Statins

[DaveGrohl]

HotJambalaya said:

I actually had to double check the first couple of posts because I thought I'd written them myself!

Anyway, just been prescribed Atorvastatin 20mg too, 44 years old.

I have a big family history of hypercholesterolemia, several heart attacks at the age of 62 ish in the family. Interestingly I'd had a blood test a couple of years ago, which had indicated high cholesterol, then by chance I had another one after 3 months in thailand eating healthy and exercising 4 times a week. It showed negligible change over that time, so they thought best to stick me on it. I asked if it was worth waiting and they said they'd rather I start immediately.

However, in the meantime I've bought this:

https://www.amazon.co.uk/dp/1907797769?psc=1&r...

and am mulling over this one which was just recommended to me today

https://smile.amazon.co.uk/gp/product/1786068257?r...

I do follow a few people that say the whole cholesterol thing is over rated, so I'd quite interested to delve more into it though I'm a little hesitant with the whole family history thing, I mean, I'm literally looking at the heart attack evidence in the family, so as long as im not seeing any side effects, I might as well.

I listened to Zoe Harcombe’s podcast with Kendrick yest as it happens. Not yet read his book, but it’s sitting in my to-read pile. Both of those books are by him. There are a huge number of medical experts who have been calling out the cholesterol hypothesis for decades. It’s garbage, which Kendrick and everyone else goes about dismantling. Ivor Cummins book Eat Rich Live Long is good at explaining how to understand for those new to cholesterol, without getting in to Kendrick’s area.

Did your doctor measure your triglycerides and HDL at the same time? These things have far more bearing on your risk of heart attack than basic cholesterol level ever will. And they are influenced by your diet in a different way than trying pointlessly to get your total cholesterol down, quite the opposite in fact. Once you get into cholesterol you quickly realise it’s complicated and that the accepted knowledge is just dumb. Anyway, sounds like you’re on the road to knowledge now. Familial Hypercholesterolemia is not to be messed with.

[HotJambalaya]

DaveGrohl said:

Did your doctor measure your triglycerides and HDL at the same time?

Yeah, the GP referred me over to the lipid clinic that took the blood and did the consultation, (about 5 vials of it!) so this was all done via the specialists and not the GP -She called me and mentioned that I specifically have some kind of protein marker that tallied with my observations that exercise and diet had hardly changed my cholesterol, saying that the marker told her that I'd always have cholesterol problems regardless of what I did.

[DaveGrohl]

HotJambalaya said:

DaveGrohl said:

Did your doctor measure your triglycerides and HDL at the same time?

Yeah, the GP referred me over to the lipid clinic that took the blood and did the consultation, (about 5 vials of it!) so this was all done via the specialists and not the GP -She called me and mentioned that I specifically have some kind of protein marker that tallied with my observations that exercise and diet had hardly changed my cholesterol, saying that the marker told her that I'd always have cholesterol problems regardless of what I did.

It wasn’t Lp(a) by any chance was it? Or C reactive protein? Lipoprotein(a) is genetic and occurs in 20% of the population worldwide. Statins actually increase Lp(a) levels, which you don’t want.

[rodericb]

Evoluzione said:

Stan the Bat said:

Evoluzione said:

rodericb said:

Evoluzione said:

The question we are asking is why we are prescribed/mis-prescribed these things so readily when a change of diet could be more beneficial.

Because it's the *easiest* for folk to do and it helps keep a massive industry going.

So basically you have no idea like the rest of us.

No, he didn't say that, he gave an opinion .

No he didn't.

I am not going to say to you or anyone else here to take them or not take them. Statins are a bit of a controversial topic and, as you have stated, handed out readily when changes in lifestyle may bring a much better outcome. I am agreeing with you on that point. It's my opinion. The people that make them say they're safe and effective. Why are you questioning it? Does something not quite add up with it all?

[gangzoom]

rodericb said:

Evoluzione said:

The question we are asking is why we are prescribed/mis-prescribed these things so readily when a change of diet could be more beneficial.

Because it's the *easiest* for folk to do and it helps keep a massive industry going.

All medicines should be prescribed and usage guided by a professional, the survival benefit of ACEi and Statins are beyond any 'debate', and in both cases their benefits are achieved regardless of their main 'design' targets of blood pressure/cholesterol control for cardiovascular disease.

You guys are going to loss your minds about SGLT2!! Look at event rate separation, it starts at 30 days post induction, and all current data suggests its got nothing to do with lower blood sugars which is main original aim of SGLT2s.



Statins only show survival benefits after 12months+ of use. Add in SGLT2 effects are in a 'stable' population versus post acute event for Statins. Essentially SGLT2s are like the RedBulls at the moment and Statins McLaren, both are top performers but SGLT2 are on a different level.

Edited by gangzoom on Sunday 26th February 09:56

[gangzoom]

rodericb said:

) Statins are a bit of a controversial topic and, as you have stated, handed out readily when changes in lifestyle may bring a much better outcome.

For people at risk or have had a cardiovascular event I've not seen any trial data to support this statement, can you point me to the reference you have got this information from?

[the-photographer]

gangzoom said:

All medicines should be prescribed and usage guided by a professional, the survival benefit of ACEi and Statins are beyond any 'debate', and in both cases their benefits are achieved regardless of their main 'design' targets of blood pressure/cholesterol control for cardiovascular disease.

You guys are going to loss your minds about SGLT2!! Look at event rate separation, it starts at 30 days post induction, and all current data suggests its got nothing to do with lower blood sugars which is main original aim of SGLT2s.

Statins only show survival benefits after 12months+ of use. Add in SGLT2 effects are in a 'stable' population versus post acute event for Statins. Essentially SGLT2s are like the RedBulls at the moment and Statins McLaren, both are top performers but SGLT2 are on a different level.

Edited by gangzoom on Sunday 26th February 09:56

Are SGLT2's approved for cholesterol control like their older statin alternatives bempedoic acid and ezetimibe?

[Yertis]

Surprised not have read much/anything about oatbran in this thread. I’ve been taking a few tablespoons every day (with yoghurt) for the last seven years or so and I’m pretty sure it’s helping keep my cholesterol in shape, along with having cut down on sugars and carby stuff.

[pteron]

gangzoom said:

All medicines should be prescribed and usage guided by a professional, the survival benefit of ACEi and Statins are beyond any 'debate', and in both cases their benefits are achieved regardless of their main 'design' targets of blood pressure/cholesterol control for cardiovascular disease.

You guys are going to loss your minds about SGLT2!! Look at event rate separation, it starts at 30 days post induction, and all current data suggests its got nothing to do with lower blood sugars which is main original aim of SGLT2s.

[Img]https://media.springernature.com/lw685/springer-static/image/art%3A10.1007%2Fs00059-022-05134-6/MediaObjects/59_2022_5134_Fig1_HTML.png[/thumb]

Statins only show survival benefits after 12months+ of use. Add in SGLT2 effects are in a 'stable' population versus post acute event for Statins. Essentially SGLT2s are like the RedBulls at the moment and Statins McLaren, both are top performers but SGLT2 are on a different level.

[Img]https://www.researchgate.net/profile/Kwadwo-Bonsu-2/publication/315807817/figure/fig1/AS:520351939809281@1501072978643/Kaplan-Meier-survival-curves-for-statin-vs-no-statin-treatment-in-the.png[/thumb]

Edited by gangzoom on Sunday 26th February 09:56

If you read the paper for the statin research instead of just pulling the graph, it actually talks extensively about the failure of research to show a benefit for statins overall in HF patients but points out that lipophilic statins may be more beneficial than hydrophilic statins (this is interesting for me as I'm post NSTEMI/CABG on a hydrophilic statin - time to chat to the doc again). Another important point is that the paper also indicates that there are racial differences in response to statins and this paper specifically targets black Africans as the study was done in Ghana.

Personally I find compelling arguments on both sides of the fence, but there are more whack jobs on the anti-statin side. I don't believe that the researchers for NICE will have been stupid or easily swayed and as a bunch of intelligent professionals will have assimilated the best information they had available. It may be out of date, but even leading edge lifestyle/longevity docs like Peta Attia still advise reducing cholesterol.

The cholesterol story has evolved over time and I shudder each time I see 'arteries clogged by sat fat' but there is still a role for LDL particles to play in atherosclerosis and my personal opinion after much reading is also that it's inflammation leading to oxidised LDL that is the key measure. I just wish we could get better measurements in the UK.

[gangzoom]

pteron said:

The cholesterol story has evolved over time and I shudder each time I see 'arteries clogged by sat fat' but there is still a role for LDL particles to play in atherosclerosis and my personal opinion after much reading is also that it's inflammation leading to oxidised LDL that is the key measure. I just wish we could get better measurements in the UK.

Why are we still discussing cholesterol and statins interims of absolute survival benefits? Its like saying SGLT2s should only be given to diabetics, or ACEi is just about BP control....

[pteron]

gangzoom said:

pteron said:

The cholesterol story has evolved over time and I shudder each time I see 'arteries clogged by sat fat' but there is still a role for LDL particles to play in atherosclerosis and my personal opinion after much reading is also that it's inflammation leading to oxidised LDL that is the key measure. I just wish we could get better measurements in the UK.

Why are we still discussing cholesterol and statins interims of absolute survival benefits? Its like saying SGLT2s should only be given to diabetics, or ACEi is just about BP control....

I think the benefit from statins probably comes from the anti-inflam effects. The wide ranging effects of ACE2 inhibition is starting to be appreciated plus for those of us of increasing age, low dose Tadalafil has much wider effects (arterial condition and muscular perfusion improvements etc) than the obvious too.

If oxidised LDL particles are the key driver of atherosclerosis then a broad brush 'reduce all LDL' may well indirectly help. The other cause mortality effects of low cholesterol haven't generally been recognised by the UK medical establishment yet, but I'm happy with my total cholesterol and LDL numbers, they are not stupidly low. My issue is that my stats (LDL, BP, weight etc) were not predictive of my NSTEMI and so I'm looking for a measure that will allow me to assess lifestyle changes proactively.

[DaveGrohl]

pteron said:

gangzoom said:

pteron said:

The cholesterol story has evolved over time and I shudder each time I see 'arteries clogged by sat fat' but there is still a role for LDL particles to play in atherosclerosis and my personal opinion after much reading is also that it's inflammation leading to oxidised LDL that is the key measure. I just wish we could get better measurements in the UK.

Why are we still discussing cholesterol and statins interims of absolute survival benefits? Its like saying SGLT2s should only be given to diabetics, or ACEi is just about BP control....

I think the benefit from statins probably comes from the anti-inflam effects. The wide ranging effects of ACE2 inhibition is starting to be appreciated plus for those of us of increasing age, low dose Tadalafil has much wider effects (arterial condition and muscular perfusion improvements etc) than the obvious too.

If oxidised LDL particles are the key driver of atherosclerosis then a broad brush 'reduce all LDL' may well indirectly help. The other cause mortality effects of low cholesterol haven't generally been recognised by the UK medical establishment yet, but I'm happy with my total cholesterol and LDL numbers, they are not stupidly low. My issue is that my stats (LDL, BP, weight etc) were not predictive of my NSTEMI and so I'm looking for a measure that will allow me to assess lifestyle changes proactively.

Except statins don’t reduce oxLDL, they reduce healthy LDL…
HDL, Triglycerides, C-Reactive protein would something better than total cholesterol and basic LDL. Or you could do a full lipid panel.

[pteron]

DaveGrohl said:

Except statins don’t reduce oxLDL, they reduce healthy LDL…
HDL, Triglycerides, C-Reactive protein would something better than total cholesterol and basic LDL. Or you could do a full lipid panel.

My HDL, Trigs and CRP are all fine, that's why I'm looking further into it.

What does a full lipid panel measure beyond those mentioned?

[the-photographer]

DaveGrohl said:

Except statins don’t reduce oxLDL, they reduce healthy LDL…
HDL, Triglycerides, C-Reactive protein would something better than total cholesterol and basic LDL. Or you could do a full lipid panel.

I can get the usual HDL, LDL, TRI numbers, how do you measure oxidized LDL levels please?

[rdjohn]

I have a great deal scepticism about Statins.

Since 2005 I have lived in France, I have never come across anyone who takes Statins despite most people over 50 having blood tests every 6-months.

Last year, we returned to the UK and my wife was told that she might need Statins. When asking how this could be, the nurse explained that the UK uses different analysis from the rest of Europe, in fact it is an American test - the only other Western country that uses Statins by the skip-load.

France has one of the lowest rates of heart disease while the UK is second worst after Finland, so not much evidence as a good preventative medication.

My wife is 5ft - 9ins and has a BMI of 22. She looks like the least likely person you would expect to be told that she needs Statins, she just happens to have highish numbers for both good and bad cholesterol. She exercises frequently and is hardly ever ill. During her 44-year working life, she had only 2-weeks off work and half of one week was when she caught flu. At 72 the only medical treatment she takes is Vitamin D as she was once diagnosed with low bone-density.

[craig1912]

rdjohn said:

I have a great deal scepticism about Statins.

Since 2005 I have lived in France, I have never come across anyone who takes Statins despite most people over 50 having blood tests every 6-months.

.

You may not have come across anyone who takes statins in France but six years ago they were no 1 in the European Statin taker league with over 7 mil taking statins , at the same time the UK was 13th with less than 6 mill prescribed.
As a country they still take more statins per head but we are probably catching them up.

[Kermit power]

craig1912 said:

You may not have come across anyone who takes statins in France but six years ago they were no 1 in the European Statin taker league with over 7 mil taking statins , at the same time the UK was 13th with less than 6 mill prescribed.
As a country they still take more statins per head but we are probably catching them up.

That seems somewhat at odds with the graph below taken from this BMJ article which shows the UK sitting third in the world behind Denmark and Canada, with France down in 29th with usage, whilst still above the global average, less than half of the UK usage, unless I'm missing something?

[craig1912]

I did say my data was a few years old and your data shows declining use in France and increasing use in UK. Never the less there are still around six million French taking them and around 8 million in this country. Our criteria has changed and whilst there is the “French Paradox” of low cardio vascular disease (despite some “poor” choices of food) they tend to be slimmer and on average take more exercise.

I guess we can go round in circles but the UK and USA are far from the only western countries that
“uses Statins by the skip-load” as the BMJ data confirms.

Edited by craig1912 on Tuesday 21st March 18:42

[Stan the Bat]

I really wish there was definitive answer to this.

I was put on them last year, even though my cholesterol level has been highish for over 40 years.

[Imasurv]

The more I read the less inclined I am to take them and look for a different approach/interpretation of my cholesterol make up and ‘lipid panel’ which I intend to do once my lifestyle and diet changes have had a chance to bed in.