Tune in to our radio show on your local public radio station, or sign up for the podcast and listen at your leisure. Here’s what it’s about:

New guidelines on statin use from the American College of Cardiology and the American Heart Association will put many more people on these cholesterol-lowering drugs. But doctors will be approaching the decision to prescribe them quite differently. Instead of measuring your cholesterol and prescribing a pill to lower it to “target range,” physicians will be considering overall risk factors.

As before, everyone who has been diagnosed with heart disease will take a statin, and so will those with hereditary high cholesterol that results in LDL over 190. Everyone with diabetes over the age of 40 (up to age 75) will be a candidate for statin treatment. Others will be treated according to the risk determined with a risk calculator taking age, gender, race, cholesterol levels, blood pressure, diabetes and smoking into consideration. We interview three physicians to get their take on the new approach to statins, and we’ll take your calls. You can read the guidelines and find the CV risk calculator. We will discuss the pros and cons.

Call in your questions and comments about this new approach to preventing heart disease at 888-472-3366 or email radio@peoplespharmacy.com between 7 and 8 am EDT.

Guests: Steven Nissen, MD, is chairman of the Robert and Suzanne Tomsich Department of Cardiovascular Medicine at the Cleveland Clinic. He is the co-author, with Mark Gillinov, MD, of Heart 411: The Only Guide to Heart Health You’ll Ever Need.

 Sidney C. Smith, Jr, MD, FACC, FAHA, FESC, is Professor in the Department of Medicine (division of cardiology) at UNC Health Care and the UNC School of Medicine in Chapel Hill, NC. He is a past president of the American Heart Association (AHA) and the World Heart Federation (WHF). Dr. Smith served on the task force that created the new guidelines.

David Perlmutter, MD, is a neurologist and Fellow of the American College of Nutrition. He is President of the Perlmutter Health Center in Naples, Florida, and the co-founder and president of The Perlmutter Brain Foundation. His books include The Better Brain Book and Grain Brain: The Surprising Truth about Wheat, Carbs and Sugar–Your Brain’s Silent Killers.

The podcast of this program will be available the Monday after the broadcast date. The show can be streamed online from this site and podcasts can be downloaded for free for four weeks after the date of broadcast. After that time has passed, digital downloads are available for $2.99. CDs may be purchased at any time after broadcast for $9.99.




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  1. Kay C.

    Interested in all comments.

  2. MS

    I have seen this happen with many of my patients that I have tapered off statins. Many have gone from 80mg of simvastatin down to 5mg with little overall change in their lipid levels. Statins and lowering cholesterol seems to me to be a big hoax. The studies do not support much, if any, benefit in the long run and have not been studied well in women or the elderly.

  3. SP

    I can tell you that I took statin drugs for years and did not realize the link between my extreme tiredness and fogginess and the statin drug. I had to go through all kinds of heart evaluation testing, only to be told my symptoms were menopause. It was only after I stopped taking the drug that I felt better.
    Years later, new information caused my physician to prescribe a statin drug once again. At this point I experienced that same almost debilitating tired feeling again. The light bulb went off for me. There was no collective consciousness going on for me.
    I researched on line and found groups discussing what was happening to them on this drug and I didn’t feel so alone anymore. So please do not judge that this is some collective consciousness of symptoms.
    Doctors will says, “Oh, that symptom is not in the literature”, and tell patients to keep on taking it. We have to be pro-active for our own health. If you listen to the commercials on TV for new drugs and listen to the symptoms one can experience, it’s a wonder anyone would put any drug in their body.

  4. LM

    This was a prescient program. Terry and Joe raised some doubts about the Cholesterol Risk Calculator, with mild support from Dr. Nissen. Then yesterday’s NYTimes reported that two Harvard Medical School researchers have cast serious doubt on the accuracy of the Calculator:
    The article quotes Dr. Nissen a day after being on this program:
    “It’s stunning,” said the cardiologist, Dr. Steven Nissen, chief of cardiovascular medicine at the Cleveland Clinic. “We need a pause to further evaluate this approach before it is implemented on a widespread basis.”
    So who do we believe now? If the Harvard researchers are correct, the statistical model that was used to create the Calculator, perhaps discriminant analysis, drew data from a skewed sample, a common problem where medical researchers misuse statistical models.
    It would be useful if Terry and Joe could have Drs. Nissen and Smith to return to the program ASAP to follow up on the NYTimes articles.

  5. SaN

    I’m so grateful I tuned in this weekend. I listen to your show often. When you had Dr. Sinatra on last year to discuss statins and cholesterol I took lots of notes. I remember Dr. Sinatra said to stop taking a statin before side effect take hold. The problem is, for some the side effects are insidious b/c they can easily be dismissed as “aging”. My husband (49 yr. old, healthy) has been taking lipitor for over 10 years for high cholesterol. I believe the harm this drug does outweighs any good. It doesn’t extend one’s life and has a 1-5% chance of preventing a heart attack. The last time my husbands cholesterol was checked, it was 140, which I believe is dangerously low. One never reads about the dangers of LOW cholesterol. That would make for a good program!
    The new guidelines do not make sense. I hope there is a neurologist doing studies on “statin” brain as there has been for concussions. I so appreciate Dr. Perlmutter speaking out on this issue and urging people to look at diet and lifestyle as a tool to optimize cholesterol levels.
    I highly recommend “Statin Nation” and also Dr. David Brownstein has done studies on statin use.

  6. richjulius

    I had moderately high cholesterol (around 230) from age 40, and was never able to lower it despite healthy eating and a regular regimen of exercise, including over a decade of martial arts training three days a week.
    So at age 48 I started taking a low dose of Simvastatin. Within 6 months my cholesterol was down to 180. But about 6 months later, I was doing a lot of travel commuting out-of-state and was consistently missing doses. And yet my cholesterol stayed around 180. After another 6 months I stopped taking Simvastatin altogether, and my cholesterol has stayed below 190 ever since.
    My doctor said he had heard that in rare cases it could act as a “trigger” to get the body to lower the cholesterol equilibrium, and that was certainly my experience. I’m happy to be living a healthy and drug-free lifestyle with good cholesterol levels. Diet and exercise are the best medicine; I took up triathlon about two years ago and I recently got a “super preferred” rating on my life insurance policy renewal, lowering my premiums significantly. Not bad for a guy in his 50’s!
    Good luck with your own health!

  7. PL

    The doctors really should be concentrating on lifestyle changes, but Big Pharmacy rules them. People also want instant results and don’t want to do the hard work to keep healthy. Decreasing inflammation, stress, and maintaining a healthy nutritious diet with regular exercise should be the goal.

  8. csoehl

    Our physicians are held hostage by the pharmaceutical industry influence on best practices. I have refused statins since I first took them with disastrous results, but my endocrinologist is compelled to offer them to me over and over again because she will be considered not to be practicing proper medicine if she doesn’t. Recently had my genome sequenced and, lo and behold, I am intolerant of statins per my genetic phenotype, something I knew from experience but had to provide proof of to stop getting pressured to take them.
    There is only one reason for the changed guidelines — GREED.

  9. Ruti

    Thanks for all the information you give us.
    Can you please write in you newsletter and talk in your radio show about treatment and prevention of Osteoporosis. Should one continue to take calcium, vitamin D and magnesium to prevent osteoporosis?
    People’s Pharmacy response: You may be interested in our show on bone vitality:

  10. SaN

    My husband has been on a statin for over 10 years and he is 49. He was first prescribed Lipitor for high cholesterol (220 most recently), but not the genetic type. He has not been diagnosed with heart disease, he is not overweight or diabetic.
    He has a leaky valve, but to my knowledge taking a statin does not fix a leaky valve nor does a leaky valve mean one needs cholesterol lowered. I have watched “Statin Nation” and it was very informative. One thing that stood out to me was a dermatologist who had take Lipitor for a while and began to have serious health problems. She said the side effects are insidious b/c one can just chalk it up to getting older/feeling older, but it was all due to the statin use.
    I have been begging him to stop taking this drug b/c I feel it has diminished his quality of life. He was once an outgoing person, but now is much more inward. I am beginning to see some of the side effects take hold, such as short term memory loss and lower sex drive. Statins do not extend ones life span or prevent a heart attack (1-5% actual lower risk). Statins poison the critical enzyme, HMG CoA Reductase. As Dr. David Brownstein says, “you can’t poison a critical enzyme and expect a good long term result.” The numbers don’t add up.
    As your physician said during the last half of the program heart and brain health are critical and very connected. The last time my husbands cholesterol was checked it was 140, which is too low, but you never hear of the dangers of low cholesterol. Our bodies need it more as we age yet now they say everyone should be on a statin. It just doesn’t make sense.

  11. PJ

    I tried numerous statin drugs with severe side effects…muscle aches, numbness [dr. said it was nerve damage and would get worse], pain in both arms that woke me during the night [dr. said nothing wrong]…. LAST drug caused mental issues.. did not recognize good friend’s name or picture in obituary!
    Liver specialist told me If you can’t take one statin… you can’t take any of them..
    I am 75, enjoy good health… good blood pressure, non diabetic… have low TSH take synthroid..
    life is good less pressure from physicians since I refuse to take any statin. ldl better with eating few process foods, increased olive oil, nuts, grains etc. sea salt.. need to increase exercise.
    My alarm clock is set for 7AM every day so I don’t miss your Saturday morning program. The sensible medical information is so valuable…blood pressure & cholesterol especially important over medicated.
    My personal opinion..drugs causing mental problems and physical pain in seniors.

  12. alxzba

    Thanks for including the link “cons”, which is excellent on the “pro” side as well as presenting arguments on both sides. Good fairness.

  13. john a

    side effects from statins almost always subjective complaints. all the publicity and controversy burns the predisposition to those side effects into our collective psyche ready to spring forth when we start the medication. it’s the little green man as alien syndrome.

  14. Lissa

    I thought that I had read that while high cholesterol is a risk factor for heart disease, that studies DO NOT show a decrease in the risk of dying from heart disease by lowering cholesterol. If this is true, this means that something other than the cholesterol is causing the increased risk and that cholesterol is a marker, NOT the cause. So treating high cholesterol is not correct

  15. GK

    I have high cholesterol but a heart cath showed that my arteries are clear. Why would I want to go on a statin?

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