Statins

[Ivor the Engineer]

What fraction of people should be on statins? Everyone over the age of 30? 40? 50?

Has science found a fundamental flaw in human biochemistry that needs to be fixed with a drug, or are statins a treatment for a problem that is usually of the individual's own making and is within their control through other means?

 

[kellyb]

Well, evolutionarily, we are more or less expendable after age 40 or 50 or so...

Reading glasses are somewhat similar.

I don't know if statins are overprescribed or not, though. But it wouldn't surprise me if people just started breaking down a lot at a certain age, and some problems could be remedied with drugs.

 

[lionking]

Sorry, can't be bothered looking it up. What are statins?

 

[Soapy Sam]

http://www.medicinenet.com/statins/article.htm

Drugs that are supposed to reduce cholesterol, helping you to die for other reasons.

 

[lionking]

Oh okay. My mum was probably on them and if so they worked well (she's over 70). As for me, when I was told that I was over the recommended level, I changed my diet.

 

[Soapy Sam]

Me too.
I take the statins religiously and have increased my chocolate intake 300%.
And I'm still alive, too!

 

[Ivor the Engineer]

Well, evolutionarily, we are more or less expendable after age 40 or 50 or so...

Reading glasses are somewhat similar.

I don't know if statins are overprescribed or not, though. But it wouldn't surprise me if people just started breaking down a lot at a certain age, and some problems could be remedied with drugs.

I'm not sure you can equate the problem(s) that lead to the need for reading glasses with the behaviour that lead to high cholesterol. Isn't high (LDL and low HDL) cholesterol more frequently related to poor diet and a sedentary lifestyle than bad genes? If so, don't statins become more like drugs of convenience than need?

 

[Ivor the Engineer]

Me too.
I take the statins religiously and have increased my chocolate intake 300%.
And I'm still alive, too!

You have made my point perfectly!

 

[frankvan]

I don't thik it's an either/or type question. There are drugs that claim to lower LDL's and raise HDL's but are not statins. Some foods, like oatmeal, make similar claims. But even though high cholesterol levels pose health threats, it also appears that some high cholesterol foods, like egg yolks, are recommended in a healthy diet in moderation. As has been pointed out, we do tend to crap out gradually past a certain age, so it is best not to abuse our selves any more than necessary, at any age.

 

[sophia8]

I'm not sure you can equate the problem(s) that lead to the need for reading glasses with the behaviour that lead to high cholesterol. Isn't high (LDL and low HDL) cholesterol more frequently related to poor diet and a sedentary lifestyle than bad genes?

Not always. I have hypothryroidism, which produces high cholesterol levels. In spite of being on a low-fat, near-vegan diet, my cholesterol level is still between 7 and 8 (which is too high, according to my doc). Having had side-effects from statins in the past, I don't want to go on them again, but I may have to. I'm waiting for the result of my latest cholesterol test; if the level hasn't gone down, then it's the statins.

 

[Ivor the Engineer]

Not always. I have hypothryroidism, which produces high cholesterol levels. In spite of being on a low-fat, near-vegan diet, my cholesterol level is still between 7 and 8 (which is too high, according to my doc). Having had side-effects from statins in the past, I don't want to go on them again, but I may have to. I'm waiting for the result of my latest cholesterol test; if the level hasn't gone down, then it's the statins.

That's why I put the phrase "more frequently" in. If you have a condition that is beyond your control, then drugs are a reasonable course of action.

However, are statins being give to people who just don't want to exercise more, loose weight and cut back on the fried / fatty food?

FYI: I think the target for total cholesterol is below 4mmol/l, with LDL of 2mmol/l. IIRC, it is actually the ratio of HDL to total cholesterol which is a better measure of risk than total cholesterol.

 

[Soapy Sam]

Not always. I have hypothryroidism, which produces high cholesterol levels. In spite of being on a low-fat, near-vegan diet, my cholesterol level is still between 7 and 8 (which is too high, according to my doc). Having had side-effects from statins in the past, I don't want to go on them again, but I may have to. I'm waiting for the result of my latest cholesterol test; if the level hasn't gone down, then it's the statins.

C'moan, hen. We're Scottish. We're SUPPOSED tae huv high cholesteroil. My mammy even gave me that cholesteroil tae drink when ah wiz a wean!

 

[patnray]

I'm not sure you can equate the problem(s) that lead to the need for reading glasses with the behaviour that lead to high cholesterol. Isn't high (LDL and low HDL) cholesterol more frequently related to poor diet and a sedentary lifestyle than bad genes? If so, don't statins become more like drugs of convenience than need?

Kellyb wasn't equating the problems, merely pointing out that problems that occur late in life, like heart disease and stiffening of the lens, are not subject to natural selection because they occur after sexual maturity and thus do not prevent the traits from being passed to future generations.

 

[Bikewer]

I've been taking them for about 15 years. At age 48 or so, I had my first cholesterol screening; through the roof. Over 300 and that with a pretty modest diet and tons of exercise. (I was riding over 100 miles a week at the time)
Exercise and a low-fat diet was not going to cut it; this was a hereditary condition. The doc put me on Lipitor and reading went into the normal range in a few weeks.

Due to the vagaries of our wonderful HMO and drug pricing, I've changed three times over the years; Lipitor to Zocor to the generic Simvastatin and now with Zetia added.

Keeps my readings in the normal range.....

Apparently, there are a variety of other benefits from the class of drugs as well, it may play a role in reducing systemic inflammation.

 

[Schneibster]

There are a lot of folks of Northern European extraction who have high cholesterol not because they eat bad stuff, but because their bodies make it, specifically their livers. I'm one of them, which is how I know about it. It doesn't matter what I eat or how much I exercise.

Be careful stereotyping, Ivor. There is a significant number of people who aren't sedentary and eat good diets and still have high cholesterol.

 

[casebro]

Plus the stress connection. My cholesterol was 440 once. A bad disc was giving me sciatica to the point of causing a limp.

Anyway, I figure that statins actually work via lowering inflammation. Cholesterol is merely a confounding. Since aspirin works as well as statins at preventing heart attacks, but both together only work 20% better than either alone, then 80% of what statins do is the same thing that aspirins do.

Then, I believe that a major source of inflammation is sub-clinical food allergies. They don't show up as antibodies in allergy tests, but do cause enough inflammation to have long term consequences.

Hmmm, or was the sciatica causing enough inflammation to make my cholesterol leap? No, aspirin does not lower cholesterol, only inflammation. Plus lessen clotting.

 

[Ivor the Engineer]

There are a lot of folks of Northern European extraction who have high cholesterol not because they eat bad stuff, but because their bodies make it, specifically their livers. I'm one of them, which is how I know about it. It doesn't matter what I eat or how much I exercise.

Be careful stereotyping, Ivor. There is a significant number of people who aren't sedentary and eat good diets and still have high cholesterol.

I suppose it was inevitable that some people who have a medical/genetic condition that raises their cholesterol level in-spite of them leading a healthy lifestyle are going to see my point of view as stereotyping. I shall therefore be more explicit:

I have no problem with people who have tried to lower their cholesterol through lifestyle changes first and found that they cannot for reasons out of their control.

What I do have a problem with is people being given statins before they have attempted to alter the behaviours which are the likely cause for them having high cholesterol. This is mainly because those same behaviours lead to other chronic health problems, such as obesity, high blood pressure, diabetes, etc.

 

[Ivor the Engineer]

C'moan, hen. We're Scottish. We're SUPPOSED tae huv high cholesteroil. My mammy even gave me that cholesteroil tae drink when ah wiz a wean!

Land of the deep-fried Mars bar

Average life expectancy in Glasgow for males 68. Government proposes to raise retirement age to 69.

 

[Mashuna]

I have no problem with people who have tried to lower their cholesterol through lifestyle changes first and found that they cannot for reasons out of their control.

What I do have a problem with is people being given statins before they have attempted to alter the behaviours which are the likely cause for them having high cholesterol. This is mainly because those same behaviours lead to other chronic health problems, such as obesity, high blood pressure, diabetes, etc.

I can agree that the whole 'prevention is better than cure' approach is the best one to take. I'm not sure what you're suggesting though. Are you advocating witholding treatment until people have made these efforts, or was it more of a 'I don't have any sympathy for. . .' kind of point?

 

[Ivor the Engineer]

I can agree that the whole 'prevention is better than cure' approach is the best one to take. I'm not sure what you're suggesting though. Are you advocating witholding treatment until people have made these efforts, or was it more of a 'I don't have any sympathy for. . .' kind of point?

The former - I think statins should not be offered to people who refuse to alter the aspects of their lifestyle that are likely to be causing them to have elevated cholesterol levels.

At least in the UK, GP's appear to be handing statins out like smarties at the moment. Some doctors have proposed everyone over the age of 50 being put on them, making it sound like high cholesterol is an unavoidable consequence of getting old!

Are we building up problems by allowing people to use statins to stave off an early heart attack or stroke, while maintaining a lifestyle that will lead to many other chronic conditions?

Is that what the NHS's role will be in the future - giving the population drugs to combat the effects of their ignorance and stupidity?

It sounds like it to me, given the projection that over half of the UK's adult population will be obese by 2050 if the current trend continues.