I have AF but it’s controlled so far with daily flecainide and bisoprolol. I get a three monthly blood test for iron overload but this week the doctor advised me to get a cholesterol blood test as well. All of my results for cholesterol were within the ranges but my doc advised that it’s recommended I go on statins as my Qrisk2 score was above 20%. Whilst I’ve read that statins can help prevent heart attack and stroke as well as reducing bad cholesterol, does anyone know if the statin interacts with my current medication. If I look at my score of 20%+ my age of 70 contributes 7% and my AF 8%. How would a statin then reduce my score to below 10%. Any advice or views would be very welcome as I don’t fancy taking any more medication if I can help it. Has anyone else bee;in the same dilemma please. Thanks
Statins: I have AF but it’s controlled... - Atrial Fibrillati...
Statins
Statins are always a marmite type of question on this forum, less so on the BHF forum, so you will get very polarised views and answers here methinks.
I think you ask some very pertinent questions which are exactly the questions I put. My GP ended up agreeing with me and I quote “In your position, I think I would make the same decision”. That is - No Thank You. Reason for that is I have a muscular neurological condition which statins are known to exacerbate.
Recent research and articles (I think it was a Zoe Podcast?) indicate that the NHS test really doesn’t cover the bases regarding the lipid testing and risk evaluation. The only benefit I could see from taking stains is - forget lowering cholesterol unless you have familial hypercholesterol - the main benefit from statins is their anti-inflammatory properties which is believed to reduce heart disease and may be of slight benefit in the case of AF. You would have to research the clinical studies to get the data.
That’s not a convincing enough argument for me as there are a lot of anti inflammatory substances with no side effects so the benefit for me considering my personal risk of exacerbation of my condition.
Always a risk:benefit ratio and only you can decide but it would a no from me.
Thanks CD. I contacted my cardio last night after getting the text from my surgery and he suggested I meet him which I’m happy to do. I’m on enough medication in my opinion and need to hear a convincing argument for statins to be honest. I rate Matt highly so we will see what he says. I’m probably like you CD as I research everything intensely before doing anything. It’s probably the CEng in me working out the mathematical calculation first. Logically looking at my stats BP v good, cholesterol good (well within range on all categories). My diet, exercise regime are good and I’m a non smoker and abstain from booze. Have to say this has got me perplexed unfortunately
You should know that GPs are under pressure from the powers that be to prescribe statins widely (mentioned by a GP).
Personally I had two cholesterol tests six months apart that were both slightly above the ideal range, about 6.7 I think from memory (my 'good' cholesterol was high). I was pretty sure that this was connected to my thyroid condition. I have hypothyroidism (low thyroid) and I had recently lowered my dose of thyroid meds and my results indicated that they were too low. Thyroid function directly connects to cholesterol levels.
Both times my GP encouraged me to take statins. I told him 'no thank you' and explained that I thought the results were connected to my thyroid situation. I then raised my thyroid meds and the next cholesterol test six months later showed my levels to be within normal range. My GP still pushed statins. When I asked why, given that my levels were within normal range he said 'there's no such thing as good cholesterol'. Which, frankly, is utter tosh. In my opinion.
My BP & HR are low normal (without meds) I have had an echo and angiogram in the past 2 years and my heart is sound and my arteries are unclogged. I'm 67 and suffer from PAF. So I said 'no thank you' again, and will continue to do so.
My 91 year old father on the other hand, who had a mild heart attack 8 years ago and has significant atherosclerosis does take them, with my encouragement, and doesn't experience any negative effects that he's aware of.
Thanks TopBiscuit that’s very helpful. I’ve got an appointment to see my cardio in a week. He emailed me back last night and suggested we meet. I took that as him not wanting to put pen to paper on his thoughts whether positive or negative which I’m absolutely fine with.
Sounds like you have a good cardio! I've had one 8 minute appointment 18 months ago with a cardio who I didn't care for and who discussed nothing and that's it, so I would relish having a clinician that I trusted to discuss things with. I'd be interested to hear what your cardio says on the subject.
I’ll post on here when I see him. He’s really food at listening to me and gives a very informed opinion of the situation. Been seeing him for around 5 years. He always leaves it that if I need him you know where I am.
I was taking 10mg of a statin and my cholesterol went down to just over 2 - my GP considered that to be too low as the brain needs a cholesterol - the dose was halved to 5mg a day and my complete blood test this month showed it a 4 - Dr is happy, I'm happy no side effects at all, so I'll just carry on cutting the pills in half !!!
Thanks pusilanimous. Statin views certainly divide opinion
Totally agree with CDreamer ands she puts it far better than I ever could 😁.
Thanks secondtry. Have you been offered statins please
Oh Yes, about 20years ago. My cholesterol has for25+yrs been around 7. IIyrs ago my heart and carotid arteries were checked and found to be fine.
I understand there are circumstances where it makes sense to take them particularly if you are concerned about inflammation from Covid, the C-jab or other. My cardiologist admitted started taking one but he has been unwell and no doubt knows a lot about the side effects some C-jab batches have caused. Luckily, he didn't try and persuade me to start. My wife had a mini stroke and she was put on one.
For me, the bottom line is if you have a specific concern statins may make sense in overriding possible side effects (aches, aggravating the liver). If you are healthy including possibly high cholesterol then it doesn't make sense to me and I have become cynical about stats usually produced by the drug selling companies or organisations indirectly financed by them.
Thanks secondtry. The other thing I’ve had done is an echocardiogram (in December) and no artery issues or valve problems or anything really was found. Cardiologist was happy with my results. I really can’t see how being on statins is going to benefit me.
It's also a clear no for me. Especially when you are in normal range. Look at some presentations by Dr. Aseem Malhotra on YouTube, he explains it pretty well and if I could I'd take him as my cardiologist.
Thanks minime much appreciated
Hi im in the same dilemma, I've been asked 3 times now to go on statins by my Dr but something is telling me no, like you i am taking enough medication already, my BP is v good im on a weightloss journey (over 2 stone)and in a really good place with my self and my AF is behaving itself at the moment lol, my cholesterol is 5.7 but im hoping it will go down the more weight i lose, im just very confused as to weather they will help or not.
Thanks Ginger. My total cholesterol was 4.6 so well within the target range. I just wonder if the NHS get financial benefits from prescribing drugs or am I being too cynical
4.6? That’s pretty good! That said, your overall QRisk, which takes in other factors as well as cholesterol, is high at 20%+ and certainly at a level NHS guidelines recommend a statin. As others have said, GP practices are financially incentivised to offer statins where the risk is over 10% via the Quality and Outcomes Framework (QOF). Read into that what you will. Hopefully your consultation with your Cardiologist will prove helpful. Can we all share him?!
The only reasons I’m above 20 is to do with my age 70 and the fact I’ve got AFIB. That accounts for 15% of the score. BP systolic is 111 and weight is fine BMI just above 25. Thanks for the details re payments. Can’t say I’m surprised as they pushed me to get a cholesterol check done. Only had one a year ago and they told me it now needs done every year. I’m not convinced
I think you’re wise.
Thanks so much for this information - I haven't heard of the QRisk before. I found the questionnaire and was able to put in all the relevant information, and apparently my 10 yr Q-risk score is 12.4 which does make me wonder why my GP was so keen for me to take statins. The only thing that raised my risk from a 'normal healthy person of my age' is the PAF.
Yes lots you can Google on QOF payment incentives. The threshold used to be risk of 20%+, then it dropped to 10%+ which put almost all men over 60 and women over 75 into the eligible bracket. Re-googling this morning in light of this post, I see that in January NICE drafted guidelines to offer them “as part of shared decision making” to those with less than 10%. Worldwide the statins market is running at around $15 billion per year.
The Q risk scoring algorithm has been shown to overestimate cardiovascular events in the real world. No doubt designed to get more people on drugs they don't need. Elderly women on the whole do not benefit from statins and large epidemiological studies conducted in Scandinavia have shown that those with higher cholesterol live longer and have less disease including cardiovascular disease than those with so called "normal" cholesterol. As CDreamer points out there is litte value in cholesterol lowering per se . The class of drugs that preceded statins lowered cholesterol very efficiently and made no difference to mortality or occurrence of CV disease. Any anti inflammatory effect of statins can be obtained with other substances that do not have the negative side effects of statins.
I would be far more in favour of statins , which do have a place in treatment, if " having the conversation with patients" was not part of doctor's Quality Outcome Framework here in UK on which pay was dependent. Some seem to think that this means they MUST get their patients onto statins and I fear this tilts the argument. When I discussed it with my GP she was happy to tell me that no all was well since she had the conversataion and that she respected my right to decline. I just fear that many are unecessaraily pursuaded .
Wow Bob that’s incredible. I’ll speak to Matt my cardio and get his unbiased viewpoint (at least I think it is)
I follow my doctor's advice on this as stroke risk is so variable and individual. Statins cause no side effects in the majority who take them and seem to do no long term harm. I have read the naysayers' comments and many reports and still feel they are most likely for the best.
Steve
Hi Steve,
Your sentence ..............
"Statins cause no side effects in the majority who take them and seem to do no long term harm. " .... and that precisely describes me. I was put on them in 2007 (age 63 ) by my GP because at the time it seemed to be the current and conventional wisdom. I'm now 79 and am still on them, just a different brand. I've yet to read or hear of anything that would persuade me to stop them. My paroxysmal AF was diagnosed in 2010. I have annual blood tests covering one issue or another including cholesterol and it never waves a red flag. As an aside I have an Electrocardiogram every two years which reveals any changes in the state/condition of my heart.
John
Hi John
I wrote it as often in threads about statins, I tend to find some people reporting how awful they are. I am sure a few do have bad side effects but, overall, when I looked at the reported figures for side effects, they do show them to be, generally, a very safe tablet to take. The evidence is increasing also that they do work well to lower cardiovascular diseases. They aren't a wonder drug, I appreciate that, but seem to be helpful and I feel better in taking them.
How is your AF these days - symptoms and frequency? I have much more in the way of palpitations than AF, and when I get that, it's not too bad. Overall, though, I feel mine is worsening.
Steve
My AF Steve, mercifully it is highly controlled to the point of being non existent, around 4 years now since my last AF event. My life these days is far more dominated by pain from an osteoarthritic left shoulder and a torn tendon on my left shoulder rotator cuff ............ wish that was as easily fixed as my AF was. Sometimes the pain is so intense I can well understand how some poor souls give up the will to live. And my pain is nothing to some pain sufferers endure. But hey ho .... summer is coming ..... I'm anticipating a full summer with average temperatures of 32 degrees .... that'd be fine. 😂😂😂 ......... ain't gonna happen is it, not in Cornwall !
John
Hi John could you advise what has controlled your afib please
Hi Profound15,
In a nutshell .... medication and diet. I was diagnosed in Jan 2010. By September that same year I had the very good fortune to identify the onset of an AF event with food I'd eaten, particularly the last and main meal of the day. Right at the get go I rejected all notion of cardioversion and ablation, relying initially on medication for life. As I say, by Sept 2010 food had crept into the equation.
My symptoms were all gut related, burping, intestinal gurgling, diahorrea and also massive and very painful bloating. None at the same time, all at random, but the feature that would trip me into AF was bloating. Saw my GP back in the day and he had tests done for Coeliac Disease and IBS. These were clear. It was around this time I learnt of the Vagal Nerve and its influence on the heart and gut. (If you are interested I suggest you Google " Vagal Nerve " schematic diagram and see how it wends its way through the body ).
I then consulted a Nutritionist who advised me to go Gluten, wheat and oats free. She also advised me to keep a food diary to more objectively look at what other foods ( and even their ingredients ) may be contributing to the bloating.
So basically it was a case of calm the Vagal Nerve, calm the gut, calm the heart.
John
I’m the same re vagal activated and I’m on flecainide which works fine. Are you on flecainide as well please
Back in 2010 I think Bisoprolol was the HR control drug of choice. So I was put on 5 mg Bisoprolol taken at night through till August 2023 .... when I began to get side effects. GP then changed me to Nebivolol 3.75mg, taken at night. Flec was never considered for me and still isn't. At the time I was put on Bisoprolol I was also put on Warfarin - that lasted till around October 2023 ( I think ) then changed to Edoxaban.
Thank you
I think it might be a nice ticking thing of being a woman and over a certain age! When a blood test shows a borderline result for cholesterol I used to take red yeast rice capsules as recommended by a friend who didn’t get on with statins and that always worked at bringing cholesterol down to an acceptable level by the next test. My paroxysmal AF is controlled by Flecainide ( 100 mg twice daily) but it seems to add to the fatigue I acquired at around the same time as the PAF and the last time I was told my cholesterol was borderline I agreed to take the statins and have had no trouble with them. I have never been overweight in my life and have a healthy diet and used to be very active until the fatigue struck. I also take Omeprazole now as I have a hiatus hernia too! All in my later 70s so had a good run! Hope you find something that works for you as we are all different!
Hi, re statins I've resisted. I've been told that because I had a stroke my cholesterol level needs to be below 2.5, mine is 2.9 down from 3.7 last year, I did this by eating less meat and little alcohol.
Thanks 2learn. Hopefully I’ll get full clarity when I see my cardio. He has never mentioned it before in all my dealings with him. I know that the calculation model only changed in December last year I believe so more people are going to be dragged in to this dilemma
Profound, at the risk of being nosy, did your cardio give you a clearer picture on the statins question? I only ask as I’ve been given the ‘summons to see Pharmacist’ too and your scenario is similar to mine.
Sorry for the delay. Yes my cardio, whilst not agreeing or disagreeing, did agree that the absolute benefit was very small (1%). If you consider that and the potential side effects which I have taken in to consideration then it a no no for me Some of the recorded side effects include diabetes and dementia. He acknowledged that these are ‘potential’ side effects and might not necessarily occur.
Thanks for coming back to me. I’ve been doing a lot of reading and have found the same solid research as your cardiologist. Absolute v relative risk is a game-changer in the decision-making process for any pharmaceutical intervention. The considerably higher risk of onset diabetes, and it’s negative implications on heart health, is also key. Always a risk-benefit calculation to be done on an individual basis, rather than population cohort, and I’m heartened (excuse the pun) that your cardiologist has done just that.
I had a text message from my surgery asking if I would like to start taking statins as I had been identified as someone who might benefit from them. My cholesterol is 5 and I do not want to take them so declined.
I recommend you look at a YouTube video by Dr. Paul Mason, "The shady truth about statins", for another perspective on statins. It's on the Low Carb Down Under YouTube channel, which has other interesting videos on statins, low carb diets, and other health matters.
Incidentally, it's a no on statins for me.
Thanks Bob. I’m deffo forming the same opinion as you
Hi, I’ve just got my blood test result today and my cholesterol is 5.7. I’ve had a text from the surgery suggesting I start Statins but I’ve declined in the past and think I will again. I don’t tolerate medicines well and I fear I won’t tolerate Statins. Good luck with your decision
Thanks Nan. I just watched the video from Dr Paul Mason as mentioned by Ozzie. Wow that certainly opened my eyes. Talk of them allegedly causing dementia and diabetes was something that concerns me. I think I’ve almost made my decision but will speak with my cardio to get his take on it. He’s a pretty honest guy I think so I’m able to make a fully informed decision after that.
Does look like many more people are trapped in this net of meeting the new (and changed) criteria.
Hi
Statins over 20mg interfere with taking my thyroxin for "no thyroid plus due to cancer".
I'm 75 and take my statins when up. Last week 7.1 but reduced by good cholesterol and it came down to 4.6.
Cardiac Sp says 4.
I'd had 3 slow cooked sausages the day prior and I just wanted to see whether the ormer changed things also a cheese sandwich.
I'll take the statin 10mg for a week and forget it. I'm on Avorastatin.
A medical magazine said no one can get a cholesterol level???
So. That's the way I work. Your anti-co.agulant is more important.
cheri JOY. 75. (NZ)
Thanks joy
"If I look at my score of 20%+ my age of 70 contributes 7% and my AF 8%. How would a statin then reduce my score to below 10%."
I hadn't heard of Qrisk2 but a quick read indicates 20%+ is high risk. Even if 15% of this comes from AF and age there's other factors increasing your risk of heart attack or stroke.
Just because you can't get your risk below 10% by taking a statin doesn't mean taking a statin isn't worthwhile. With a score of 20%+ you should be looking at every option to reduce your score (risk). Whether that's taking statins, losing weight or through other changes you should be seriously considering every option IMO and that would be the basis of a discussion with my GP if it was me i.e. what are my options and what would you do if you were in my position?
I'm on Flecainide but a different beta blocker (Metoprolol) and I haven't noticed any problems with starting statins ~6 months ago. YMMV.
Thanks for your input
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