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And it seems that I have about a 12% chance of living longer if I’m on a statin after ten years, than not. That sounds pretty good, too.

On the other hand, there’s no way at present to know if eating healthy foods and exercising a lot doesn’t have the same or better beneficial effects on longevity than taking statins.

I do know, that at 64, I eat healthy foods and I can ride my bicycle 100 miles in a day. And I get muscle pain from statins. For now, I prefer not to take a statin, partly on the untested theory that what I am doing is as effective as taking a statin.

The question I ask myself is if taking a statin would confer an extra measure of potential protection from having another heart attack, in addition to the protection I might have from exercising and eating well. As drug companies won’t conduct such a study, I guess I’m experimenting on myself.

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I have read lots of statin studies. In primary prevention (no heart attack), and if you are a middle aged male, taking statins might lower your risk of a heart attack by 20% over a ten-year period, but the reduction in all-cause mortality is somewhere around 0% (one-side or the other). If you have had a heart attack (secondary prevention), risk reduction may be 25% to 35% (I suspect low side because of bias in the studies) for heart attack/events but all-cause mortality risk reduction is probably 8% to 15%.

Some things to note: First, statins have modest positive effects in specific situations, and it is not known whether these result from cholesterol reduction or anti-inflammatory effects. Regardless, one has so much residual risk that you need to look hard at other ways of protecting yourself (my focus has been raising my HDL from 40 to 60+, and nutrient sufficiency for magnesium, choline, selenium, Vit. D and Vit K-2). Second, side effects are much more common than is believed, and can be serious. So, overestimated benefits, underestimated side effects risks.

If I had had a heart attack, I would probably work hard to find a dose I could live with, but I gave up on statins due to side effects.

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For me, it seems like taking a statin might be worth the risk of side effects, because I had a heart attack.
From the 4S trial: “to prevent one definite MI and/or CV death, NNT (5 yrs) = 13).”

I had a heart attack in December, 2008. Despite a 100% blockage of my right coronary artery, I was able to ride my bike 100 miles in one day about three months after my heart attack. According to my cardiologist, though, I still had an area of approximately 70% blockage in my left coronary artery.

In fact, I needed two more stents eight months later, despite lots of exercise, healthy eating, and 40mg of Simvastatin a day, when I started experiencing angina pain. So for me, a statin didn’t work, at least not at 40mg, and despite my rigorous exercise and healthy eating.

Last March, my cardiologist decided to put me on 80mg of Simvastatin, to get my LDL down to 70mg/dl or less, on the theory that any remaining plaque buildup (estimated at 20% in a number of areas in my arteries) could be reversed. He switched me to Lipitor a few months ago, when I had muscle pain.

And the SATURN study that just came out seems to show plaque reduction might be possible for about 65% of the people who take Lipitor or Crestor. Which is why, if that study is correct, it might be worth it to keep taking my high dose of Lipitor.

I still have doubts, though that my reduction of risk for another heart attack with a statin outweighs the potential risk from side effects, like my muscle pain, dementia, rhabdomyolysis, etc. I guess that’s something for each person to have to decide – it’s good to make the decision with as much knowledge as possible.

Thanks again!

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This post starts off with: “When I was hospitalized after my heart attack” and then goes on to criticize statin use for people who DON’T have heart disease. There are two sentences related to people who have had heart attacks:

“Some patients do receive SIGNIFICANT [emphasis mine] benefits from taking statins, like Lipitor (from Pfizer), Crestor (AstraZeneca) and Pravachol (Bristol-Myers Squibb). In studies of middle-aged men with cardiovascular disease, statin users were less likely to die than those who were given a placebo.”

What does “significant” mean? For example, how much less likely to die are middle-aged men with cardiovascular disease, compared to someone taking a placebo? On average does that statin-taker live a month longer, a year? Five years? Does it take 1,000 men, or 10,000 middle-aged men with CVD taking statin drugs for 1 year, or 5 years, to keep one from having another heart attack or to die from a heart attack?

Without knowing what “significant” means, it’s difficult to know if there is any benefit. Yet I see this statement posted over and over and over again on blogs and in news reports – statins help those with CVD. But do they? How can we know if we can’t see the numbers. And I’m pretty sure neither the author of this blog, or any other, can come up with those number very easily.

If the numbers are available though, I’d like to know them. All I ever see is the claim that statins can help those with CVD.

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