Statins and Cholesterol

Fatcat1974

I'm in a predicament and I wonder if there are many people on here with experience of this. There were some posts on statins a few years ago.

I'm under 40 (just!), I don't smoke, I'm perhaps a pound overweight at most, I have no family history of premature heart problems or stroke. Importantly, I eat well, I don't drink much and I keep fit. I ride as much as 3 young kids under the age of 5 will allow, and I go to the gym a few times a week.

So it was a surprise to me when a blood test last year came back with a cholesterol reading of 6.85. I looked at my diet and decided it was perhaps indulging in too much cheese and red meat. I was also very run down at the time and hadn't been exercising much. I became stricter with myself and improved my diet. I lost a bit of weight and trained more. I even started taking Benecol.

I had a test just after the new year (probably the worst time to have a cholesterol test for anybody!) and it's come back 6.4. So i've made some progress but my doc says it's still far too high, plus my blood pressure is a little raised, though not technically too high at present.. At this point she's suggested a statin, but she says she's prepared to hold off for a few more months because I'm not at huge risk yet.

I'd be interested to hear from anybody who's had to start taking statins or who has particular knowledge of such issues.

Stu Coops

My mate i ride with regular takes Atorvastatin for a heart attack he suffered 10yrs ago along with an Asprin and Atenolol, basically he was unfit smoked ate crap so consequently suffered a mild heart attack at 34 he's now same age as me 44 and races Road, MTB and Cross and has done for the 8yrs.

So if your question is should you be worried about taking statins, absolutely not, my wife is a nurse and consultants she works with believe that every person over 40 in the UK should be on statins.

This is debateable obviously but that's the opinon of experts just go online and look at the plus points for taking them. Hope this helps

Fatcat1974

Thank you. That's very helpful and it's good to hear such a positive view. The problem with researching symptoms and treatments on-line is that people generally like to write about negative experiences and worst-case scenarios. So thank you again for your response.

Legolam

It's thought that you can only lower your cholesterol by around 10% through diet alone, so don't feel too bad. Cholesterol is mainly synthesised in your own liver, as it is necessary to rebuild cells. Too much is definitely a bad thing, though, especially if you have a bit of high blood pressure (+ family history of heart disease, smoking or diabetes).

If you are a numbers person, go to www.qrisk.org and input your numbers to get an idea of your risk of having a heart attack in the next 10 years. It makes for interesting reading (but then, I am a cardiologist!). You can then make an informed decision about the benefits to you of taking a statin.

Hope that helps,
Hannah

Fatcat1974

Thank you Hannah, I'll do that when I get some down time today. And, while I've got the attention of a cardiologist (!), is there anything that someone in my position could do via my GP to check on my general cardio health now? I won't go into details, but I've felt a bit strange of late but I still run at the gym and ride my bikes and I guess I'd quite like to be given the all clear to carry on with my training and before I tackle the 100mile + events I've got planned for the spring and summer.
Thanks again.

Legolam

There's no test for "general cardio health" as it's such a complex area. Each test available to us answers a specific question regarding the muscle function of the heart, its electrical activity or the blood supply.

Generally, if you're able to sustain a decent level of exertion for a decent level of time without symptoms then I don't tend to worry too much. Obviously, if you have specific symptoms then you're best off speaking with your GP.

Remember, there are no absolutes when it comes to medicine - no-one will ever be able to give you a 100% guarantee/all clear that things are safe. However, more people die of too little exercise than too much!!

Fatcat1974

Ok, thank you for that. I'll take it up with my GP. All very helpful.

paulski1966

With regards to your cholesterol level get a break down of it - total cholesterol is made up of a number of components and can be very deceptive. The reason your GP is possibly interested in getting it down is that GPs are targeted in the GP contract in getting patients below a total cholesterol of 5. Problem is total cholesterol is not a great indicator of risk - much more important is your HDL (high denisty lipoprotien) to LDL (low density lipoprotein) ratio. Your GP surgery will have the details of this - put very simply HDL is good cholesterol LDL is bad (its a bit more complex then that but thats essentially the bones of it)- you would expect a normal HDL level to be around 1 and LDL around 3 (these figures are from the top of my head - I used to sell statins, but that was 5 years ago so apologies if they are wrong). My cholesterol is 5.8 which would be considered slightly high - however I have a HDL level of 1.7 so its not an issue - this is why its important to get a breakdown.

With regards to diet etc I wouldn't worry about it too much - an awful lot of your cholesterol level is hereditary, diet helps but I normally wouldn't expect much more then a 20% effect (also do not pay attention to cholesterol levels in food - prawns and eggs are relatively high in dietary cholesterol but are good for you). Losing weight and getting fitter will help - but often not as much as a statin.

Statins as a drug are incredibly well tested and tolerated and relatively clean (few side effects) and very very safe. Most common side effect is muscle pain - this is normally transient (meaning it will disappear with time) but if its severe - especially if on a high dose statin see your GP (rhabdomyolisis is a possible dangerous side effect of statins - but its is ridiculously rare, I know cardiologists who have never seen a single case of it). If you are prescribed a statin you are most likely to be offered simvastatin or atorvastatin as these are both off patent now (generic drugs are much cheaper for the NHS and work exactly the same). Both are good but Atorva is slightly more effective at lower doses and I have heard anecdotal evidence that there are fewer side effects with it - people occasionally report headaches or nightmares with Simva - again these are rare though. As a drug they are amazingly effective at bringing down cholesterol - and there is a large growing body of evidence to suggest they may have other cardio protective properties. I have spoken to a large number of people who have been on statins for years with no issues at all.

With regards to the Blood Pressure - don't worry to much. White Coat hypertension (an increased blood pressure reading because you are nervous about being at the doctors) is VERY common - high BP levels should only really be diagnosed with 24hr monitoring. The fact that you may have been nervous about getting your cholesterol results may have pushed it up.

Hope this helps.

wytco0

Hope you don't mind me butting in here but I have a few related questions.

I am also on BP and cholesterol lowering drugs and I have been for some time. However I am now losing weight and getting fitter and I would like to think that at some point I could reduce or even stop taking some of the BP tablets. However I have no idea how to tell if the weight loss and training is working to reduce my BP and Cholesterol, is there some way of monitoring this? will the training and wight loss continue to reduce my BP below that affect of the tablets I take? if that's true I assume that I may notice some light-headedness etc?

From the information above it looks as though there really is no problem with staying on the cholesterol anyway?

And to the OP I remember feeling somewhat concerned when I had to go on BP and cholesterol medication, but my Doctor explained that these type of interventions are well understood and more importantly are known to extend life. Weighing up the statistics I feel that the risks from the medication is a small price to pay for the reduction in BP that they give.

apreading

I think the only way to test if you still need statins is to come off them for 3 months and do a blood test. However, if you are only just in the band you need to be while on them, then it is likely your cholesterol will go over if you stop.

mmacavity

http://www.bbc.co.uk/programmes/b006qy05

http://www.cbn.com/cbnnews/healthscienc ... t-disease/

http://www.livestrong.com/article/43577 ... tosterone/

https://docs.google.com/viewer?a=v&q=ca ... 48iSZC4EiQ

pilch

Historically my Cholesterol has been on the up for the past few years, not massively but a worrying trend nonetheless, over the past 12 months or so I have trained hard and raced lots, I have also changed my diet on advice from a nutritionist.

I eat lots of fish, chicken, brown carbs and vegetables, I do eat red meat, but in moderation. Breakfast is porridge & berries, lunch is salad, I snack on fruit, nuts & seeds, evening meal is meat/fish brown rice & veg. I keep to this 90% of the time then have a couple of meals where I just eat what I like.

I cut down on the beer, I still drink it but more often than not i'll drink red wine.

My family has a history of heart problems, I lost both parents to heart related/high blood pressure issues and they both had replacement heart valves and were on associated drugs after.

My cholesterol went down this year from 4.3 - 3.4, my blood pressure is text book and my resting heart rate was measured at 43bpm, my risk of heart attack has also gone down from 5.2% to <5% which is fairly unusual too... i'm 50 this year.

It may not be the same result for everybody, but diet & exercise have a massive impact on your well-being.

mmacavity

http://www.youtube.com/watch?v=uv2Z3UWYJKk

mikeburroughs

I've been on simvastatin for a few years now with no side affectsproblems, also on lisinopril for blood pressure but i am t2 diabetic so the risks with elevated bp and HDL/LDL are greater, but i've had no side effects with either. Moo.

My cholesterol and bp are both low, but docs have said risk of coming off not worth it.

BigAirNig

You may find this interesting - re. Nutritional Ketosis

A low carb diet will enable your cholesterol levels to improve - as Peter Attia talks about in this video....

http://www.youtube.com/watch?v=NqwvcrA7oe8

Some good books on the subject are available.

Worth discussing with your doctor - though they may not be overly aware of this way of eating, perhaps.

fossyant

I had a full test about 7 or 8 years ago, when not as fit as I a now (i am a roadie mainly and always have been, but love MTB).

Anyway, my levels were higher than expected, but with a full medical test, my Heart Attack risk was very low, and this was when I was in a 'less active' point in my life. Keep cycling, keep fit, eat well, and don't worry too much.

As has been detailed above, there are two readings, and overall 'fitness' has to be taken into account.