Statins - Do I want to be on them?

photonic69

Hi. Just had a message from my GP. They want to put me on statins. I have had raised cholesterol markers over the last 4 years. Nothing massively high but just of 'concern'. Have a healthy vegetarian diet. Don't eat a lot of fat. A healthy weight. Get lots of exercise. My blood pressure is also slightly high. Not massively but when I'm checked at the GP its usually 140/85 ish. When I check at home and I relax and check I get 115-120/74-80 range.

Anyone on them? What can I expect to go wrong when taking them?

pblakeney

*This is not medical advice.*
In my experience once you are put on something it is difficult to get taken off them.
A little known fact is GP's get paid for every prescription. A cynical person could think...

Wheelspinner

*disclaimer: not a medical expert. Barely a numpty*

Avoid if you can. They do work for cholesterol lowering, but there are side effects. Muscle and joint aches are the common one, but I’ll add lethargy and reduced capacity for exercise. On them, my max heart rate is measurably lower.

I’ve had a cardiac stent, back at age 48, and a family history of heart trouble, so I am in the risky category. I take the minimum dose I can to maintain the results, and periodically stop them altogether for a month or two for a system break.

Would much rather I didn’t take them at all.

joe2019

oxoman said:

I was sent to my gp after wellman check at work a few yrs ago for hi cholesterol and high BP. The gp did a thorough cholesterol test and results came back as borderline for statins. We spoke about diet etc and whilst slightly overweight I was eating healthy, very little meat low or zero fat everything and running half marathons and riding. His words of advice where carry on as is and dont worry about statins yet. I was 52 then nearly 56 now. The BP was classed as pre hypertension and stress related. Personally I'd love my BP to be 125 / 85 area but I can dream. As per PB above this isn't medical advice just our experience the choice is yours to make.

I find that eating full fat everything is works pretty well for me.

57 years, 5' 11, 65 kg, BP 115 / 75 - I'm not on any medication.

Munsford0

I'll be 65 this year and old age has caught up with me to the extent I'm now on statins and something for mildly elevated blood pressure. No side effects I've noticed

pblakeney

joe2019 said:

oxoman said:

I was sent to my gp after wellman check at work a few yrs ago for hi cholesterol and high BP. The gp did a thorough cholesterol test and results came back as borderline for statins. We spoke about diet etc and whilst slightly overweight I was eating healthy, very little meat low or zero fat everything and running half marathons and riding. His words of advice where carry on as is and dont worry about statins yet. I was 52 then nearly 56 now. The BP was classed as pre hypertension and stress related. Personally I'd love my BP to be 125 / 85 area but I can dream. As per PB above this isn't medical advice just our experience the choice is yours to make.

I find that eating full fat everything is works pretty well for me.

57 years, 5' 11, 65 kg, BP 115 / 75 - I'm not on any medication.

Well done you. 👏👏👏

veronese68

I got put on statins about a month ago as apparently I've had a stroke at some point in the past. All of my figures are good and should put me in a low risk category for everything, but a scan for something else showed scarring which means it had happened. I was advised to go onto statins as a result, told minimal side effects if any and all that. I've not noticed anything as yet. I put any lethargy and tiredness down to not being as fit as i could be and a bit lazy, so interesting to read what Spinner wrote above. I have a review after 3 months so I might see what they say and take a break after that and see what effect it has.

photonic69

joe2019 said:

I find that eating full fat everything is works pretty well for me.

57 years, 5' 11, 65 kg, BP 115 / 75 - I'm not on any medication.

You...Absolute...Barsteward....

Munsford0

It's mainly down to genetics. I eat a pretty healthy and varied diet, do an active job plus a fair amount of exercise, do intermittent fasting to keep my weight where I want it, drink in moderation, never smoked. On the other hand both parents had major heart attacks, one of them fatal....
I figure taking a couple of pills to reduce blood pressure and improve blood lipids is a small inconvenience if it moves my risk of a cardiovascular event in the right direction.

orraloon

As per Munsford above, I was advised (well in fact asked by practice nurse doing the MOT review why I wasn't already on them) to start taking them ~ 4 years ago. Slightly raised cholesterol, getting older, but for me more significantly that my mother's side of my gene pool has track record in her generation of serious cardio issues. She was 2nd youngest of 10 (😳), her older and younger are only ones left, rest died in their 40s -70s with cardiovascular issues.

So what I had to ask myself was 'do I feel lucky?' Easy decision to take the statins. No side effects noticed.

Mad_Malx

It's a mistake to assume your elevated cholesterol is coming from dietary fats. Along with your genes, increased dietary carbohydrate (relative to fat) is a big driver of elevated LDL ("bad cholesterol", but I'm not keen on ascribing sentience to chemical entities).
Avoid cutting unsaturated fats if it means you consume more carbs to feel sated. We need our carbs to keep going (and get up Bathwick Hill), but look to reduce the refined carbs if you can.

As for the statins, they have undisputedly helped avoid millions of strokes and cardiac events. At low doses signifcant side effects are rare, but that doesn't mean they never happen. Muscular pain & atrophy is associated (still uncommonly) with higher dose, but it was more of a problem before the risk was well known.

Not that sort of a doctor, but did spend a long while looking at these things.

veronese68

Thanks MM, that's pretty much what the GP said to me about statins. After an initial chat with another GP along the lines of 'all your other indicators are low' I opted not to. Then had a call from one of the senior guys that knows me and he said any history of strokes means you're at risk do you really want to chance it? Talked it over with the Mrs and bizarrely she wants me to stick around, so I'm on statins.

First.Aspect

Any thoughts on the alleged effects on memory?

While he could remember, my dad blamed them for advancing his condition.

Munsford0

First.Aspect said:

Any thoughts on the alleged effects on memory?

While he could remember, my dad blamed them for advancing his condition.

Given the vast number of people taking them, pretty soon they'll be able to tease out any trends of that kind. Although Covid after-effects might confuse things for a while...

photonic69

Mad_Malx said:

It's a mistake to assume your elevated cholesterol is coming from dietary fats. Along with your genes, increased dietary carbohydrate (relative to fat) is a big driver of elevated LDL ("bad cholesterol", but I'm not keen on ascribing sentience to chemical entities).
Avoid cutting unsaturated fats if it means you consume more carbs to feel sated. We need our carbs to keep going (and get up Bathwick Hill), but look to reduce the refined carbs if you can.

As for the statins, they have undisputedly helped avoid millions of strokes and cardiac events. At low doses signifcant side effects are rare, but that doesn't mean they never happen. Muscular pain & atrophy is associated (still uncommonly) with higher dose, but it was more of a problem before the risk was well known.

Not that sort of a doctor, but did spend a long while looking at these things.

Thanks MM. My diet is mostly unrefined carbs - brown basmati rice, rough cut porrige oats every morning (no sugar), homemade wholemeal bread with rye. I do eat quite a lot of nuts and usually have peanut butter (and marmite) in my daily sandwiches. Rarely eat white pasta or potatoes. Not a cake person. Don't eat a lot of eggs or cheese etc. Always have olive oil based margarine instead of butter etc, so really doing all the right things to try and keep my LDL levels low. Maybe statins are the only thing that will help? I'll collect them from my pharmacy and start taking them on 1 April so I have a datum to compare. Really hope they don't affect my ability to get up Bathwick Hill! Having enough trouble post COVID with less strength in my legs.

joe2019

photonic69 said:

Thanks MM. My diet is mostly unrefined carbs - brown basmati rice, rough cut porrige oats every morning (no sugar), homemade wholemeal bread with rye. I do eat quite a lot of nuts and usually have peanut butter (and marmite) in my daily sandwiches. Rarely eat white pasta or potatoes. Not a cake person. Don't eat a lot of eggs or cheese etc. Always have olive oil based margarine instead of butter etc, so really doing all the right things to try and keep my LDL levels low. Maybe statins are the only thing that will help? I'll collect them from my pharmacy and start taking them on 1 April so I have a datum to compare. Really hope they don't affect my ability to get up Bathwick Hill! Having enough trouble post COVID with less strength in my legs.

Strength in your legs, or lack of, won't be affecting your ability to climb Bathwick Hill.

Mad_Malx

joe2019 said:

photonic69 said:

Thanks MM. My diet is mostly unrefined carbs - brown basmati rice, rough cut porrige oats every morning (no sugar), homemade wholemeal bread with rye. I do eat quite a lot of nuts and usually have peanut butter (and marmite) in my daily sandwiches. Rarely eat white pasta or potatoes. Not a cake person. Don't eat a lot of eggs or cheese etc. Always have olive oil based margarine instead of butter etc, so really doing all the right things to try and keep my LDL levels low. Maybe statins are the only thing that will help? I'll collect them from my pharmacy and start taking them on 1 April so I have a datum to compare. Really hope they don't affect my ability to get up Bathwick Hill! Having enough trouble post COVID with less strength in my legs.

Strength in your legs, or lack of, won't be affecting your ability to climb Bathwick Hill.

I really hate that one. Widcome steeper but doesn’t go on forever, North road much kinder. My daily commute was Brassknocker for 10y before switching to Claverton bcs of traffic (and Winsley home). Retired now - much longer rides but lost my climbing ability.

Mad_Malx

Sorry for OT

jp1970

pblakeney said:

*This is not medical advice.*
In my experience once you are put on something it is difficult to get taken off them.
A little known fact is GP's get paid for every prescription. A cynical person could think...

GP don't get paid per prescription... The local management team (CCG) monitor practices prescribing habits/costs etc.

pblakeney

Many sources but this will do.

https://www.diabetes.co.uk/news/2016/jun/gps-given-financial-incentives-to-prescribe-statins-in-type-1-diabetes-91453132.html

jp1970

It's a few years out of date.
GPs get paid for a shed load of 'items of service'

Majority of the guidance is based on the NICE guidance.. Love it or loath it.

Latest QoF guidance is this :-
https://england.nhs.uk/wp-content/uploads/2021/03/B0456-update-on-quality-outcomes-framework-changes-for-21-22-.pdf

SFE guidance is this :-
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/975395/GMS_SFE_2021.pdf

PS I work in NHS Primary Care & Informatics

pblakeney

Yeah. Doctors get paid for prescribing. Doctors can be held to account for over prescribing. Both can be true.

webboo

pblakeney said:

Yeah. Doctors get paid for prescribing. Doctors can be held to account for over prescribing. Both can be true.

It would appear my old doctor didn’t get paid for prescribing anything. Unless he got paid for giving crap advice.
“ My right hip that you diagnosed as having some mild arthritic problems is now quite painful when I ride for for four or more hours” “ Don’t ride for for fours then”

photonic69

jp1970 said:

It's a few years out of date.
GPs get paid for a shed load of 'items of service'

Majority of the guidance is based on the NICE guidance.. Love it or loath it.

Latest QoF guidance is this :-
https://england.nhs.uk/wp-content/uploads/2021/03/B0456-update-on-quality-outcomes-framework-changes-for-21-22-.pdf

SFE guidance is this :-
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/975395/GMS_SFE_2021.pdf

PS I work in NHS Primary Care & Informatics

Thanks for that. So without having to go through the 230 odd pages can you give a brief synopsis of what is says?

jp1970

photonic69 said:

jp1970 said:

It's a few years out of date.
GPs get paid for a shed load of 'items of service'

Majority of the guidance is based on the NICE guidance.. Love it or loath it.

Latest QoF guidance is this :-
https://england.nhs.uk/wp-content/uploads/2021/03/B0456-update-on-quality-outcomes-framework-changes-for-21-22-.pdf

SFE guidance is this :-
https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/975395/GMS_SFE_2021.pdf

PS I work in NHS Primary Care & Informatics

Thanks for that. So without having to go through the 230 odd pages can you give a brief synopsis of what is says?

GP's get paid to 'treat' patients and keep them well. The financial remuneration model is based on the above two documents.

Essentially the key (financial) aim is to avoid a patient spending time in a hospital bed or having a clinical procedure at a hospital or Outpatients setting as the 'cost' of a bed day can run into thousands per day.

If prescribing a drug (i.e. a statin) can prevent/ lessen the risk (AKA Risk Stratification) of a patient have CVD (Cardio Vascular Disease) or CV event the prescribing option is the suggested method (in-conjunction with the patient's wishes etc).

Prevention is better than cure.
Happy FriYAY all

DeVlaeminck

I'm just listening to a podcast on cardiac health in endurance athletes. The experts seem keen on a cardiac calcium score as an assessment of heart attack risk.

I don't know if that might be something worth getting done - I'm doing other things so not followed the discussion in detail but they seem to suggest that it's a more direct measure of the risk of blocked arteries than some other risk factors which are more indirectly associated with heart attacks.

Wheelspinner

DeVlaeminck said:

I'm just listening to a podcast on cardiac health in endurance athletes. The experts seem keen on a cardiac calcium score as an assessment of heart attack risk.

I don't know if that might be something worth getting done - I'm doing other things so not followed the discussion in detail but they seem to suggest that it's a more direct measure of the risk of blocked arteries than some other risk factors which are more indirectly associated with heart attacks.

My cardiologist has published a book about “predicting” a heart attack based on a number of things. He’s quite big on the use of that calcium test, and also high-res CT imaging. Neither test is yet included on the government funding schedule here, so can be a bit expensive for individual patients, so he recommends them only for those who show risk profiles elevated in the usual tests such as lipids score and treadmill stress testing.

Warrick Bishop - “Have You Planned Your Next Heart Attack?” is the book.

DeVlaeminck

Unfortunately I can't find the link to this podcast - it was quite interesting - one of the cardiogosts said his clinic charged $55 dollars for this calcification scan - I mean whether that's as a loss leader I don't know it was USA based.

The impression I got was that most people over 50 would benefit from some kind of drug to lower their risk - I'm hoping that is not universally accepted as I'm nearly 54 and it's not something I've ever even considered!

They did discuss some alternatives to statins though which might be relevant to this thread.

There was also some discussion of diet and what is and isn't worth doing to lower the risk.

veronese68

DeVlaeminck said:

They did discuss some alternatives to statins though which might be relevant to this thread.

Be interested to hear if you do remember. I've got my review after 3 months of statins due in early May I think. I've still not noticed any ill effects, being generally knackered is due to lack of sleep and other things going on I'm pretty sure.

Mad_Malx

DeVlaeminck said:

The impression I got was that most people over 50 would benefit from some kind of drug to lower their risk - I'm hoping that is not universally accepted as I'm nearly 54 and it's not something I've ever even considered!

Some time back there was a semi-serious suggestion to put statins in the public water supply.

trekvet

Few years ago my cholesterol was 5.5, and PSA was 8, so both a worry. By cutting out saturated fat as much as possible, and increasing pumpkin seeds and tomatoes, both now read 4.6.