bottles of crestor lipitor and simvastatin cholesterol-lowering drugs

Dr. Steve Nissen is Chairman of the Department of Cardiovascular Medicine at the Cleveland Clinic. He maintains that “56 million Americans are considered eligible for statin therapy, with about half actually receiving treatment.” That means that there is a very good possibility you need a statin based on the American Heart Association (AHA) recommendations.

Have You Used the Risk Calculator?

The American College of Cardiology and the AHA have created an electronic “Heart Risk Calculator.” You can visit this online resource (www.cvriskcalculator.com) to determine your 10-year risk of heart disease.

You enter your age, sex, race, total cholesterol, HDL cholesterol, blood pressure and whether you smoke or are being treated for high blood pressure or diabetes. At the end of the process you’ll be told whether:

“you should be on a moderate to high intensity statin”

or

“you have no indication to be on a statin.”

Just in case you have been hiding in a cave for a couple of decades, statins are used to lower cholesterol.

The Age Trap: All Seniors Need a Statin!

The problem with this seemingly scientific calculator is that it relies very heavily on age. A reader shared this experience:

“I am 64 and not on any medications. I am in great health except for a heart abnormality I was born with. Due to that, I see a cardiologist twice a year for a checkup. When I was young, a cardiologist warned me to avoid alcohol, drugs and tobacco and I have done so my whole life.

“All my lab values have always been at the low end of normal. Over the last 10 years, my cholesterol and lipids have been slowly creeping up. They now are all smack in the middle of the normal range. My blood pressure has never been above 115/90.

“At my last heart checkup, my cardiologist suggested he and I try the online heart risk calculator. He put in the numbers and it recommended I start a statin. We were both shocked.

“He had some time, so we played around with the numbers, reducing them category by category. Eventually we got all the numbers down to the lowest lab values that were considered to still be normal and my BP was entered as 95/70. With all these changes in place, the calculator still recommended I be on a statin!

“The only way we got the recommendation to change to ‘no statin recommended’ was to change my age to under 50. Is this a realistic estimator for people? Or is it influenced by the pharmaceutical industry’s need for sales? I suspect it is structured to ignore alternative approaches such as exercise or diet.”

Do You Need a Statin…Really?

Like this reader, we have discovered that the risk calculator recommends that virtually every man 64 or older and every woman 71 or older should take a statin. Even if you are a vegetarian, run 10 miles a day, have great cholesterol and blood pressure readings, accumulating too many birthdays puts you on the statin staircase. That’s true even if your parents lived into their 90s without heart disease.

Will Stopping Statins Kill People?

was a question we asked last week after Dr. Nissen’s editorial in the Annals of Internal Medicine. Dr. Nissen titled his opinion piece: “Statin Denial: An Internet-Driven Cult With Deadly Consequences.” He suggests that many so-called statin side effects are due to the “nocebo effect.” That means that the complaints are not really attributable to statins and would have occurred if the patients were getting a sugar pill.

Dr. Nissen blames the Internet:

“Statins have developed a bad reputation with the public, a phenomenon driven largely by proliferation on the Internet of bizarre and unscientific but seemingly persuasive criticism of these drugs.”

You can read more about this controversial question: Will stopping statins kill people? at this link.

Not All Cardiologists Agree that You Need a Statin:

Dr. Rita Redberg is a cardiologist and editor of JAMA Internal Medicine. She and a colleague wrote an editorial about the use of statins in otherwise healthy people (JAMA Internal Medicine, Nov. 15, 2016):

“Statins for Primary Prevention
The Debate Is Intense, but the Data Are Weak”

“Using the current data, the decision aid shows that of 100 people who take a statin for 5 years, only 2 of 100 will avoid a myocardial infarction [heart attack], and 98 of the 100 will not experience any benefit. There will be no mortality benefit for any of the 100 people taking the medicine every day for 5 years. At the same time, 5 to 20 of the 100 will experience muscle aches, weakness, fatigue, cognitive dysfunction, and increased risk of diabetes.”

The doctors conclude their editorial with this advice to colleagues:

“it is in the interest of public health and the medical community to refocus efforts on promoting a heart healthy diet, regular physical activity, and not smoking.”

Readers Comment:

Kat took the drug company’s advice:

“When I was prescribed a statin I actually read the very small print in the brochure that accompanied the drug. It said that it would lower my cholestrol along with proper diet and exercise. I decided to just opt for the proper diet and exercise and lowered my cholestrol without any medication!”

Sally in Nevada reacts to the admonition that all older people need a statin:

“Stopping statins, even if someone is experiencing muscle pain or weakness, is considered counterproductive to heart health.” This is ridiculous – what about quality of life?

“So you have a healthy heart and are in a wheelchair from muscle weakness? Both of my parents stopped statins and did not suffer heart problems. Unfortunately, it was too late for my dad, who developed all of the horrible side effects from statins, including dementia and diabetes. These drugs should be used cautiously and short term.”

Anne in Bakersfield, CA is not a statin supporter:

“They almost killed my husband. He also was told that he would die if he went off them. They lied! If he had stayed on them he would have lost all of his muscle capacity, most of his brain agility, and been bed-bound.

“He refused to take them any more and is 100% better than when he was on them. Ask your doctor how many free vacations he has gotten from the pharmaceutical company that has him prescribing them to his patients.”

Joan in Florida shares an interesting story:

“There is nothing to do about the side effects of the statins. My cousin was having so much pain she could hardly walk. Why she was on a statin I don’t know. Her cholesterol (both) was very low. Her heart is good at age 71.

“The Dr told her she had to stay on it to help her heart and gave her an anti inflammatory [for pain] and that helped some. I did try to talk her out of taking the statin but she thinks because the Dr said take it she has to.

“Then there is my daughter who was on a statin for a year until she had to sit on the stairs to get up to her apartment because her legs no longer could climb. I told her…go off the statin. She tapered off but has lasting damage to her back muscles. She is 54.

“Then there is my husband who had a heart attack after being on Lipitor for under a week. I recently read on one of the Internet websites that it’s the fault of the Internet that people are going off statins. Who is paying them to say that? Big Pharma?

“Thanks People’s Pharmacy for telling us the truth.”

Do You Need A Statin?

We think using the risk calculator may be misleading. The only way to know if you really do need a statin is to have a heart-to-heart conversation with your physician. Ask your doctor to review the numbers so you can make an informed decision.

Questions to ask:

  1. Based on my family history, lifestyle, diet and medical assessment, what is my risk of developing heart disease over the next several years?
  2. How good is the evidence that a statin will reduce my risk of experiencing a heart attack or stroke. Put another way, how many people like me will experience a cardiovascular event over 5 years if they don’t take a statin. How many would experience an “event” if they do take a statin? Those numbers are available. Show your doctor Dr. Rita Redberg’s editorial in JAMA Internal Medicine. By the way, she is a cardiologist!
  3. Will a statin extend my life? If so, by how many days, weeks, months or years? That data is also available should your physician wish to look. Again, See Dr. Redberg’s article.
  4. What side effects should I be aware of?
  5. What should I do if my muscles start to hurt or become fatigued?
  6. What should I do if my blood sugar levels start to climb?
  7. Are there any alternatives to statins that you would find helpful?

Good luck and let us know how you make out. We recognize that some people absolutely do need a statin! Are you one of them? Comment below.

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  1. /Fran
    FLORIDA
    Reply

    I have been told that Red Yeast Rice will lower my cholesterol. Would it have any side effects? I do have a problem with Crestor with my legs. My cardiologist says to get off Crestor, and my primary care doctor thinks I need it. I am 89 years old.

  2. Lorraine
    Jacksonville
    Reply

    I took statins for 1+ years without side effects but then the leg aches started. Slowly at first and then every night. My next issue was joint pain. I remember thinking “This is what 100 years old feels like” but I was 68!
    The final straw was a leg cramp so severe and long lasting–an 11 on a scale of 1 to 10.

    I stopped the statin the next day and very slowly returned to normal.

    I wish the MD who thinks this is all in my head could live in the body of someone with these side effects for a month. He might change his tune!

  3. Gale V
    Illinois
    Reply

    Regarding statins.
    When I was 64 years old my Dr prescribed statins, Crestor, to raise my HDL. I had already lowered my LDL by changing my diet. Overtime my HDL went from 43 to 57. I have also become uncomfortably stiff in my joints and lower back especially during that time. I am now 78, still on the same 10 mg a day Crestor and occasionally very stiff with Joint and muscles aches. (I’ve had a few Falls which could also be causing the problem).
    X-rays have shown that I do have arthritis. Whether I would have had that without Crestor, who knows. About six months ago I terminated crestor for 3 months to see if it made any difference in my level of joint soreness and muscle aches. It did not so I went back on the Crestor.

  4. Gary
    Oregon
    Reply

    Sorry, Dr. Nissen, but Internet fear mongering had nothing to do with my stopping simvastatin. I did do some Internet research and the common thread on several medical sites was that statins can cause severe muscle pain.

    The pain in my legs and other muscles was so bad I had to stop taking it. I had a difficult time even falling asleep. Within a year after starting simvastatin I was diagnosed with Type 2 diabetes. There is no history of diabetes in my family. Perhaps a coincidence but I don’t think so.

    With more and more evidence through legitimate studies showing little benefit for many people I question it’s value except to the drug companies. I am now taking red yeast rice and have slightly modified my diet and my cholesterol is not where they say it should be but is much lower and just above the upper normal limit. The “test” to see if you need a statin or not sounds way too swayed to age. One size doesn’t fit all. But like many things my experience is just that – my experience.

  5. Rick
    Reply

    I am 72 years old was put on a statin after cabage heart surgery 7 years ago I was non compliant to their wishes . After an echo-cardiogram was told my heart is perfect for a person of my age. I told the cardiologist that I did not take any medications not even an aspirin and certainly not statins his blood pressure shot up and it appeared as if he may stroke!

    I told him that arteriosclerosis is what occludes your arteries not lipids as ROS reactive oxygen species are what cause the inner lesions in the arterial wall and not LDL or HDL circulating through you blood stream. What finally occludes the artery is the inability of your immune system to keep the blood flowing through the occlusion and these occlusions could have manifested them selves very early in life.

    If statins saved one life it would be a fluke all you have to do is check out the molecular structure of statins to find the truth.

  6. Lorraine
    Atlanta
    Reply

    I am 64 and used the cv risk calculator and got a risk of 2.8% so age doesn’t automatically cause the calculator to say you need a statin. My blood pressure is 110/68. What really helped me was my cholesterol at 162 and my HDL at 79. My cholesterol used to be 220. How did I achieve 162? A whole foods plant based diet. I am a vegan. My husband had high cholesterol and LDL and was on a statin for several years. He also became a vegan and has cholesterol levels like mine. He was able to go off the statin. Don’t want to be on statins? Change your diet to plant based.

  7. Anne
    Reply

    Dr. Nissen blames the internet??? His comment shows the arrogance that some doctors have in ignoring the complaints of his patients who relate to him their issues when on statins. Dr. Nissen is a disgrace!

  8. Joseph
    Houston, TX
    Reply

    I want to be kept informed of any class action suit against the manufacturers of statins. I tried several; they ALL caused muscle aches, muscle weakness and irreversible (to date) muscle damage to my quadriceps. I’ve had medical professionals (note plural) tell me privately that although statins can reduce cholesterol, overall their recommended use is a dirty little secret within the medical community, and that anyone who exhibits negative side effects should run from statins.

    I cleaned up my diet and I exercised with dedication. My cholesterol numbers are just over the borderline range. That does NOT mean I’m going to have a heart attack.

    By going strictly vegan, my cardiologist told me that I passed my nuclear stress test with “normal” results and that he discharged me from care…with the recommendation that I follow my exercise routine and a move from strictly vegan to more Mediterranean Diet. He did NOT see any further need for statins. Not that I’d have taken them anymore anyway. To each his/her own, but there is NO way I’m going to sacrifice my quality of life to Big Pharma.

  9. Sylvia
    Texas
    Reply

    Could you spell out for me who it is that needs to be on a statin? Is it someone whose parents both had heart attacks and their own cholesterol is a little high? Is that enough to say they need a statin? What if neither parent had any heart disease but the person has some clotting in their arteries but no heart attach (yet)?

    And I don’t suppose you could also explain to me how to determine if I 100% have heart disease if I have not had a heart attack? Would I go to get something like a sonogram to see if I have build up in my arteries???

  10. DS
    TX
    Reply

    I am waiting to see a story about people who live to 100 in which the old folks say ” I attribute my long life to taking statins and other medications.”
    My guess is that the people who live the longest ignore AHA advice about low fat, no saturated fat, etc. The people who live the longest and retain their cognitive abilities have ” high” cholesterol.

What Do You Think?

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