Statin Question

[Charlie]

Hi all,

Sorry for my absence of late but life has been busy. Yesterday was my 6 month anniversary post op. I feel fantastic and life is everything I want to be. I had an AVR on July 20 of this year.

Before my question a little background.

My AVR was rough and I coded twice during the procedure I had a PFO after the operation that caused extremely low blood oxygen but finally the PFO closed 8 days post op and I was released two days later. Did I mention I hate hospitals....blech

After my first visit with my surgeon post op he told me that my heart and veins showed absolutely no evidence of arterial disease and was impressed with the fact that my diet must be good (which it is). Further he expected a full recovery which I now can say came true.

After being released from the Surgeon I was handed over to my VA Cardiologist who immediately started pushing me to take statin drugs (Crestor). I DO NOT want to be on them primarily because my diet is good and I feel that the clean bill of health from the Surgeon was enough of an indicator for me not to take them. Additionally I feel that the risk of cognition problems down the road (I'm 62) would be accelerated by taking statin drugs (a common side effect).

However, there still is a side of me that says go with conventional wisdom and take them. I have always refused to "drink the coolaid" and have searched for other options.

Since the initial meeting with my Cardiologist and subsequent visits with my primary care physician I have been badgered to the point of feeling bullied to take Statins. Were do you all stand on this? I would like to hear your opinions.

Thanks

 

[escargome]

I would follow your gut. Sometimes I feel like doctor's never hear a word we say and just prescribe what the drug du jour is. If you have no arterial problems why load up on a drug you don't need. Just my 2 cents worth.

 

[newmitral]

These days, doctors seem to prescribe a lot of medications that may not be essential, and may not be needed by everyone.

When I was sent home from the hospital after my mitral valve replacement, the doctors had prescribed, in addition to the anti-coagulation warfarin:
1. A strong pain killer
2. A stool softener
3. A cholesterol lowering drug (Crestor)

I did not need, and did not even fill the prescription for the stool softener and pain killer pills. I had not needed them in the hospital during recovery and did not take them there either. Although they were offered while in the hospital, the nurses did not push them.

Like you, my vessels showed no signs of vascular disease. The surgeons did a catheterization to look around before the valve replacement to see if there was any blockage, in case they needed to take care of that as well as the valve replacement. My particular problem was endocarditis and not cholesterol related.

I did take the Crestor for a few weeks post recovery, but like you, I do not like taking unnecessary medication. I was also concerned by the side effects of the statins. When I had my first post-surgery checkup with my doctor, I asked why the Crestor was recommended if I had no problem with high cholesterol. He reviewed my blood cholesterol levels and concurred that the Crestor seemed unnecessary, and I stopped taking it, with my doctor's approval.

I had another cholesterol test a few months later to confirm everything was still fine.

It seems that the statins are prescribed almost routinely, but your doctor should review your specific situation and help determine if they are really required for your specific case.

I would ask your doctor to do a new blood test for cholesterol levels and if your levels are within the recommended range without taking the drugs, ask your doctor to explain to you why he feels they are needed.

 

[bradvo]

Is your cholesterol high ?? I got a clean bill when I had a cath scan of arteries but my cholesterol is 285. I also read where high cholesterol can be part of the problem with Aortic calcification.
I have been off Lipitor for years, liver enzymes came back good but I felt some aches and pains, mostly when the dosage was upped from 10mg to 20mg.
I decided to go back on Lipitor at 10mg and check my levels again around 3 to 4 months from now. I know it works, I had bad levels before and a crappy diet and watched it come way down.
I don't really like taking all these chemicals tho...

 

[Greg a]

Is your cholesterol high ?? I got a clean bill when I had a cath scan of arteries but my cholesterol is 285. I also read where high cholesterol can be part of the problem with Aortic calcification.
I have been off Lipitor for years, liver enzymes came back good but I felt some aches and pains, mostly when the dosage was upped from 10mg to 20mg.
I decided to go back on Lipitor at 10mg and check my levels again around 3 to 4 months from now. I know it works, I had bad levels before and a crappy diet and watched it come way down.
I don't really like taking all these chemicals tho...

Knowing your target numbers and then KNOW YOUR actual numbers before messing with the meds on your own.......if you feel it is wrong SAY SO you are your best advocate

 

[Paleowoman]

I also read where high cholesterol can be part of the problem with Aortic calcification.

I'd be interested to know where you read that - can you post a link please ?

Charlie - I would look into this more carefully if your arteries are clean and your cholesterol levels are okay. If your cholesterol is high check the lipid profile - what is your HDL, LDL and triglyceride levels. There's lots you can do to lower cholesterol and get good ratios without statins. Plus a lot depends on whether you believe the cholesterol hypothesis of heart disease - watch this on the Lipitor Paradox: http://www.youtube.com/watch?v=GqdzJLOQM2I

 

[bradvo]

Knowing your target numbers and then KNOW YOUR actual numbers before messing with the meds on your own.......if you feel it is wrong SAY SO you are your best advocate

Sorry Greg, me no understand what your referring to about messing with meds on my own ?? These meds have to be doctor prescribed, maybe Canada is different?

 

[bradvo]

I'd be interested to know where you read that - can you post a link please ?

Charlie - I would look into this more carefully if your arteries are clean and your cholesterol levels are okay. If your cholesterol is high check the lipid profile - what is your HDL, LDL and triglyceride levels. There's lots you can do to lower cholesterol and get good ratios without statins. Plus a lot depends on whether you believe the cholesterol hypothesis of heart disease - watch this on the Lipitor Paradox: http://www.youtube.com/watch?v=GqdzJLOQM2I

This is what I read , may or may not be right but I took it as if your high, like I am, your not helping the issue. If I was not high and no problems, I would be more apt to say no, or ask more questions as to why take statins. My wife is one who it totally against statins and says the verdict is not out yet on that drug. I can only go by my personal experience.

Of course this is like too late in a way, the valve now has been replaced in my case and many others.

But, since I have had the thrill of OHS and recovery and my levels are high and I know my weakness, a 10mg might be right for me.


http://www.mayoclinic.com/health/aortic-valve-calcification/HQ00245

Aortic valve sclerosis — thickening and stiffness of the valve — and mild aortic calcification usually don't cause significant heart problems, but require regular checkups to make sure your condition isn't worsening. It's important to have your cholesterol checked because you may need medications to lower cholesterol and help prevent aortic valve sclerosis from getting worse. If the valve becomes severely narrowed (stenotic), aortic valve replacement surgery may be necessary.

 

[Paleowoman]

This is what I read , may or may not be right but I took it as if your high, like I am, your not helping the issue. If I was not high and no problems, I would be more apt to say no, or ask more questions as to why take stations. My wife is one who it totally against statins and says the verdict is not out yet on that drug. I can only go by my personal experience.

http://www.mayoclinic.com/health/aortic-valve-calcification/HQ00245

Aortic valve sclerosis — thickening and stiffness of the valve — and mild aortic calcification usually don't cause significant heart problems, but require regular checkups to make sure your condition isn't worsening. It's important to have your cholesterol checked because you may need medications to lower cholesterol and help prevent aortic valve sclerosis from getting worse. If the valve becomes severely narrowed (stenotic), aortic valve replacement surgery may be necessary.

I'm high too (total cholesterol 317 but HDL 116 and trigs only 44 so really good profile) but not on statin. My cholesterol has actually risen as my pressure gradient rises BUT how do we know that the raised cholesterol isn't the body's way of trying to "fix" things ? I mean my HDL, which is the protective, helpful lipoprotein, is so high that it puts me in the "longevity syndrome" bracket ! Which is why I think the jury is still out on this cholesterol business.

Oh, just add that my coronary arteries are clean - I had a CT angiogram which showed them fine.

 

[RealtorRick]

I was diagnosed with BAV 6 years ago. Cholesterol was 228. Dr immediately put me on ProCardia and Zocor. Cholesterol came down 60 points in 60 days. Started having muscle cramps. Dr told me to cycle on off for a week and then go back on. I noticed it mostly in summer months when I sweat a lot so I added Potassium supplement. He said that was fine. After 5 years the cramps came more frequently. Cardio switched me to Crestor 10 mg and I have only had cramps 1 time. Liver tests are fine. Just had pre-op testing and arteries are clear. I have no side effects from statins and if Doc says take them after surgery, I will. That being said, I too believe that if we do not need something, don't take it. I was prescribed Vicodin 2 weeks ago for severe shoulder pain and destroyed them after taking 2. Wicked stuff!

 

[Greg a]

Sorry Greg, me no understand what your referring to about messing with meds on my own ?? These meds have to be doctor prescribed, maybe Canada is different?

It was from the use of "I" that led me to think you are taking on your self to adjuat your meds did not mean to insinuate that the drugs were/are not prescribed but wondered if you were altering the dose

Is your cholesterol high ?? I got a clean bill when I had a cath scan of arteries but my cholesterol is 285. I also read where high cholesterol can be part of the problem with Aortic calcification.
I have been off Lipitor for years, liver enzymes came back good but I felt some aches and pains, mostly when the dosage was upped from 10mg to 20mg.
I decided to go back on Lipitor at 10mg and check my levels again around 3 to 4 months from now. I know it works, I had bad levels before and a crappy diet and watched it come way down.
I don't really like taking all these chemicals tho...

 

[tobagotwo]

After my first visit with my surgeon post op he told me that my heart and veins showed absolutely no evidence of arterial disease and was impressed with the fact that my diet must be good (which it is). Further he expected a full recovery which I now can say came true.

Whatever your cholesterol levels, the catheterization is the gold standard. You have good/lucky genes (they matter even more than diet).

The scoop on Crestor, as recounted in WebMD http://www.webmd.com/cholesterol-management/news/20100402/should-healthy-people-take-statins:

Statins are a class of drugs that lower cholesterol. In February 2010, the FDA approved the use of AstraZeneca's statin drug Crestor for preventing first-time heart disease. The approval is for people who meet all of the following conditions:

Age: Men 50 or older or women 60 or older

High blood levels of C-reactive protein (CRP). CRP is an indicator of inflammation in the body. Inflammation is a major part of the process leading to heart disease.

At least one other risk factor for heart disease, such as high blood pressure, low HDL "good" cholesterol, smoking, or a family history of premature heart disease

Not included on this list is a high level of LDL "bad" cholesterol. Why? LDL cholesterol is a major contributor to heart disease. But half of all heart attacks and strokes happen in apparently healthy people with LDL cholesterol levels below the current level of concern.

Please see the full article to ensure you have the full context.

I get the general sense that you don't fit this profile. Regardless, it's your body and your call. You have no coronary artery disease now. What makes him think you will get it later? (Note: people with bicuspid aortic valves often have preternaturally clean arteries through some undetermined genetic mechanism, although I don't know if you had a BAV.)

Statins are drugs that can have severe side effects. If you don't have an obvious need for them, he shouldn't be bullying you to take them. If you don't fit the FDA profile, and he won't listen, complain to the VA administrator about his subordinate's overzealous pillpushing.

Best wishes,

 

[bradvo]

It was from the use of "I" that led me to think you are taking on your self to adjuat your meds did not mean to insinuate that the drugs were/are not prescribed but wondered if you were altering the dose

Hey Greg, I see that now.. well I got off the Lipitor last week, I began to feel more aches and pains and decided to stop the statins. I let my doctor know Thursday why I did, he was not happy but he is not feeling the muscle aches and pains . I told him maybe it was bad timing , taking the drug while healing and said I may give a go later. I just feel that statins might not be for me.


After giving this some thought I can't believe my doctor wanted me to stay on Lipitor after telling him how I felt. Even the TV commercials would say to contact your Doctor if you had muscle aches and pains as this could be a serious side effect.

 

[yotphix]

I was pressured somewhat recently by my family doctor to take a Statin. I asked him why, and he said that my cholesterol was high. I asked him what he thought of my HDL LDL ratio. He conceded that it was excellent. I pointed out to him the report in my chart from my cardiac cath, which declared my arteries to be whistle clean (what does that mean anyway, aren't whistles full of spit?). Still, he persisted, his cholesterol isn't as high as mine and HE takes a statin! I pointed out to him that my diet is excellent, and described it to him. Again, he said, I really think.... I told him that I would take it up with my cardiologist at my next appointment (I didn't mention that I've been cleared to stay clear of my cardio for three years!) That satisfied him.

Doctors don't always know what make sense, or is right. Putting a very active 42 year old man with demonstrably clear arteries and an excellent diet, not to mention a fantastic ratio of HDL to LDL, on Statins makes no sense at all.