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England's National Institute for Health and Care Excellence (NICE) has issued new draft guidelines for NHS doctors detailing which patients should be offered statins to prevent or delay heart attacks or strokes. These widen the patient pool which are recommended receive these drugs as a matter of course.

Statins reduce the production of low-density lipoprotein cholesterol (LDL) in the liver. High LDL levels are associated with heart attacks and strokes. Doctors use a calculator called the QRISK2 test. This is the model used for the UK however you should note that the UK postcode field - the equivalent of the US Zip+4 long code - is taken into account in the calculation (leaving it blank knocked 1.3% off my risk).

The QRISK2 uses various factors to calculate your risk of having a heart attack or stroke in the next 10 years. Previous guidelines recommended that doctors offer statins to all patients with a risk factor of greater than 20%. The new guidelines reduce this to 10%.

The use of statins by otherwise healthy people is controversial. Some side effects have been experienced in a few cases and liver function tests should be used to check the suitability of the patient and to make sure that function is not impaired by the drug. Other measures like weight loss, diet changes and exercise also reduce LDL levels. Anti-hypertension (high blood pressure) drugs should also be considered.

Bear in mind that NICE make their recommendations based on cost-benefit analyses. The NHS currently pays about £450 million (US$743 million) for statins based on the 20% risk. This is offset by the cost of treating patients who would otherwise have heart attacks or strokes within the 10 year window.  Obviously the cost-benefit analysis using US costings may well indicate a different level where in purely financial terms statins are advised. This does not of course mean the non-financial benefits (better life expectancy!) should not be considered.

As with all such advice, check with your own doctor before buying off the shelf drugs - preventive medicine to reduce overall costs like this is what Obamacare is all about. Arm yourself with information in advance - a good starting point in the NHS patients' site which is about the best source of unbiased information on all sorts of conditions.

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Comment Preferences

  •  Tip Jar (7+ / 0-)

    "Come to Sochi, visit the gay clubs and play with the bears" - NOT a Russian advertising slogan.

    by Lib Dem FoP on Wed Feb 12, 2014 at 01:30:59 PM PST

  •  Well, that's depressing... (2+ / 0-)
    Recommended by:
    lgmcp, Crider

    At 62, no matter how trim and fit I am and how good my cholesterol and systolic pressure are, it says I need to be on a statin (10 yr. 15% risk) because my father had a heart attack before age 60. Even if I didn't account for my dad, I'd still be at 10% and therefore on a statin.

    Just another faggity fag socialist fuckstick homosinner!

    by Ian S on Wed Feb 12, 2014 at 01:59:01 PM PST

    •  The heck with 'em, I say (7+ / 0-)

      Just because they offer, doesn't mean we have to accept.   For myself I'm pretty certain that the risks from the medication are underestimated.  

      "The extinction of the human race will come from its inability to EMOTIONALLY comprehend the exponential function." -- Edward Teller

      by lgmcp on Wed Feb 12, 2014 at 02:06:10 PM PST

      [ Parent ]

      •  That is the point of NICE (2+ / 0-)
        Recommended by:
        lgmcp, RiveroftheWest

        These are clinical guidelines which should be tailored for each patient however the general principle that statins for this group improve life expectancy is established by the background papers.

        They also take into account quality of life issues like side effects and it is for the patient to decide if these are bad enough (it can take several tries to get the one best tolerated) to outweigh the long term benefits. NICE's answer is "yes" for most people in the risk group.

        I'll also re-emphasize that lifestyle changes are perhaps more important than simply taking one family of drugs. Cut out completely if you can all sodium chloride and use salt replacements carefully. I use about 750g per year of sodium chloride which includes all cooking uses so much is thrown away with the water from pasta etc. Sparing use of a low salt alternative for table use (about 200g pa) and that in food brings my intake well below the 6g recommended maximum. That in itself should bring your blood pressure and therefore risk factor down.

        "Come to Sochi, visit the gay clubs and play with the bears" - NOT a Russian advertising slogan.

        by Lib Dem FoP on Wed Feb 12, 2014 at 02:22:14 PM PST

        [ Parent ]

      •  Statins cause dementia! (1+ / 0-)
        Recommended by:
        lgmcp

        I've seen it happen to a number of older folks I know.

        As soon as they're on Lipitor, their short term memory goes to hell.

        A friend got his dad off statins and started cooking low fat meals for him, and his cholesterol went down while his memory improved.

        I'm fortunate enough to be genetically blessed so that I don't have to worry about cholesterol, but if I wasn't I would NEVER take statins!

        "Everybody wants to go to Heaven but nobody wants to die" --- Albert King

        by HarpboyAK on Thu Feb 13, 2014 at 01:26:54 AM PST

        [ Parent ]

    •  Do they have you taking CoQ-10 as well? (0+ / 0-)

      Statins inhibit the body's synthesis of coenzyme Q10 in the same way they inhibit cholesterol synthesis
      and that creates a whole host of issues long term problems.
      Doctors here are funny about it as though it is some new age hippie concern, while in Canada statin labeling is required to warns of CoQ10 depletion. Science.

    •  That doesn't make any sense (2+ / 0-)
      Recommended by:
      lgmcp, Ian S

      Why would you take a drug that lowers cholesterol if you already have low cholesterol?

      If your dad had a heart attack because, say,  he was 100 lbs overweight and smoked like a chimney, I'm going to go out on a limb here and say that shouldn't be counted as a risk factor for you.

  •  Funny! (4+ / 0-)
    Recommended by:
    lgmcp, sfbob, terabytes, sillia

    Last night, I was overjoyed because I stopped taking my hypertension meds after a few weeks on a whole foods, plant based diet.

    Maybe the next big thing will be having all meats and cheeses fortified with Lipitor — like they fortify white flour with vitamins — so that people won't have to bother getting a prescription!

    "Societies strain harder and harder to sustain the decadent opulence of the ruling class, even as it destroys the foundations of productivity and wealth." — Chris Hedges

    by Crider on Wed Feb 12, 2014 at 02:10:23 PM PST

    •  Good for you! (1+ / 0-)
      Recommended by:
      lgmcp

      GREAT for you. These drugs cause so many problems. Blood pressure meds are famous for causing memory problems, cognitive issues, etc. Older people who have these symptoms (like my elderly mom) usually just attribute them to 'old age' and don't realize it could be the meds. And/or poor blood circulation to the brain due to fatty diet.

      My husband and I are sticking to our plant-based diet--we don't want all these problems that our peers are getting. It makes me sad, and angry and frustrated at all the ignorance...willful ignorance on the part of agencies that could be promoting better health.

      Sigh.

      Where in the Constitution does it say: "...on behalf of corporate interests" ???

      by sillia on Wed Feb 12, 2014 at 05:51:56 PM PST

      [ Parent ]

  •  The 'talk to your doctor' is the important part. (0+ / 0-)

    I managed to stop smoking about six weeks ago, and only thereafter began to hear that for those with a medical condition I have, the cessation of smoking will in all probability produce a pronounced and possibly longish term, two years, round of bad news of the kind I take medicine to prevent.

     In order to prevent  or limit the damage of  that, I started looking at what I needed to do besides seeing the doc, diet and that sort, at which point I found a list of foods to discontinue because they affirmatively messed with the medicine I take, which had the collateral issue that they were most of the good stuff on the low glycemic index for diabetes avoidance, and, of course, that I should eliminate gluten and soy and dairy, categorically.

    I also began to see the references in the literature about the connection between my ailment and cholesterol issues, which may mean taking the medicine I do for THAT won't help either.  And diabetes, which may or may not mean that my efforts to act so as not to trigger that are also doomed to failure.  

    My doc and I have an appointment next week on all this, before I go nuts or do  myself damage.Since he and everyone else are clear that smoking cessation is the numero uno issue.

     The peculiar thing is that I have been taking the same medicine profile for nearly thirty years without any doc at all mentioning any of this stuff to me,  especially the one wherein smoking is a neutral matter for my medical condition that old, as long as it is going well, but will trigger the mess I mentioned if there is either a hypo or a hyper aspect to it in me.

    Gonna be an interesting appointment next week.   Grrrr.

  •  don't drink the koolaid (3+ / 0-)
    Recommended by:
    sillia, agnostic, chimene

    Statins have a number of deleterious effects on health.  They worsen  glucose metabolism, increasing risk of diabetes.  The brain is dependent on cholesterol, and statins have been shown to cause memory impairment and "brain fog".  They impair metabolic function in the muscles, causing muscle fatigue, making it harder to maintain an active life and hampering exercise tolerance.  Nerve fibers are covered with a myelin sheath, which is made from cholesterol.  Guess what, statins can cause painful neuropathy.

    Please, if you are thinking of taking a statin for prevention, do a little research on adverse side effects of statins.    These are not benign medications.  Cholesterol is an essential substance for the human body, especially the brain and nervous system.   Now that patents have expired, the only way drug companies can maintain their profits is by convincing everybody that they need to take them.  

    Being fit, eating a diet rich in whole unprocessed foods, avoiding sugarand junk foods, these will go a lot fufurther in preventing heart disease than taking a pill that interferes with one of your bodies essential metabolic pathways.

  •  My dad takes all that stuff (1+ / 0-)
    Recommended by:
    chimene

    I guess he is the target audience, since he is also completely unwilling to cut back on red meat or booze or heavy salt, unwilling to lose weight, and unwilling to exercise.  

    If he did all those lifestyle changes, or even some of them, and was still at very high risk, I'd be okay with him taking all these meds, or at least some of them.  But to choose them INSTEAD of sensible dietary changes, makes no sense to me.  

    "The extinction of the human race will come from its inability to EMOTIONALLY comprehend the exponential function." -- Edward Teller

    by lgmcp on Wed Feb 12, 2014 at 05:58:42 PM PST

  •  Hey, I covered this in November here: (0+ / 0-)

    What we call god is merely a living creature with superior technology & understanding. If their fragile egos demand prayer, they lose that superiority.

    by agnostic on Wed Feb 12, 2014 at 06:26:57 PM PST

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