You need a statin – now what was the question?

As many of you are aware the American College of Cardiology (ACC) and the American Heart Association (AHA) came out with new guidelines on cardiovascular disease prevention a few days ago. As part of this, they produce a risk calculator. Using this calculator, if your risk of heart attack or stroke is greater and 7.5% over the next 10 years, you should take a statin – for the rest of your life.

I downloaded this calculator, and I have been playing around with it. I think I would tend to agree with the headline in the NY times 18th November 2013:

Risk Calculator for Cholesterol Appears Flawed

To be frank you can fiddle around with the figures on this calculator for hours. I think my OCD is getting worse. (Maybe I should take a statin to cure my OCD). One of the questions I wanted to find an answer to was the following, at what age would a perfectly healthy man (with ‘optimal’ risk factors) have to take a statin for the rest of his life.

So, I fed in the figures, and use the ‘optimal’ figures for cholesterol and blood pressure on the risk calculator

THE PERFECTLY HEALTHY MAN

  • Male
  • Age 63
  • Race: WH (white)
  • Total cholesterol 170mg/dl [This is 4.4mmol/l in Europe i.e. very low]
  • HDL cholesterol 50md/dl [This is 1.3mmol/l in Europe]
  • Systolic blood pressure 110mmHg
  • Non-smoker
  • No treatment for high blood pressure
  • Non diabetic

CV risk over the next 10 years = 7.5%

So, there you are. You can do absolutely everything ‘right’ be as healthy as healthy can be – according to the AHA and ACC. Yet, by the age of sixty three you need to take a statin – for the rest of your life.

The next question I wanted to find the answer to was, at what age does a ‘normal’, very healthy man have to start using a statin? In the UK, the average total cholesterol for men is 5.0mmol/l. [this is 193mg/dl in the US]. The average blood pressure in the UK systolic is 129mmHg.  (To be frank, I think the average cholesterol level for men is higher than this, but the WHO says not).

Feed these figures in, and you would need to start taking a statin, for the rest of your life, by the age of fifty eight. Which means that very healthy men, with no real risk factors for cardiovascular disease – at all – have to start statins at fifty eight.

What of women. Well, they get another seven years of statin free life. A super healthy woman, with optimal risk factors, reaches the dreaded 7.5% risk aged 70. An ‘average’ healthy women, with average BP and cholesterol levels, would have to start a statin aged sixty three.

In summary, using this risk calculator, extremely healthy men will be starting statins at fifty eight, and very healthy women at sixty three. This, then, marks the age at which life becomes a statin deficient state. You can be as healthy as healthy can be. You can do everything right, have no risk factors at all for cardiovascular disease, and yet you still need to take medication to reduce the risk of cardiovascular disease.

Sorry, what was the question again?

European cardiovascular disease statistics can be found here.

50 thoughts on “You need a statin – now what was the question?

  1. Elaine hamnett

    I thought that HDL and LDLs were lipoproteins so all figures were arbitrary? Higher cholesterol levels mean longer life- don’t they?

    Reply
    1. Dr. Malcolm Kendrick Post author

      Yes, I don’t agree with the risk calcultor in any way. Everything is called cholestero, even lipoproteins that are not cholesterol. We have good cholesterol, bad cholesterol, light and fluffy LDL and small and dense LDL. Science flew out of this window a long time ago to be replaced with non-science e.g. nonsense.

      Reply
      1. Mary Adair

        Dr. Kendrick, when I read your comments, I laughed until tears came down my face. That is all I have to say today. I think you said it all. You look pretty young so I won’t say “Who’s on First?” but I think Kim Kardashian could do a better job of developing the new risk calculator.

        Mary Lyles Adair

  2. V

    Despite the risk of sounding extremist, given my three years of unpleasant (to say the least) experience(s) with statins following an MI episode, I will never, ever, use those awful drugs.

    My brain and muscles were mashed enough, thank you. So I’d rather die than take one more statin pill. There…

    Reply
    1. David Bailey

      I wonder occasionally, what I would do if (God forbid!) I had a stroke or a heart attack – would I accept the advice to take statins? I don’t think I would, because I think I would be crippled by the statins chewing away again at my polio leg! Even if all that mattered was longevity at any cost, the loss of fitness resulting from my lifestyle with statins would surely counteract any gain from the anti-inflammatory properties of the statin.

      Reply
      1. Dr. Malcolm Kendrick Post author

        Its a brave person who is willing to risk doing nothing. As they used to say ‘nothing acts faster than Anadin…’ the correct response being ‘well, I should use nothing then.’ Changing this slightly ‘Nothing acts better than statins.’ The correct response being ‘Well, then I had better use nothing.’ But in the wee small hours, the doubts gnaw away.

    2. Chris Wunsch

      V, Could you elaborate on your Statin experience for me…I have been disabled for 11 years now from what Dr Golomb called a Statin Induced Effect. Brain biopsy shows holes (apoptosis), muscle biopsy shows Mitochondrial DNA mutation, My UW Madison MD, says Statins dont do that, and called my 28 day, alzheimers like stay, a VIRUS…If you would be so kind as to share your experience with me, I would appreciate it.

      Reply
  3. Tom Welsh

    Hmmmmm…

    Number of men alive at 58 * (life expectancy – 58) + Number of women alive at 63 * (life expectancy – 63) * cost of statins for 1 year =…

    HUMONGOUS PROFITS!!!!!

    Trebles all round!

    Reply
  4. celia

    I just read the New York Times article. It appears from this the committee who produced this calculator could end up with a lot of egg on their faces. I certainly hope so…

    Reply
  5. Jane

    An hour ago I sat in my GP’s surgery to review my thyroxine prescription. A propos of nothing except can’t-help-myself she observed that my cholesterol reading was 9.2.
    She said – and I quote – “I’ve never seen anyone with cholesterol as high as yours who didn’t go on to have a heart attack or a stroke.”
    I ignored the menace implied in that remark and we chatted quite nicely. I mentioned Dr Kendrick. (Who? Nope.) Then this:
    “Statins are keeping people alive. We are all living longer because of statins. They have all kinds of benefits other than cholesterol. There are thousands of people with vascular dementia who would otherwise be dead but whose hearts are pounding away because of statins.”
    I said – how could we know that they would have died? And how can we know it was down to statins and not drinking of tea (that’s the latest, isn’t it?)
    Stony ground.
    My Dad used to say to us kids that the lion powder was working. (“You don’t see many lions around here, do you?”)

    Reply
    1. Jo

      “There are thousands of people with vascular dementia who would otherwise be dead but whose hearts are pounding away because of statins.”

      That’s an interesting quote from the doctor. I assume she doesn’t mean that the statin has caused the dementia! LOL. My dad has heart disease and Alzheimers. He says he is hoping his heart finishes him off before the Alzheimers progresses too much.

      “I’ve never seen anyone with cholesterol as high as yours who didn’t go on to have a heart attack or a stroke.” I guess that’s because she’s a doctor and she mostly sees sick people. I bet there are lots of healthy people out in the real world with high cholesterol who don’t bother to see the doctor. In fact, not seeing a doctor may increase your lifespan

      Reply
      1. dearieme

        “I’ve never seen anyone with cholesterol as high as yours who didn’t go on to have a heart attack or a stroke.”

        I wouldn’t be inclined to believe that. It sounds like rhetoric.

    2. Susan

      She’s using anecdotal evidence. By the same measures, you’d accept a lot of folk remedies and alternative cures. This doctor is all too typical and it’s very scary.

      Reply
      1. Dr. Malcolm Kendrick Post author

        I am not as bothered by anecdote as some people. Anecdote is how science starts – in many cases. As Isaac Asimov said ‘The most exciting phrase to hear in science, the one that heralds new discoveries, is not “Eureka” but “That’s funny..’

    3. chris redwood

      I was on Levothyroxine (T4) and my cholesterol was ‘dangerously high’, my TSH was normal, but I knew something wasn’t right and refused the statins & other medications. I did a lot of research and after quite a journey I am now taking T3 only. my blood pressure & cholesterol levels are fine now! & my weight is reducing slowly and steadily on a healthy diet that involves good quality animal fats and olive oil.
      Relying soley on TSH tests and prescribing statins and blood pressure lowering medications to people who are hypothyroid and need the correct treatment is a scandal.
      Oh, forgot to say that I have lots more energy and no long feel like a bloated depressed blob who most doctors were happy to blame for the terrivble situation I found myself in. I refused to take anti-depressants either.
      I used to sit in my dr’s surgery going ‘no, no,no’ I don’t want to take this stuff, I want to get well!
      The medical profession worldwide is bitterly opposed to treating hypothyroidism with T3. Could it be because it restores genuine good health and eliminates the need for all the lucrative stuff that is peddled in surgeries?

      Reply
      1. Sam

        Are you able to say if you are on a private prescription for T3 as its impossible to get one out of the NHS people? Some good books to read are ‘Stop the thyroid madness’ and ‘Recovering with T3 only’ Thyroxine does not work and it raises cholesterol levels. If one has reverse T3 then T3 only can be the better route or NDT.

  6. Kim Brebach

    What an ingenious way to get everyone on these drugs. From the frontline: a friend stopped taken statins as a results of the ABC program and our discussions on the subject. He has had severe muscle pain every since he took these drugs, and they simply went away. He says he’s never felt better in his life.

    Reply
    1. V

      Getting everyone on statins would eventually amplify the feeble, but yet international, outcry we see today – for quite some time, actually.Yes, there are many more people who tolerate statins rather well, than people who are eaten alive (or have died) due to the numerous side-effects of this drug. But I suspect that there are also legions of people on statins usually ill-informed or completely unaware that a great deal of their daily physical and psychological misery is caused by these drugs.

      Just to give you some perspective, here’s what I experienced while on statins: muscle pains, back pains, chest pains, joint pains, confusion, amnesia, loss of sleep (and awful nightmares in those rare moments when I could fall asleep), disorientation, erectile dysfunction (and combined with beta-blockers one gets a solid zero libido), permanent nausea and severe depression (which kinda follows logically, if you sum up all of the above). And I’m only 45.

      All that went away (maybe except some mild and rare amnesia episodes) after I abandoned statins, some five months ago.
      I also ditched beta-blockers, and am currently only on blood thinners (Plavix and aspirin). Also on a HFLC ‘diet’ – and I feel great.

      Thanks to Dr. Kendrick and a few other ‘light-bearers’ like him, the general level of awareness is on the rise. Please, keep up the good work!

      Reply
      1. Dr. Malcolm Kendrick Post author

        Thank you for being honest, and thank you for your kind comments. I know that the adverse effects of statins are massively, massively, under-reported by patients. And when reported are horribly, terribly, dismissed by doctors.

      2. daniellyons64

        agree with you 100%. Only differance was i ditched the Plavix and stayed on the beta blocker and Aspirin. Without a doubt stopping the statin in my case lipitor 40 made a fantastic differance to my health

  7. dearieme

    “I know that the adverse effects of statins are massively, massively, under-reported by patients.”
    May I ask how you know?

    Reply
    1. Dr. Malcolm Kendrick Post author

      I ask them and they then tell me. Actually, sorry to be flippant. I know because I have read the clinical trial reports. Whilst the studies claim that statins cause no more side-effects than placebo this is clearl nonsense. In the IDEAL study the rate of adverse events was 95% (one statin vs. another). In METEOR, adverse effects were 83% in the statin arm and 81% in the placebo arm. In WOSCOPS it was 0.6% statin and 0.6% placebo. So, when the statin causes 0.6% adverse effects, do does placebo. When the statin cause 83% advserve effect, the placebo causes 81% adverse effects. Intersting things, placebos. They mirror the adverse effects of the statins.

      Reply
      1. V

        There are also rather plenty of cases in which the patients misinterpret statin-induced adverse effects as being ”normal” symptoms of their current condition(s).

        For example, I can readily explain all the grim ”discomforts” I experienced as a direct result of statin usage. Chest pains? Why, they are ”normal” after a heart attack. Muscle pains? If you don’t exercise much (and I’m not allowed, due to a bonus arterial aneurysm I have), those can also be normal. As is lack of sleep, often associated with the lack of exercise. It’s also normal to feel depressed after nearly dying, and who wants to shag while depressed? Memory loss can strike at any age, and even more so after an extremely traumatic event.

        So, Dearleme, you see, there are hosts of similar examples in which the patients are just not aware that they actually suffer of adverse effects from a drug. They simply think it’s normal to feel what they feel.

        This is why awareness and critical thinking (”question everything”) are of fundamental importance in oh-so-many respects. This is what Dr. Kendrick and his very few peers are trying to do: raise the general awareness and do the critical thinking for the general public who would rather follow than think for itself.

      2. Judy

        Forgive me for being cynical, but how do we know they even used placebos? How do we know they didn’t use statins for both? Hmm, my trust in big pharma, scientists, studies, and medicine in general knows no bounds. 🙂

  8. V

    It took me a full three years, tons of literature that often went over my head (so I had to do a lot of side-learning in order to comprehend it) and a lot of balls to be able to break the medical paradigm du jour regarding statins and cholesterol. By myself. It was only after that when I discoverd Dr. Kendrick’s book and blog. Happy to be here, by the way.

    I’m a journalist by training and an inquisitive spirit by nature, thus I can describe myself as above well-accustomed to critical thinking. Yet it took me quite some time to ”see the light”. I admire those who managed to do it more quickly. And I pity those who haven’t done so, yet.

    I’m simply horrified of knowing there are many more people not very much unlike me and you, who are relying in good faith on anything their GP (or specialist MD) says. Not to mention the ”kook” branch of ”professionals”. The fact that the vast majority of GP’s and specialists have a substantial interest in prescribing, and then some, anything Big Pharma sells, should be like a blaring naval siren – but isn’t, unfortunately.

    I know there are some studies which suggest that statins are good for heart (or stroke) patients. They are either not significantly good, or otherwise not worthy. Adding 15 minutes to one’s life expectancy over a decade of miserable living caused by statins it really, really isn’t worthy, believe me. I’m a heart patient, and I’be ‘been there, done that’. Statins can actually cause harm to anything muscle and neuron (including the brain) – Dr. Kendrick can tell you more on that.

    To end this rant, my personal recommendation is: steer clear of statins. If you’re on them, ditch them. Even if you have some coronary condition(s). Abandoning statins will do you more good than harm. And there are plenty of other, way healthier alternatives. Also, do whatever is needed to avoid distress. And carbs. Those are our main enemies. Thank you. 🙂

    Reply
  9. tedhutchinson

    Distinguishing the adverse effects of statins with the adverse effects of ageing with a disability such as Polio which David Bailey above has mentioned earlier is very difficult.
    Statin-induced myopathy in a patient with previous poliomyelitis.
    Post-polio syndrome, spinal cord injury and statin myopathy: double trouble or incorrect diagnosis?
    Many of the anti-inflammatory strategies I’ve used to slow progression of my Post Polio Syndrome are are also suitable for reducing inflammation generally.
    Perhaps the reasons why the AHA appear to be sticking to their new guidelines and risk calculator may be deduced by looking at the membership of AHA-Pharmaceutical Roundtable
    Each of those 10 leading pharmaceutical companies has been found guilty of fraud over the last few years.

    Reply
  10. Charlie

    Even is there were no big pharma incentive to prescribe more statins there is a big conflict of interest for the doctors making the recommendations especially for the cardiologist since it create an avalanche of new “patients” that need to be treated for their new “sickness”. They will of course need regular visits, regular test and the opportunity that they will need to be treated for many other “diseases” many maybe caused by the side effects of the statins drugs they prescribed in the first place.

    Reply
    1. V

      Sure, but that situation also creates an incentive by itself, don’t you think? Fueled, again, by Big Pharma, albeit indirectly. If there weren’t any ”magic pills”, most doctors would have to – alas! – talk and get to know the patients better, even intimately (not in a sexual way), in order to treat them well. The dreaded ”Patch Adams” approach of maximum empathy. Who needs that, other than the patients? Doctors are supposed to make boatloads of money, not of acquaintances and dear friends, are they not?

      There’s no wonder that this purely materialistic approach has had the disastrous results that are visible to us all.

      Reply
  11. Jennifer

    There is another side to this phenomenon of GPs who fail to address the reported concerns of their patients taking statins:-
    It is now common practice for patients with chronic conditions to be managed at arms length away from sight of the GP. When chronic patients are ” in the system”, we are periodically invited to have blood tests performed by the ‘once receptionist, now turned phlebotomist after a quick course”. The results are perused by a person in the surgery who compares the numbers with a check list, or, indeed, just looks for the asterisk showing scores at variance to the accepted norm. The ‘consultant nurse’ then tasks someone to pass on the message to raise ( never lower, in the case of statins) the medication. A quick phone call from the receptionist, by now sitting back at her front line post, says that a new script is ready for collection.
    Requests for an appointment to see a real Dr are now triaged by the Nurse, who, once you explain about severe muscle pains and/or incapacity, proudly makes out a script for analgesia, and a suggestion to self refer to the physio dept.
    Where am I? Oh yes,……. I want to get past the gate-keeper to see the Dr.
    And what a reception I get. Such a cheek to question the system! Such a cheek to have learned to read and write in the first place! Such a cheek to apply logic……off with you…..and you can join the rest of those who just chuck the repeat prescriptions in the bin…..and fail to follow my advice.
    How do I know? Been there, got the tee-shirt, as the saying goes.

    Reply
  12. ken

    what do you think of a particle test? and the calcium scan? all I know is my chol was very high,I started a statin and now its low..no side effects that I can see as of 3 yrs? And my heart and lungs as told to me by the top cardiologist in my state was the best he ever seen,but yet high chol?

    Reply
  13. Jules

    Perhaps you should vote with your feet Jennifer. The surgery where I work does, admittedly, use a ‘trained up’ phlebotomist, but I cannot imagine a practice allowing anyone, even a ‘consultant nurse’, to casually peruse results and then make a clinical decision. That’s usually left to the GP!

    Reply
  14. Jennifer

    In reply to Jules.
    There are Registered Nurses who are legally entitled to prescribe medications, and most GP practices employ them, so I am unlikely to avoid this recent change in NHS policy.
    My taxes paid for years of training to enable qualified doctors to prescribe and monitor medications, and after all, that is what a doctor does! Nurses have been appropriately trained in a different discipline, and the two ought not to be confused. Both have the same aim, I.e. to manage the unwell human being, but the professions are not interchangeable.
    I may have a change of heart if I see the docs doing bed pan rounds, and when Nurse Prescribers can demonstrate a profound knowledge of drug therapy.
    By the way, retrieving a used bed pan is not the domain of some menial task— back in the 1960s it was impressed on us students the importance of not harming a patient during this delicate procedure, and how one could observe much about the patient’s state of well being, or otherwise.
    From statins to bedpans, in a couple of paragraphs! Who would have thought they could be so easily linked.

    Reply
  15. Henry

    According to one book I read, statins are “bad” most of the time, but not if you’ve had an angioplasty, in which case they are “good” because they counter arterial inflammation. But I thought inflammation was a curative process…So do they truly perform a positive function in cases of prior infarction and angioplasty?

    Also, I read that it is imperative, after an angioplasty, to take blood thinners (plavix, aspirin) sometimes for months or even years to avoid a recurrence of a thrombosis, yet I read above that one person ditched the plavix but kept the statin, and another did the inverse. Is it good medical practice–supported by good studies–that once you’ve had an angioplasty to be prescribed the blood thinners for some time (at least not the rest of your life)? Is there a good article on this subject?

    Reply
  16. Henry

    Thank you, Dr. Kendrick!
    May I press you for a reply regarding the other questions? Do statins ever perform a positive function for post-angioplasty cases? If so, is this a permanent need or just a few months?

    Ditto the question regarding blood thinners (plavix + aspirin–eventually removal of plavix and lifetime on aspirin?).

    I realize you are not giving medical advice, but only pronouncing on what the best available medical information tells you.

    Reply
  17. Henry

    Forgot to add, assuming that the blood thinners are a good thing for post angioplasty, and in view of info on the mentioned report, does it mean that ACE inhibitors should be prescribed, but perhaps not ca channel blockers?

    What does one prescribe in cases of allergic reactions, such as hayfever symptoms from the drugs?

    Why not forget the drugs and take potassium and/or arginine?

    Reply

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