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Thursday, July 24. 2008

How do statins work?

How many of you fellows out there are on statin medicines, like Lipitor or the others? Raise your hands.

Well, it's a good idea to take them. It may turn out to be a good idea even if your cholesterol and triglyceride levels are in the normal range.

Why? Because the way they seem to reduce arterial disease leading to heart attack and stroke may not be just - or even mainly - so much by altering cholesterol and triglyceride blood levels, but by stabilizing the endothelium (inner lining) of arteries. Here's a technical paper on the subject. One quote: 

Several clinical trials including Heart Protection Study (HPS), Collaborative Atorvastatin Diabetes Study (CARDS) and Treating to New Targets (TNT) Study have suggested that statins can offer protection to patients with normal lipid levels through various nonlipid-lowering effects.

The inflammation, clots, and plaque on arteries are the main cause of terrible events. American males already have visible arterial disease in their 20s. I saw it and touched it when doing autopsies in medical school, in young people who died of other causes.

Everybody dies. Statistically, if you reach maturity and don't die in a car crash, the odds are that half die of cancer and half of heart/arterial disease. So, if you can postpone that arterial disease, you get to die from a cancer.

That's today's cheery medical news.

Posted by Dr. Joy Bliss in Medical, Our Essays at 15:56 | Comments (11) | Trackback (1)

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Monday morning medical happiness
brought to you by Dr Joy Bliss over at Maggies Farm Everybody dies. Statistically, if you reach maturity and don't die in a car crash, the odds are that half die of cancer and half of heart/arterial disease. So, if...
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Tracked: Jul 28, 04:47

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Can you see me raising my hand Dr Joy? Not to taking the statin's, but too high cholesterol. Some where in the 3's, I thought the higher the number the better off you are. What is normal anyway? I'm much happier being abnormal. My BP is very good, I don't smoke, my weight floats between 180 and 195. (The holidays are tough) What I have has been handed down to me just like it has been handed down to my parents. There is no escaping genetics. Stay away from sugars and processed foods; they're real killers. I have carnal thoughts of you in that bathing suit, dreaming at night. Am I still normal?

Jappy - Knight of the Crossed Ewes

PS Sorry for my sophmoric and juvenile behavior. I enjoy reading all of your posts and I am sincere about that.
#1 jappy on 2008-07-24 18:26 (Reply)
Shame on you, Jappy. (But you are normal.)
I am a 46 year-old happily married lady, but I am in darn good shape.
#1.1 Dr. B. on 2008-07-24 18:47 (Reply)
That's okay, you take them.

The side effects are not worth the consolation of being able to die from either cancer or the consequences of an Obama Presidency. For a year or two more of life in these decaying times, I'd rather go out with taste.

Let us know how you do on this junk, say in twenty-thirty years.
#2 John Hetman on 2008-07-24 19:34 (Reply)
I just assume that any drug eventually ruins your liver and so avoid them. It's just a question of the study being done.
#3 Ron Hardin (Link) on 2008-07-24 20:02 (Reply)
Just gotta hope your liver outlives you.
#3.1 BD on 2008-07-24 20:41 (Reply)
The odds of your liver outliving you are much better than you outliving your liver.
#3.1.1 KRW on 2008-07-24 21:20 (Reply)
Liver, dither. Another round, for me and my friends. Life on the sword edge, that's me motto.
#3.1.1.1 Carroll on 2008-07-24 23:00 (Reply)
Well now, Dr. Joy. I hope you will continue to investigate this topic.

I will raise my hand.

I take 20mg of Crestor daily. I do so upon doctor's advice following an MI. A minor MI but an MI nonetheless. On the day of the MI my cholesterol profile was 20 HDL, 110 LDL. I don't recall the tryglicyrides (sp). I was scoped and had no blockages beyond 15%. No stents inserted.

I have made adjustments to my lifestyle and my cholesterol profile is now 60 HDL, 80 LDL, 60 triwhatevers. A poster child. Crestor is NOT the full cause of that change. I stopped using cigarettes, I exercise, I use plant stanols and red rice yeast, etc. I moved, over 18 months, from 110 LDL to 90 LDL to 80 LDL.

In that time I have experienced muscle cramps (especially legs) that I think are directly related to the statin and also some difficulty with memory. The difficulty with memory seems, upon investigation and effort, reversible or, at least, fightable with "brain exercises" and such.

All in all I would like to get off the statin or reduce to minimum dosage. I ran into someone whose opinion I trust implicitly the other day, however, and she suggested I stay on the statin forever since it is showing some clinical advantage in fighting Alzheimers.

Now I'm torn...

Please do keep following this for us, willya. In the meantime my plan is to see if I can get the LDL to 70 and then demand at least a reduction in the dosage if not complete elimination. To be honest, however, getting LDL to 70 is a challenge - even for a poster child.

BTW, what are your thoughts re: the small particle thing about cholesterol (HDL and LDL) and homocystenes (sp?).

Sorry, too lazy to go break out the books I've perused on these topics.
#4 Knucklehead (Link) on 2008-07-24 23:30 (Reply)
Memory is the side effect I fear, but I forget why?
#5 John on 2008-07-25 06:52 (Reply)
One very rare side effect of statin use is involuntary sex change. Just ask Zoe Brain of Australia. There are other conditions that need to be met, but who cares when you're got a sensational story to tell?
#6 Alan Kellogg (Link) on 2008-07-26 00:26 (Reply)
It is more than just memory - after being on lipitor for 6 months I started having problems recovering stamina... then having sudden attacks of being unable to move voluntary muscles. My endocrinologist took me off of that and all statins, as I had also seen weight gain on a previous one. The statins can also inhibit the necessary ability of the body to repair itself, and that was measureable on an MRI, in my case. A later PET scan showed no continuation of the damage.

As I have a familial background of sleeping disorders going back at least three generations, the damage triggered that off along with memory loss. Some function does come back over time. Now I am retired on disability from the agency I worked for... SSN still has some strange idea that being unable to drive or be physically active for more than a few minutes does qualify one for some sort of work. But then they are set up to say *no*, aren't they?
#7 ajacksonian (Link) on 2008-07-26 19:42 (Reply)

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