Many doctors are following the recommendations by the American College of Cardiology and the American Heart Association. People over 65 with perfect cholesterol levels, normal blood pressure and no family history of heart disease are told to take statins to lower cholesterol. That would be true even if running marathons, followed a vegetarian diet and meditated three hours a day. This reader wanted to know why the doctor prescribed statins to all persons over 65 years
P I am 76. In my recent check-up, all my blood in a normal range, including triglycerides, HDL, LDL, total cholesterol and glucose. I take lisinopril for blood pressure and metformin for diabetes.
My doctor prescribed simvastatin “as a preventive of heart attack and / or stroke.” I heard statins can have negative side effects such as liver damage or muscle pain and do not want to take any more medication than necessary. If all my numbers are within the normal range, it is necessary to take a statin because my doctor said “prescribe this to all your old patients”
A. people who have had a heart attack or diagnosis of heart disease may need a statin, but there is a lot of controversy over whether healthy elderly as you benefit from these drugs.
There was a time when some cardiologists almost advocated putting statins in the water supply. They perceive statins as super safe with virtually no side effects and were convinced that these drugs prevented many heart attacks and saved many lives, even for people with no apparent risk factor for heart disease.
Statins to lower cholesterol: Recommendations AHA
If you go to American Heart Association “risk calculator” and put in the following numbers:
Total cholesterol: 180
HDL cholesterol 85
systolic blood pressure: 120
diastolic blood pressure: 80
“based on your age and risk of heart disease or stroke, the ACC / AHA suggests that should be in a moderate to high intensity statin.”
If you check the boxes that say “treatment for high blood pressure and diabetes,” unequivocal recommendation is to take statins to lower cholesterol. What seems to be forgotten in this equation is something called the ACCORD trial .
In this large, well-controlled clinical trial, people with type 2 diabetes were followed for about eight years to see what impact lower systolic blood pressure of 120 and get the bad LDL cholesterol below 100 would have on important health outcomes.
The authors concluded that ( JAMA July 7, 2010 ):
“Strict control systolic blood pressure in patients with diabetes and CAD was not associated with improved cardiovascular outcomes compared with usual control. ”
Another surprise: subjects with type 2 diabetes who received both blood pressure and blood cholesterol in the target range diabetes had better cognitive function than the volunteers treated with placebo ( Archives of Internal Medicine online February. 3 2014 ).
What about longevity when people take statins to lower cholesterol?
A review of research on statins and survival reveals that healthy people taking medications such as atorvastatin, pravastatin, or simvastatin live about three additional days after several years of treatment ( BMJ Open September 24, 2015 ).
The statistics on this are a bit complicated, but suffice to say the benefits for the elderly may not be as big as your doctor thinks. If your blood pressure and blood sugar levels are well controlled, the benefits of adding statins to lower cholesterol remain unclear.
Statins and blood sugar
A paradox that many health professionals have a hard time with involves the impact of statins on blood sugar. It took a long time researchers find that statins increase the risk of developing type 2 diabetes There is still controversy as to whether statins make it harder to control blood sugar in patients diagnosed with diabetes.
We have heard from visitors to this website statins to lower cholesterol can alter the control of blood sugar .
A study in Finland ( Diabetologia May 2015 ) reveals that the relationship between statins and type 2 diabetes may be stronger and more worrying that most Americans would like to believe cardiologists. The study also confirms what visitors to our website have been saying for a long time, ie statins to lower cholesterol make it difficult to control blood sugar. For us, this seems like a counterproductive exercise, a bit like trying to climb a very steep hill with galoshes lead feet.
What else can you do?
Cholesterol is just one of the more than 240 other risk factors that contribute to heart disease. For more information about how you can improve your chances of avoiding a heart attack, here’s a link to our guide, controlling cholesterol and heart health .