U.S. panel calls for taxing sugary foods to curb obesity

[unsmiley 111]

I have been on statins for about two decades and more than the normal dose. Hate them. But, like anything else, you get used to them. Getting old sucks.

Curious why you hate them. I take them with no apparent issues.

[Dakine10 5,452]

There also is at least one medical study that suggests that almost everyone should be on a statin above a certain age.

Wonder who funded it?

I think it's a drug that works well for a relatively small target group. I also think there is a huge incentive to make that target group bigger.

Curious why you hate them. I take them with no apparent issues.

Apparent being the operative word.

[unsmiley 111]

Wonder who funded it?

I think it's a drug that works well for a relatively small target group. I also think there is a huge incentive to make that target group bigger.

Not sure who funded the study, but many statins are now generic and are dirt cheap - I can get 3 months worth for $15.99. Not much of a profit motive there.

[I AM NOT THAT GUY 5,715]

Curious why you hate them. I take them with no apparent issues.

Statin cough, insomnia, loss of muscle mass. Doc says I am crazy, but I know when I miss a dose, the symptoms go away.

[Dakine10 5,452]

Not sure who funded the study, but many statins are now generic and are dirt cheap - I can get 3 months worth for $15.99. Not much of a profit motive there.

Multiply that by 100 million people and it's a couple of billion a year.

Is that cost your copayment or the full cost?

[I AM NOT THAT GUY 5,715]

Multiply that by 100 million people and it's a couple of billion a year.

Is that cost your copayment or the full cost?

And at what dose? I am taking simvastatin at 80 mg/day.

[Dakine10 5,452]

Statin cough, insomnia, loss of muscle mass. Doc says I am crazy, but I know when I miss a dose, the symptoms go away.

Loss of muscle mass makes sense. Cholesterol is important for cellular repair. It's also used to synthesize testosterone. Doctors should know that.

[TBoneTX 46,320]

Tying it to calculated risk factor is not a great idea, because many of the people in this group have little to no clinical evidence of heart disease. It is appropriate for people who are at high demonstrated risk for cardiac events or stroke, but they should otherwise be giving a lot more consideration to the long term of effects of blocking cholesterol synthesis before giving people this drug.

My doctor doesn't prescribe statins without doing a carotid artery ultrasound except for cases of familial hypercholesterolemia. If there's no evidence of plaque, you don't need them. Once the long term risks of statins become better established, I believe this will become the standard.

Good points. However, who might die in the meantime as we wait for valid studies of the long-term effects of statins? Would not the short- and midterm effects (the positive ones) reduce the potential of major adverse cardiac events and stroke in people who are asymptomatic but hyperlipidemic? There need not necessarily be distinct clinical evidence of ischemic heart disease for statins to be beneficial, as a preventive or prophylactic measure.

As I understand it, the negative effects chiefly involve hosing the liver and elevating one's glucose level. If the liver-enzyme levels are monitored regularly and aren't hosed, and if the glucose level isn't more than a few points above the high red line, wouldn't the lowering of LDL-C (low-density-lipoprotein, or "bad," cholesterol) be beneficial to other organ systems and to overall health?

In answer to my question (some time ago) about the possible prophylactic benefits of low-dose statin therapy, my own doctor said that there were no groups that statins hadn't helped. He said that they were first used on the most grievous cases, and the therapy helped them; statins were then prescribed to the next group down, and the therapy helped them; and so on. He saw no reason that statins couldn't help patients who are asymptomatic but borderline, slightly, or moderately hyperlipidemic. This anticipated the recent conclusions of the American College of Cardiology/American Heart Association.

He further noted that statins work on total cholesterol and LDL-C, and fish oil works on HDL-C (high-density-lipoprotein, or "good," cholesterol). Therefore, statins and fish oil can be good as combination therapy.

I'm purely curious: On what basis does your doctor think that good results of carotid artery ultrasound indicate no need for statin therapy? Have recent studies been published about this? If so, I'd very much appreciate citations of the articles.

Risk factor isn't perfect, but it might be the best that we have to go on. What's better?

(Abbreviations above are expanded as a courtesy to anyone who might be reading.)

Edited February 21, 2015 by TBoneTX

[Dakine10 5,452]

Good points. However, who might die in the meantime as we wait for valid studies of the long-term effects of statins? Would not the short- and midterm effects (the positive ones) reduce the potential of major adverse cardiac events and stroke in people who are asymptomatic but hyperlipidemic? There need not necessarily be distinct clinical evidence of ischemic heart disease for statins to be beneficial, as a preventive or prophylactic measure.

As I understand it, the negative effects chiefly involve hosing the liver and elevating one's glucose level. If the liver-enzyme levels are monitored regularly and aren't hosed, and if the glucose level isn't more than a few points above the high red line, wouldn't the lowering of LDL-C (low-density-lipoprotein, or "bad," cholesterol) be beneficial to other organ systems and to overall health?

In answer to my question (some time ago) about the possible prophylactic benefits of low-dose statin therapy, my own doctor said that there were no groups that statins hadn't helped. He said that they were first used on the most grievous cases, and the therapy helped them; statins were then prescribed to the next group down, and the therapy helped them; and so on. He saw no reason that statins couldn't help patients who are asymptomatic but borderline, slightly, or moderately hyperlipidemic. This anticipated the recent conclusions of the American College of Cardiology/American Heart Association.

He further noted that statins work on total cholesterol and LDL-C, and fish oil works on HDL-C (high-density-lipoprotein, or "good," cholesterol). Therefore, statins and fish oil can be good as combination therapy.

I'm purely curious: On what basis does your doctor think that good results of carotid artery ultrasound indicate no need for statin therapy? Have recent studies been published about this? If so, I'd very much appreciate citations of the articles.

Risk factor isn't perfect, but it might be the best that we have to go on. What's better?

(Abbreviations above are expanded as a courtesy to anyone who might be reading.)

High cholesterol is correlated with heart disease but it's neither a cause or a symptom. If it's neither a cause or a symptom, it's probably not the right target for treatment. The important factor in the pathogenesis of heart disease is the formation of plaque on arterial walls (atherosclerosis). There is some debate over the exact cause(s) of atherosclerosis, but if you don't have it, you don't need to treat it. The benefits of statins are minimal in this scenario.

There are many people with high cholesterol who show no formation of plaque. There are many people with normal and even low levels of cholesterol who do. I think if statins were relatively harmless it would be fine to use them prophylactically, but they are not harmless. There was a recent study showing women who used statins for 10 years had twice the risk of breast cancer. As time goes on, they seem to be finding more side effects.

[Dakine10 5,452]

He further noted that statins work on total cholesterol and LDL-C, and fish oil works on HDL-C (high-density-lipoprotein, or "good," cholesterol). Therefore, statins and fish oil can be good as combination therapy.

Just to point out, statins work by inhibiting cholesterol synthesis. LDL and HDL are lipoproteins that transport cholesterol. LDL transports cholesterol from the liver to the tissues and HDL transports cholesterol back to the liver for reuse. If the liver is not making cholesterol, then circulating LDL-C will obviously decrease as there is nothing to transport.

The terms bad and good cholesterol are a little misleading, since it is the same cholesterol, just going to different places. If LDL is high, the important question should not just be how to stop it, but also why is it high and where is it going. The body doesn't waste cholesterol, so there is almost always going to be another issue going on, and just blocking cholesterol synthesis is not going to address that.

[unsmiley 111]

Multiply that by 100 million people and it's a couple of billion a year.

Is that cost your copayment or the full cost?

My full cost for generic simvastatin. No copayment, no insurance company involved.

And at what dose? I am taking simvastatin at 80 mg/day.

10 mg/day.

[I AM NOT THAT GUY 5,715]

My full cost for generic simvastatin. No copayment, no insurance company involved.

10 mg/day.

Minimal dose explains your experience for both cost and lack of side effects. You are getting the prophylactic dose. If you have no family history of heart disease and marginal numbers, with no other risk factors, you will probably stay at that dose.

[LibCampFireClub 635]

What the world needs now, is more big government, it's not for those who think, but for those who don't