The People's Perspective on Medicine

Should Everyone Over 65 Take a Statin to Prevent a Heart Attack?

Statins can help prevent a second heart attack in middle-aged people. What about older people? Will a statin prevent a heart attack in the first place?

Do statins help older people live longer? That is a question that has been controversial for decades. Tens of millions of people are currently taking a statin-type cholesterol-lowering drug every day. The American College of Cardiology (ACC) and the American Heart Association(AHA) have issued guidelines for Americans. Any man over 64 and any woman over 70 is supposed to take a statin to prevent a heart attack. That recommendation is based largely on age more than cardiovascular health. But will statins prevent a first heart attack, stroke, or death from cardiovascular causes? A new study contradicts the conventional wisdom.

A New Analysis of SPRINT:

An analysis of data from the Systolic Blood Pressure Intervention Trial (SPRINT) shows that people over 65 or 70 do not appear to benefit from statin-type cholesterol-lowering medicine (JAMA Internal Medicine, online, Jan. 22, 2018). There were over 9,000 men and women recruited for the SPRINT trial. They did not have cardiovascular disease at the start of the study but they all had hypertension. Some of these patients were taking statins when they entered the study. Even though these older adults were at relatively high risk for cardiovascular events, statins did not protect them.

This new research analysis published in JAMA Internal Medicine will come as a shock to many physicians. Those health professionals who relied upon the AHA and ACC guidelines will likely be annoyed by this report. After all, experts in the cardiology community are supposed to make decisions and recommendations based on the scientific evidence. They have been advocating statins to prevent a first heart attack (primary prevention) for years.

Conclusions from SPRINT Revisited:

The author of the new analysis concluded his analysis this way:

We still do not have sufficient numbers of primary prevention trials to make strong recommendations about statins in intermediate-risk populations (6%-12% 10-year risk), at least on the basis of survival. Yet even in this relatively high-risk older adult population (22%-25% 10-year risk), significant reductions in cardiovascular events were not found.

“Accordingly, until the Australian STAREE randomized trial of statin use among older adults concludes, this study lends some support to the concerns increasingly raised about benefits and harms of statins among older adults at higher risk of CVD [cardiovascular disease].”

Translating Cautious Medicalese:

The researcher who wrote that conclusion was being very careful not to contradict the cardiologists who wrote the statin guidelines for the ACC and the AHA. Nevertheless, he made it quite clear that recommending statins for primary prevention in older people is not based on solid scientific evidence.

What About Younger People?

Will taking a statin to prevent a heart attack prolong life? That is a question that almost everyone wants to know. We suspect that most health professionals believe that if they prescribe a drug like atorvastatin, lovastatin, pravastatin, rosuvastatin or simvastatin, they will add years to their patients’ lives.

An article published in the journal BMJ Open (online Sept. 24, 2015) reviewed key randomized controlled trials of statins. Here is what the authors reported:

The survival gains we found are surprisingly small. The highest value was 27 days, found in the 4S study, achieved by 5.8 years of simvastatin therapy in participants with a history of unstable angina or myocardial infarction [heart attack].”

Perhaps even more alarming was the discovery that:

The median postponement of death for primary and secondary prevention trials were 3.2 and 4.1 days, respectively.”

When I have shared this data with caring and thoughtful physicians they tend to look at me like an alien from another planet. Such statistics contradict everything they believe to be true. Have you ever heard of confirmation bias? It is the tendency to accept that which you believe and reject that which you doubt. Just consider politics today. Confirmation bias affects health professionals even though they have been admonished to practice evidence-based medicine. Here is an article we wrote on this very topic:

Doctors Battle Over High Cholesterol and Blood Pressure

What Do Readers Say About Taking A Statin to Prevent a Heart Attack?

Jackie experienced severe statin side effects:

When my doctor insisted I start taking statins due to a family history of heart disease, I developed, leg cramps and muscle weakness, balance problems (forcing me to use a cane), and intense pain down to my fingertips. My legs would give out suddenly without warning, causing me to fall down steps three times. I could not climb steps very well, either.

“My doctor switched me from one brand of statin to another, to another, at least four times. That did not help. The pain and weakness intensified. I could not walk without assistance. My doctor finally agreed to take me off statins when my husband pushed me into the office in a wheelchair.

“My muscle pain immediately subsided. But it took me over a year to be able to walk without a cane. I am on ezetimibe and fenofibrate, which my doctor assured me are not statins, but I’m beginning to wonder if they have side effects too. I have metabolic syndrome (low thyroid, diabetes, high blood pressure, obesity), osteoarthritis, gout, and kidney disease (as a result of high doses of ibuprofen prescribed to offset pain caused by statins). All except thyroid dysfunction were not diagnosed until after I turned 50.”

Gary in Buffalo, New York advocates lifestyle changes:

In many cases, lifestyle interventions work better than medicines. Of course, there is much less profit to be made when people adopt a whole food plant-based diet and exercise more. But such a lifestyle would produce far better health improvement than taking statins. Consumers need to be better informed.”

Statins and Exercise:

Just about every health professional we have talked to over the last 40 years advocates exercise for good health. But as Jackie points out, some people have a hard time moving, let alone exercising, after taking a statin to prevent a heart attack. We fear that can be counterproductive. You may find our article on this topic of great interest:

Do Statin Side Effects Make It Harder To Exercise?

Who Benefits from Statins?

People with diagnosed heart disease do appear to benefit from statins. So do people who have had a heart attack. That is called “secondary” prevention. The goal is to prevent a second or third event from occurring. And of course no one should ever stop taking any prescribed medication without discussing it first with the prescribing physician.

The point of this article is to bring you up to speed the latest analysis of statin-type therapy for “primary” prevention. Based on guidelines from the AHA and the ACC, millions of people who do not have heart disease are being prescribed statins to prevent a first heart attack. Many of these people are “older” Americans: men over 64 and women over 70. And the primary factor driving those prescriptions is their age, not their overall health. That is what is being challenged in the research letter published in JAMA Internal Medicine. The findings should be discussed with an open mind by health professionals.

Share your own statin story in the comment section below.

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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Because of my high cholesterol (269), I was put on several different statin changes because of side effects of each one. I deliberately discontinued all of them for 2 months due to leg cramps and weakness, -not helped by exercise and felt measurably better. Unfortunately, my Cholesterol went up even higher to 328. Somewhat against my better judgment, I went on back on Pravastatin which caused the least symptoms of any of the other statins. I still think even it has caused weakness and thought processing problems. I requested heart monitoring to be sure it was necessary but was turned down because there were no discernable symptoms. I am still trying to decide if the elevated cholesterol is enough of a threat, to stay on the statin.

Human beings are not stamped out with a cookie cutter. We are all different. I discovered that I have an intolerance to all medications and have worked hard to get off of all of them. I will not take pharmaceuticals. Period. They are too dangerous.

Seriously! Only in America. One of the best things about ‘social medicine’ is the cost benefit ratio. You don’t get medications that MIGHT help you. They have to have solid proof that they DO work. Statins fail this criteria miserably. Also, social medicine is bigger on cheap treatments that work. I still laugh at American parents who change baby doctors that recommend bleach baths for eczema. It works and it is standard in the UK, on the NICE (national institute for clinical excellence) website. We can all be Google doctors now. Research is the key. I agree, lifestyle change is the better option by far. Doctors, refer your patients to an exercise scientist. I suspect the cautious tone of the researchers is so they won’t by sued by the Pharma companies. John Yudkin and his research into the evils of sugar in the 1970s is a lesson well known to all researchers. Repeat your article on Ansel Keynes poor methodology.

I took statins for approximately 4 months experiencing leg pain, loss of balance and fatigue. Though my LDL went down, it was not worth it. The last day I took a statin, I spent all day on a couch feelings as thought I was coming out of anesthesia from surgery. I couldn’t stay awake, I couldn’t think and could barely hold a conversation. I went off the medication, and researched the medication including your pamphlet on Statins and the side effects.

I am so glad I did because 5 years later my husband was put on statins. After 3 months he said he couldn’t write , he couldn’t problem solve and was having difficulty sleeping. He was experiencing the symptoms of major depression, one of the side effects I learned from your pamphlet.
Thank you for continuing to write about the side effects of this drug.

I think the main benefit from the “everyone should take this to prevent something just in case” is to the drug company that makes it. I wouldn’t take it unless there was a clear indication that it would help a condition I have (not just a condition that a lot of people have)

Not a good idea at all! Their use may be linked to microscopic colitis! Trust me, you don’t want a lifetime of misery with watery diarrhea.

“Should Everyone Over 65 Take a Statin to Prevent a Heart Attack?” is the title of this article.

It must be ten years since The People’s Pharmacy published results of a study showing that for there was no significant improvement of mortality or morbidity caused by statins for populations over 65 years of age. This study hasn’t been cited recently, but it seems to presage the newer information.

It’s one thing to reject a single study because of confirmation biases; what about a decade’s worth of studies?

I would like to hear what some commentators cholesterol
numbers are and how low they get…
Too low can be worse than too high….from what I’ve witnessed.

I suffered a minor stroke February 2017 due to family stress. (A very difficult family situation was on going for many months) The ER doctor who saw me said he checked my cholesterol and blood pressure levels which were normal. Even though, he wanted me to take atorvastatin and lisinopril (blood pressure med). He called it “preventative medicine.” Two weeks after starting the statin my whole body ached. Muscle aches from my shoulders to my feet. After speaking to some friends who also had the same experience and talking with my doctor, she advised me to stop the statins.

I also stopped the lisinopril due to constant coughing. It is now January 2018 (11 months later) and the muscle pain is still in my legs. The pain would ease up from time to time and I thought I was getting better. I made the mistake of going to the gym and used the stationary bike for 15 minutes in the easy pedal mode. The next day I had mild pain in the legs, two days later I could hardly get out of bed. My legs felt like lead. I have to use a cane now and my legs are very weak. I have filed an on line complaint with the FDA. I am now seeing a doctor in the pain clinic. Also, I am unable to get massages anymore due to the severe pain the following day. The statin meds should be removed from the market.

I’m 84 and have been on statins for a long time altho I’ve never had any heart symptoms. When I was on Crestor I had lots of leg cramps so my doctor changed me to Lipitor and I no longer have leg cramps. But I’m leery of ANY pharmaceuticals and I’d like to stop taking these too.

When I was diagnosed with type 2 diabetes many decades ago it was when the threshold dropped from 140 to 120, and I’ve always believed that it was because a lot of money was going to cancer, heart, aids, etc, and diabetes wasn’t getting as much, so they just lowered the threshold and presto, there were lots more diabetics who “needed” medication. I believe this is probably true of other “diseases” too.

I am amazed when I read “my doctor insisted I take statins”. I always believed, and still do at age 90 (91 in March) that it is the patient who makes the final decision about what drugs he is to take. I take no medications at all, but do take vitamins. I have had two hip replacements, cancer in my jaw which was removed with surgery, with no chemo or radiation necessary as it had not spread. That was in 2007. Fortunately, I had a doctor who used many different modalities, and always listened to me and included me in any decisions. I have had chiropractic, acupuncture, Feldenkrais therapy during my lifetime, and use natural remedies as often as possible, and rarely take pain meds.

I am 75, I was on statins 25 years and Prevacaid 15 years, Lisinopril 10 years. I am in kidney failure now getting ready to go on dialyze. So you be the judge, which one caused kidney failure?
But my heart is 10 years than my body the doctor says. Now my kidneys are going to take me down, Was it worth it? not sure at this time. If I had it to do over, no statins for preventative, take Rolaids, controlled my BP 160/80 with diet. But I tried to take the short cup. So now I am only on Lisinopril 5 mlg when needed, vitamin B’s and keep my BP from 120 to 145 over /80.

Here you good folks go again. Statins bad, hard to take etc. My wife would not take them because of some discomfort with them.

Sure enough, “heart attack”. This could have been avoided, but oh no, statins bad.

You have a good email, but when will you all stop this anti med nonsence?

My husband was on a statin for years after a heart attack. He still had another heart attack during his statin use…. Bad side effects and no prevention either! Forget statins they are oversold by the drug companies and do not prevent heart attacks.

I’ve said it before and I’LL say it again. There are many reports of terribly painful leg cramps from people who have taken statins for a long period of time and I am one of those people. I would wake up in the middle of the night doubled over with such painful leg cramps that I could just cry. After stopping statins my leg cramps started to subside in just a couple of weeks.

I agree with Gary from New York. However, doctors are happy to write a prescription. Noted from the countenance of my doctor. His eyes glazed over when I talked about my diet. Which is better than any of my friends. But still includes waste foods. I am trying to come up for a word that fits many food products that are consumed as food….Or maybe food is so degraded that it is assumed to be food. I find that I have little respect for my doctor. However, well educated, he is misinformed, dull witted, and complacent. Why happened to natural curiosity and asking why???

The doctor I was seeing 19 years or so ago put me on stains due to my cholesterol being so high. After taking it for a few weeks I developed cramp in my legs, started to have memory problems. When I discussed this with the doctor he put me on a different statin. Going from one statin to another one for some time and still having problems with the meds.

Finally, I told the doctor that I had enough and was no longer going to take the statins. In the meantime I learned about Red Yeast Rice. I took it upon myself to try it. The next time I saw the doctor my cholesterol was down and I was not having any problems with the Red Yeast Rice. But I do believe that taking so many different statins over a period of 1-2 years has left me with problems that I have to deal with on a daily basis.

Statistics prove that only middle aged men with a previous heart event benefit minimally from statins. No woman benefits from taking statins, according to Dr. Barbara Roberts, MD, author of “The Truth Anout Statins,” and director of the Women’s Cardiac Center at Miriam Hospital in Rhode Island, who has reviewed the statin studies and examined the statistics. So many have been permanently damaged, physically and mentally, from statins.

I wonder what the precise definition of ‘having heart disease’ is other than a previous heart attack. If you have some calcium or plaque on your coronaries, does that mean you have heart disease? What if you have high blood pressure and high cholesterol/triglycerides. Is that a diagnosis of heart disease? If you have some coronary plaque, but no previous heart attack or symptoms, should you take a statin?

Thank you for bringing this up again. My husband, who will be 64 in May, was recently prescribed statins by his physician. I was really upset when he told me, but he seems to think he needs to do this. So far, he has not complained of any side effects, but I think it’s a wasted effort. Another physician tried talking him into taking them several years ago and somehow I talked my husband out of it. I’m hoping this article will be enough for him to change his mind again.

All I can say is NO to statins as a preventative. After having a heart attack in February of 2017 I was given a statin. Within a month I noticed that I could hardly get up after sitting in a chair. Shortly after that my cognitive skills started to decline and it came to a head when I had a hard time finding my car in my local Costco shopping center.

I went to my doctor and all I was told to to keep taking it, he lowered my dosage but the adverse symptoms just got worse. I finally took myself off of the statin and it took several months to get back to what I would feel normal.

I radically changed my diet and started exercising and WOW my cholesterol numbers has gone down with this , my own treatment.

For me taking a statin would make me a living ZOMBIE, That’s not going to happen. Quality of life is more important to me than just a lower cholesterol number.

Taking a statin may not be the only solution to what I see is a complex issue.

There are far too many folk expressing concerns about statins and that they are of dubious value to everyone to justify the pro-statin hype. We should proceed cautiously until the dangers are known and ignore big pharma who are only interested in profit

Why not take 20,000 IU’s of Vitamin D3 plus 400 mcg of Vitamin K2-MK7 plus Vitamin A daily?
Have a look at the book, “The Calcium Paradox”. Also, “The Rotterdam Study”. Pretty simple way to remove calcium from the soft tissues and put it into your bones and teeth. You can buy D3 and K2 in bulk from to save money.

PS Check out a Brazilian therapy for autoimmune disease by a doctor Coimbra using high dose Vitamin D3.

I agree with you. There are OTHER more natural ways to lower cholesterol. Its just that these doctors are trained by the book. Oh its over need a statin. They are poison from what my mother said. I will never take one. Find another way.

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