Q. I am a family medicine physician and I rarely prescribe statin drugs because I do not believe they are the “cure-all” they are made out to be. Cholesterol is a necessary building block for the nervous system and many hormones, etc.
To treat a laboratory number that is not even a disease is ridiculous. The studies do not support the use of statins and cholesterol-lowering as the answer for heart disease especially for primary prevention. They may have other effects, both good and bad, that as yet are not fully evaluated, which means it is best to play it safe and not overprescribe them.
The drug companies are laughing all the way to the bank. As a physician, it is difficult to do my job when I am expected to follow “guidelines” that I consider misguided and unsupported by the actual studies available to review. Furthermore, the “guidelines” keep changing and are like dealing with a moving target. One year it’s good to take calcium, another year it’s bad. Eggs are good, no bad, no good!!
Moderation and healthy living is the best answer. Not everything can be cured by a pill. We have bigger issues to deal with in this country, such as unhealthy food and lack of oversight of medication and vaccine production, poor water and air quality, poor social support, excess stress, poverty, and the list goes on.
A. Dear doctor,
We couldn’t have said it better ourselves. The response from visitors to our website has been overwhelmingly negative to the new guidelines from The American College of Cardiology and The American Heart Association (which you can find at this link). Here is just a random sampling of concerns:
“Right now, my numbers are all wonderful (I am totally plant-based in my eating, and I exercise regularly), and my age is not high enough to put me into a category where it would be recommended that I take statins. But according to lots of people writing in on the New York Times comment section on the new guidelines, when you fiddle around with the online calculator, there are certain ages after which NO blood result leaves you in the clear.
“A white guy who’s 63 with GREAT numbers needs to be on statins, according to the risk calculator. And one person said he was in the clear with a 5% risk when he typed in 119 as the systolic blood pressure number. But if he put in 120, the risk went up to 35% (what?!?).Over 7.5% they’re supposed to be prescribed a statin.
“Until they come up with guidelines that also include CRP [C-reactive protein a marker for inflammation], resting heart rate, etc., I will ignore guidelines. It troubles me that doctors will be getting in trouble for not prescribing statins. That could make for a tense relationship with some doctor I have years from now.
“I also found it interesting that apparently several prominent people resigned from the guideline committee when they saw where things were going. I’ve heard that evidence was squelched in the process of coming up with the recommendations. Isn’t this the same group that’s been promoting the “heart healthy” diet that preached low fat but has resulted in a more overweight population than ever?” A.X.
“When the doctor put me on Crestor it almost made me bedridden in less than a week. I started listening to The Peoples Pharmacy radio show and reading all about the side effects of statins.
“I now watch my diet. I get plenty of exercise, and at almost 73 I feel better than I have in many years, now that I am off all meds! Forcing me to take a pill is not health and healing, it is dictatorship.” R.A.B.
“I am intolerant of statins and resist taking them. I have tried every statin on the books and they cause fatigue and weak, aching legs. I can barely make it up the stairs when taking those drugs. We should be suspicious of this new report and investigate the interaction of the drug companies with the doctors who crafted these guidelines.
“I exercise regularly, lost weight (70 pounds), plan to lose more weight, and eat carefully–mostly follow the Mediterranean Diet.
“According to the guidelines, I am a prime candidate for taking statins. I’ve had two heart attacks, bypass surgery, have diabetes (Type II), and am over 65. But, I refuse to take statins because I want to remain as active as possible and involved with life until I die (hopefully quickly) with my third heart attack.
“I refuse to die inch by inch with this weakness caused by statins. I refuse to take yet more medications, which cause side effects, which cause my doctor to prescribe more medications to offset those side effects, etc. More people go to live in nursing homes because of over-medication and while getting ever less involved in life, they die a slow and sad death. Not for me.” Mary
There are lots of ways to reduce the risk of heart attacks and strokes…even after you have had one. A fascinating “invited commentary” in the journal JAMA Internal Medicine (October 28, 2013) offered the following observation about people who had experienced a heart attack (“post MI” patients) and followed something called the Alternative Healthy Eating Index2010 (AHEI2010).
“Just reflect on this: the protective effects of the post-MI AHEI2010 on cardiovascular mortality in patients with highest adherence and of Mediterranean diets on total cardiovascular disease in high-risk PREDIMED participants neared a 30% reduction: this is as powerful as the effect of statins, without the adverse effects or costs.”
In other words, a Mediterranean diet is about as effective as statin medications on survival risk after a heart attack.
Share your own statin story below.
