question is how can this small number of people help NHS understand the bad side effect when professors are saying satin is best medication and all over 40 needs to taken them and better way of spending NHS money!

[ursa in reply to sandybrown]

Only a few people are voicing adverse side effects because a) the side effects do not manifest themselves straight away b) many people do not make the association of the side effects they experience with statins c) only until recently was the usefulness of statins openly questioned d) GP's, from my experience, do not actually point out to patients to report any, even slight, changes in their conditions after commencing a statins 'treatment'