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Statin Drugs

Dale Mabry

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This thread will be for information on statin drugs. Statins are drugs used to lower cholesterol and prevent heart disease. The problem with this is that they really don't preventeheart disease, and lowering your cholesterol may be unnecessary and unhealthy, especially if you are female. People with familial hypercholesterolemia have a need to take these drugs as they have a genetic defect that prevents them from removing LDL from the body. 1 in 500 people have familial hypercholesterolemia yet 1 in 15 people take statin drugs. It is thought that within the next couple of decades, 1 in 2 people will be on these drugs. The purpose of this thread will be to disseminate the whole story with regard to statins so that people can make an informed decision on whether or not to take them. If you don't have familial hypercholesterolemia, fix your diet, taking these drugs is not a license to eat like an asshole as they have side effects and eating like an asshole will eventually lead to bigger problems down the road.
 
June 21, 2011, 4:59 pm
Cholesterol Drugs Linked With Diabetes Risk
By TARA PARKER-POPE

Cholesterol-lowering drugs called statins, which have been shown to lower a person???s risk for heart attack, can also slightly increase a patient???s risk for developing diabetes, particularly at higher doses, new research shows.

The findings, based on new analyses of five clinical trials involving 32,752 patients, raise new questions about how much we really know about the long-term effects of statins, which are the most widely prescribed drugs in the United States. The focus on the link between statins and diabetes comes at a time when some medical experts and pharmaceutical companies have pushed to broaden the use of the drugs beyond the 40 million at-risk patients who already use them to healthy people who would take the drugs for prevention of heart disease.

Doctors cautioned that patients should not overreact to the diabetes news, saying that the increased diabetes risk is very small, and that the benefits of statin therapy still far outweigh any side effects.

???I don???t think it???s very clinically important,?????? said Dr. Steven E. Nissen, chairman of cardiology at the Cleveland Clinic, who consults with drug companies that make statins but requires his fees be donated to charity. ???What I worry about here is that people will read this story and say, ???I don???t want to get diabetes so I???m going to stop my statin,??? and then they have a heart attack.??????

Last year, the medical journal The Lancet published an analysis of major statin trials involving 90,000 patients that showed statin users had a 9 percent higher risk of developing diabetes than those who didn???t take statins. But questions remained about whether the effect was real or something that may have just been due to chance.

However, the latest analysis, published today in The Journal of the American Medical Association, makes the strongest case yet that statins can trigger diabetes in some people. The report focused on differences in diabetes risk among moderate-dose and high-dose statin users, and found that those taking high doses had a 12 percent higher risk of developing diabetes compared to moderate-dose users. That translates to a 20 percent overall increased risk of diabetes for high-dose statin users, compared to those who don???t take the drugs, according to the study???s senior author.

Even so, medical experts, including the study authors, argued that while more study is needed to understand the diabetes link, the increased risk doesn???t eclipse the strong health gains achieved with statins, which in some studies have reduced heart attack and stroke risk by half.

Based on the data in the study, a total of 498 people would need to take a statin before triggering one extra case of diabetes. By comparison, just 155 people would need to take a statin to prevent one heart attack.

???The net benefit favored the statins overall,?????? said Dr. Kausik Ray, professor of cardiovascular disease prevention at St. George???s University of London and senior author on the paper. Dr. Ray says he has consulted for drug companies that make statins.

Exactly how statins may increase diabetes risk isn???t entirely clear, though animal studies suggest that statins can increase muscle resistance to insulin, resulting in higher levels of circulating blood sugar. Dr. Kausik notes that the patients in the studies were diagnosed with diabetes because of elevated blood sugar levels, but that the long-term consequences of higher blood sugar levels triggered by statin use aren???t known.

???Diabetes is defined by blood glucose levels, but none of us are absolutely certain if this is going to carry the same risk as if you traditionally developed diabetes,?????? Dr. Kausik said.

In addition, Dr. Nissen says the statins don???t cause blood sugar to shoot up rapidly but instead can slightly elevate blood sugar enough to push borderline patients across the threshold into diabetes.

???It doesn???t take much to tip a few people over that boundary to the point where we call them diabetic,??? said Dr. Nissen. ???We can???t dismiss it, but I also don???t want to scare people who need these drugs. They are the best thing we???ve got going to prevent coronary disease events.???
 
Clin Cardiol. 2009 Dec;32(12):684-9.
Statin therapy decreases myocardial function as evaluated via strain imaging.
Rubinstein J, Aloka F, Abela GS.
Source

Cardiology Division, Department of Medicine, Michigan State University, East Lansing, MI 48824, USA.
Abstract

OBJECTIVES:
The purpose of this study was to evaluate the effects of statin therapy on myocardial function as measured with echocardiography with tissue Doppler imaging (TDI) and strain imaging (SI) independent of its lipid-lowering effect.

BACKGROUND:
Statin use is known to improve outcomes in the primary and secondary prevention of ischemic heart disease, but their use is also associated with myopathy, muscle weakness and in rare cases, rhabdomyolysis. We sought to evaluate whether TDI and SI is able to identify changes in myocardial function associated with statin use.

METHODS:
Myocardial function was evaluated in 28 patients via echocardiography with TDI and SI. We identified 12 patients (5 females) without overt cardiovascular disease (including hypertension, smoking, and diabetes) that were on statin therapy and compared their echocardiographic findings with 16 (12 females) age, sex, and cholesterol-profile-matched controls. Tissue Doppler imaging parameters of diastolic (E(')/A(') and E/E(')) and systolic (S') function were measured. Regional systolic function was obtained by SI in 4-chamber, 2-chamber, long axis, and average global views.

RESULTS:
There was no significant difference in myocardial function as measured by Doppler and minor differences as measured via TDI among the 2 groups. There was significantly better function noted with SI in the control group vs the statin group in the 4-chamber (-19.05% +/- 2.45% vs -16.47% +/- 2.37% P = 0.009), 2-chamber (-20.30% +/- 2.66% vs -17.45% +/- 4.29% P = 0.03), long axis (-17.63% +/- 3.79% vs -13.83% +/- 3.74% P = 0.01), and average global (-19.0% +/- 2.07% vs -15.91% +/- 2.81% P = 0.004) views.

CONCLUSION:
Statin therapy is associated with decreased myocardial function as evaluated with SI.
 
Thanks for these valueable informations
It is very useful
 
Ok first of all the above does not address secondary prevention, ( those who have already had a heart attack or known peripheral artery disease etc.) it clearly prevents a second heartattack or vascular event, so much so, you could successfully sue me if I didn't put you on a statin after your heart attack.

Primary prevention is difficult, depending on the population studied, that is true.

Here is one of many studies with robust secondary prevention data:

MRC/BHF Heart Protection Study of cholesterol lowerin... [Lancet. 2002] - PubMed - NCBI

20,536 UK adults (aged 40-80 years) with coronary disease, other occlusive arterial disease, or diabetes were randomly allocated to receive 40 mg simvastatin daily (average compliance: 85%) or matching placebo (average non-study statin use: 17%). ...

INTERPRETATION: Allocation to 40 mg simvastatin daily reduced the rates of myocardial infarction, of stroke, and of revascularisation by about one-quarter. After making allowance for non-compliance, actual use of this regimen would probably reduce these rates by about one-third. Hence, among the many types of high-risk individual studied, 5 years of simvastatin would prevent about 70-100 people per 1000 from suffering at least one of these major vascular events (and longer treatment should produce further benefit). The size of the 5-year benefit depends chiefly on such individuals' overall risk of major vascular events, rather than on their blood lipid concentrations alone.

In my healthy patients with minimal risk factors ( diabetes being different) lifestyle and better eating are definately first line.

don't have time at work to watch the videos but did anyone address the JUPITER trial? Though not perfectly designed you can't ignore the primary prevention data and sweep it under the rug.
 
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It's recommended that you supplement with CoQ10 if you're on a statin. Statins deplete your body of CoQ10. I believe it's an antioxidant that works with vitamin E to fight free radicals. Not sure about the specifics of it, but didn't see anything on it elsewhere so thought I'd mention it. Obviously, talk to a doctor before trying anything new.
 
Statin

anyone. Would you kindly steer me to links here and elsewhere about the effectiveness and/or advisability of statin drugs? DH just visited a new young doc who wrote him a prescription based on nothing more than, "Well, youre 70 years old." I think thats baloney. But I would like to have some evidence to back up that opinion. Thanks.
 
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