THE GREAT STATIN CONTROVERSY
STATINS! GOOD OR BAD
Anyone suffering a heart attack these days is most likely prescribed STATINS as a precaution against further heart attacks. In the UK over 8 million people routinely take them. As a result over 55 million of them are taken each year. This huge number reflects both their value to the drug companies and the almost automatic prescribing from most GP"S and Cardiologists.
My 90 year old father in law suffered a small heart attack in January and has been on statins ever since. We, in all truth have not noticed to date, any causes for concern in his case, but recent revelations of a divided opinion about use of statins in the medical ranks gives food for thought at the very least.
It appears that some patients, having had a heart attack and placed on statins find that they begin to experience strong and often severe chest pains. This is common apparently in those who have undergone heart surgery, but not only such patients and some cadiologists are now recommending in such cases that the patient discontinues statin use. This is at direct odds with the normal advice from GP"S that effectively, once on statins then always on statins. The reasoning behind this latter view is clear. Statins lower cholesterol levels in the blood and that it will prevent heart attacks in the first place and reduce risk of further attacks if one has been sustained before commencing use. My wife is in this category having been put on statins by our own GP because of a higher than normal cholesterol level. To date she has experienced no chest pains, but news of division in the use of the drug by the medical profession has alerted us and made us more vigilant.
The controversy over statin use relates to the fact that the medical profession is now divided about the benefits to health to be obtained frm lowering cholesterol which statins certainly do well. On the other hand research now suggests that earlier trials of the drug over emphasised the benefits and under emphasised the side effects of use. These early trials of the 1980"s have been taken as gospel largely until recently. As a result over 3 million additional people, including my wife and her father have been put on statins since the year 2003.The NHS has even provided extra funding to meet the requirement.
To support the above, heart attack deaths have reduced by up to 40% during this time though no research has linked statins to this progress. The reasons for the reduction is thought more likely to relate to advances in heart surgery such as angioplasty immediately following on from a heart atteck. My brother in law is one who has benefitted from this advance. Others point to numbers of heart attacks reducing as a result of the reduction in smoking over the past 30 years. It is calculated now that 20% of the popuation smoke against 40% in the 1980"s.
Further evidence on heart attack reductions shows smoking reduction to be a big factor. In 2007, the UK banned smoking indoors in public places. As a result heart attacks dropped by 17% then. Outside of that the increased use of aspirin tablets at early stage indicators of potential heart attack has reduced deaths and continuing to take a tablet thereafter has proved effective.
The cause for concern against blanket use of statins has recently been increased by the revelation by the Annals of Public Medicine that 20% of statin users reported bad side effects such as, stomach ailments, muscular pains and, perhaps significantly in my father in law"s case, memory disturbance. This 20% rate of complaint contrasts in stark relief to the 1% claimed by the drug companies.
It is now reccomended that anyone on statins experiencing any such side effects should consult their Gp and seek approval to cease taking them for a 2 week trial period to see if the side effects are diminished. It is stated that no harm can accrue from a short break in use. Even so, some GP"S are not persuaded of the potential benefits of even a short break, in which case it is suggested that the opinion of a cardiologist be obtained.
THE SIMPLE POTENTIAL ALTERNATIVE.
The overwhelming and simple alterative to drug use in such cases seems crystal clear. Basically it is lifestyle change based on diet. The so called Mediterranean diet is well known for the benefits it can offer to those with heart problems and those who have had a heart attack. Olive oil, greasy fish, fruit, vegetables and even red wine in moderation are calulated as being up to 3 times more effective than statins. This type of diet is more effective than even low fat diets in reducing heart and stroke risks ,especially in those of middle age and above.
All the above really point to the fact that well above drugs like statins, the most important factor is the lifestyle of the patient. My Hubs focus often on the dangers of obesity, the need for regular excercise and a concerted effort where necessary, to lose weight. Add to this the factors of smoking cessation and good diet and the case for these factors above and beyond drug treatments is clear.
Maybe due to the huge advances made over the last 30 years in medicine that both ourselves and the Doctors have become too readily focussed on pills and potions as our "quick fix". Maybe, now the medical profession is beginning to strongly question itself on matters such as use of statins, the balnce may be redressed. Perhaps, and where possible, it is time for the individual to take charge of themselves instead of relying on overworked Doctors, who often feel pressured into prescribing when the alternative would be more effective and risk free. This is not to say that statin use in all cases should be discontinued as there will be cases when it fits the need exactly. However when 55 million are prescribed annually in UK there is, at the very least, time for a rethink..