OT - Statins and You

http://www.ncbi.nlm.nih.gov/m/pubmed/22981406/

A new study published in the journal Atherosclerosis about Statins use and coronary artery plaque composition concludes:

Statin use is associated with an increased prevalence and extent of coronary plaques possessing calcium. The longitudinal effect of statins on coronary plaque composition warrants further investigation.

I have tried statins and could not tolerate the side effects. I got the muscle pain side effects pretty badly. I have very high cholesterol and if it was not for my history of statin induced muscle pain, my physicians would have me on the most powerful statin Im sure.

I have this to say about statins. I wish I could tolerate one and wish I could take one. I had two grandparents who had severe clogged arterties which caused massive strokes in both. Had statins been around in the sixties and had their high cholesterol and hypertension problems been detected years before hand, perhaps they could have prevented the strokes and all the disability and costs the strokes caused to them.

At the same time, if you try one, get the side effects it is not worth developing a muscular disease that destroys your mobility.

Triglycerides, while not cholesterol, can usually be controlled by a lot of exercise, diet and maintaining a proper weight. Cholesterol on the other hand, is heavily genetic, though not entirely. It is possible to get your good cholesterol elevated by a lot of aerobic exercise. I have done that in the past. I personally believe cholesterol can be combatted by longterm and aggressive aerobic exercise and weight management. Now doing that and following thru into middle age is oftentimes a hard thing to do for many. But I believe the marathon runner thing or masters swim team thing has a lot to be said for if you want to manage cholesterol and hypertension into middle and older age.

Hopefully, the pharmaceutical companies will develop cholesterol drugs with a better side effect profile at some point in the future. Better drugs are needed now for those who cannot tolerate statins.

If you tolerate a statin well and have high cholesterol, by all means take it. I dont agree that all statin prescription is corporate greed. I have seen too many stroke patients and people who have survived heart attacks. Trust me, if you can prevent that, you will prolong your independence and quality of life a good many years.

Eric

Dr. Thomas Dayspring is a lipidologist. He is interviewed here: http://www.askthelowcarbexperts.com/201 ... ters-most/.

Highly worth a listen. You'll learn a lot about cholesterol and treatment.

Janknitz wrote:Dr. Thomas Dayspring is a lipidologist. He is interviewed here: http://www.askthelowcarbexperts.com/201 ... ters-most/.

Highly worth a listen. You'll learn a lot about cholesterol and treatment.

Excellent presentation by Dr. Dayspring; thanks, Jan.
Reminds me that my NMR is due. Maybe I can get it done next week.

Jay

One reference supporting Dr. Dayspring's remarks:

http://atvb.ahajournals.org/content/27/3/661

Improving Prediction of Ischemic Cardiovascular Disease in the General Population Using Apolipoprotein B
The Copenhagen City Heart Study


Methods and Results— We studied 9231 asymptomatic women and men from the Danish general population followed prospectively for 8 years...

Conclusion— ApoB predicts ischemic cardiovascular events in both genders, and is better than low-density lipoprotein cholesterol in this respect. We suggest that prediction of future ischemic cardiovascular events could be improved by measuring apoB.

and this:
http://circ.ahajournals.org/content/112/22/3366.full
Apolipoprotein B Versus Non–High-Density Lipoprotein Cholesterol
And the Winner Is…
An editorial by Allan D. Sniderman, MD
Which argues the case for using apo B to determine the risk of CVD

Jay

There is a lot about statins, cholesterol, and heart disease that most people and doctors just don't know.

I was taking 10mg of Lipitor back in 1999, and my complaints about muscle pain were totally brushed off by my doctor. Unfortunately, I ended up losing my left kidney through atrophy before I wised up and quit taking it. Yes, I am a documented case, and sadly I had to destroy the career of an otherwise competent physician legally to get that documentation. Rhabdomyolosis is rare, but it happens and can be more deadly than the heart disease these drugs attempt to prevent.

I am now taking 10mg of mevacor (lovastatin) which is about as little as a person can take and still see any effect on cholesterol levels. So far, it has dropped my LDL levels 30 points, but more importantly raised my HDL levels 8. No side effects whatsoever this time.

Point is, everybody's body is different and they need to work up to an "ideal" dosage they can tolerate instead of the "ideal" that their doctors want to maintain.

The question, Duckdog, is whether you're really at risk based solely on LDL-c levels in the first place? Have you had LDL-P measured?

Statins lower LDL, but I've heard this compared to treating pneumonia with aspirin. Yes the fever (symptom) will go down but that does nothing for the underlying infection. Statins may reduce your LDL-C, but does that really address the underlying risk??? As Dr. Dayspring describes it, only in very select circumstances. The first line if defense against cholesterol problems (real ones) is a low carb diet--the opposite of what most people are counseled.

Too many physicians prescribe statins based on LDL-C alone exposing their patients to risks like you suffered when there may be little or no cardiovascular risk.

Given your history, I hope you are seeing a lipidologist, as the nuances of this are far beyond the training and scope of most general physicians and cardiologists.

I have spent the last 20 years studying this and trying to interpret the findings of various studies beyond the belief that statins need to be added to the water supply.

What I am taking now does a few very beneficial things. One, it reduces cardio inflammation, which is a huge indicator of heart risk. Second, it raises my HDL levels to almost protective levels, while still not optimal, offers protection. Three, it has lowered my total LDL levels (not that big of a thing), but has specifically lowered my vLDL levels to a beneficial level.

A lipidologist? Are you kidding? I'm 500 miles from one of those!!! LOL I'm on my own there. My primary physician is a great guy, caring, and medically mostly adequate. I've had to figure this issue out for myself.

Janknitz wrote:Too many physicians prescribe statins based on LDL-C alone exposing their patients to risks like you suffered when there may be little or no cardiovascular risk.

And conversley, Duckdog, the statin prescribed may not be enough, even though it brings LDL-c down to an acceptable level. The position of many and those quoted above is that a better assesment of risk and therapy is through the measurement of apo-b or LDL-p. Have you had either test?

Jay

Jay Aitchsee wrote:

Janknitz wrote:Too many physicians prescribe statins based on LDL-C alone exposing their patients to risks like you suffered when there may be little or no cardiovascular risk.

And conversley, Duckdog, the statin prescribed may not be enough, even though it brings LDL-c down to an acceptable level. The position of many and those quoted above is that a better assesment of risk and therapy is through the measurement of apo-b or LDL-p. Have you had either test?

Jay

Yes, I have a full lipid breakdown done annually.

Duckdog wrote:Yes, I have a full lipid breakdown done annually.

And that's the point. A standard lipid profile does not yield apo-b or LDL-p. To get them, you must order an apo-b test or an NMR.

Jay

Why we need to be informed and proactive in our health care.

Well, I'm off the two - Simvastatin & (can't remember the other one now) but on 20mg of Atorvastatin.

Not sure what to think of this right now. No adverse side effects as of yet that I'm aware of. Been on this switch/dosage for aprox 3-4 weeks?

Janknitz wrote:Dr. Thomas Dayspring is a lipidologist. He is interviewed here: http://www.askthelowcarbexperts.com/201 ... ters-most/.

Highly worth a listen. You'll learn a lot about cholesterol and treatment.

Thanks for the link. I learn so much on this forum!!

Here is a paper from the Mayo Clinic which addresses various methods of assessing CVD risk. It's a little technical, but not too bad. Basically, the paper concludes the best method of determining risk is to measure the number of atherogenic particles (apoB).

http://www.mayomedicallaboratories.com/ ... 11/11.html

Cardiovascular Risk Assessment Beyond LDL Cholesterol:
Non-HDL Cholesterol, LDL Particle Number, and Apolipoprotein B

...a large body of evidence indicates that a narrow focus on LDL-C assessment and treatment alone is not the optimal strategy for patient care.

...at lower LDL-C concentrations near the cutoff of 100 mg/dL, there is an error of plus or minus 15 mg/dL, indicating the “true” LDL cholesterol is somewhere between 85 and 115 mg/dL.5 This presents a major opportunity for misclassification of patients in terms of risk assessment and management. Thus, calculated LDL provides only marginal reflection of true LDL cholesterol concentration.

...While early studies emphasized the atherogenicity of small LDL particles, we now know that all LDL particles are atherogenic, as evidenced by patients with familial hypercholesterolemia who have large, buoyant LDL particles and early atherosclerosis. Thus, the primary focus should remain on reduction of the number (ie, concentration) of LDL particles, without a significant amount of effort to distinguish between large and/or small LDL particles.

...Multiple epidemiological and clinical trials support apoB and LDL particle number as the superior marker for cardiovascular risk prediction when compared to non-HDL-C and LDL-C