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Monday, 31 March 2014

Why take statins? - British Heart Foundation

reposted from: https://www.bhf.org.uk/heart-health/treatment/statins.aspx

Statins

Statin drugs - British Heart Foundation

Statins are the most commonly prescribed medicines in the UK. They work to lower the level of cholesterol in your blood. There are different types of statins, but they all work in much the same way.

Why do I need to lower my cholesterol?

Cholesterol is essential for your body to work well, but too much ‘bad cholesterol’ (called low-density lipoprotein or LDL) is unhealthy. Statins reduce the amount of ‘bad cholesterol’ your body makes.
High levels of ‘bad cholesterol’ in your blood can lead to fatty deposits building up in your arteries. This can increase your risk of developing cardiovascular disease, which includes conditions such ascoronary heart disease  (leading to angina and heart attack) and stroke.
Your body will always make cholesterol so if you stop taking a statin, it’s likely your cholesterol levels will rise. If you are prescribed a statin, you need to take it every day. Statins are most beneficial when you take them on a long-term basis.

Why do I need to take statins? 

If you’ve had a heart attack or stroke, you may be advised to take statins in order to reduce your risk of another event. If you have peripheral arterial disease statins can help to slow the progression. If you are diabetic, you are at a much higher risk of developing cardiovascular disease, and taking statins will help to reduce this risk.
Even if you’re in good health, you may be prescribed statins if you’re at high risk of developing cardiovascular disease, for example, if you have a strong family history of cardiovascular disease. Statins can help lower your risk.

When should I take my statin?

It’s important to take your medication regularly as prescribed. Most statins are taken at night, as this is when most of your cholesterol is produced. Check with your doctor or pharmacist when you should be taking your statin.
Most statins come as tablets. The most common one is simvastatin.
Look up your medication on the Medicine Guides website.

Are there any foods, drinks or other medications I should avoid? 

Check with your doctor or pharmacist before you take any other medications. Taking certain medicines together may affect how well they work.
If you’re taking simvastatin or atorvastatin, avoid grapefruit and grapefruit juice as they can increase your risk of side effects.
If you take another type of statin, limit your intake of grapefruit juice to very small quantities or you may want to avoid it all together.

Do statins have side effects?

Like all medication, statins have potential side effects. The most common are muscular aches and pains, but many people experience none at all. Statins are among the safest and the most studied medications available today.
If you do experience side effects, or if your side effects change or become worse, tell your GP.
Statins target the liver cells where cholesterol is made. Before you start taking statins, you will have a blood test to check how well your liver works. Your doctor may request that you have a follow-up blood test a few months later. If your liver is affected, your doctor may want to reduce your dose or change your statin to another kind of medication that lowers your cholesterol.
Find out about other possible side effects from our Statins information sheet.

Can I buy statins over the counter?

Low-dose statins are available at some pharmacies without a prescription, but they are not a substitute for prescription statins or for making lifestyle changes to reduce your cholesterol level. If you are at high risk of heart disease, your doctor may prescribe a statin for you.

What are the differences between statins?

Lots of people don’t need a strong statin to reduce their cholesterol level. Your GP or cardiologist will find the right statin for you, depending on your medical history and the cholesterol level they think you should aim for.
If you’re sensitive to one statin, you might not be sensitive to another. You should have a blood test after any change of statin to see how effectively the new medicine is lowering your cholesterol.

Can I take a statin if I'm pregnant?

If you’re pregnant, breastfeeding or planning a pregnancy, you should not take statins. If you’re already taking statins but would like to become pregnant, speak to your GP first.

How else can I lower my cholesterol?

You can also lower your cholesterol by:

Statins reduce my risk of heart attack or stroke by 20%!

I started taking statins (Pravastatin 10mg/day) in January 2013 after I decided that statins would be good for my health.

With QRISK.org I reckon I have cut my risk of a heart attack or stroke in the next 10 years from 7.8% to 6.3%, a 20% reduction. I've had no side effects.

I can't be sure of course that it was the statins that caused the Cholesterol/HDL ratio reduction. Changes in my diet and / or exercise in the last year might have helped too.


Before I took Statins (3/1/13)



1 Year after taking Statins (21/3/14)






What's your QRISK?

Wednesday, 26 March 2014

Lipid Modification - NICE draft guidelines 2014

reposted from: http://www.nice.org.uk/guidance/index.jsp?action=folder&o=66546

Consultation documents

The full version describes the evidence and views that have been considered, and sets out the provisional recommendations that have been developed. My recommended read.
The NICE version presents the provisional recommendations only with some brief supporting information. My recommended read.
crabsallover highlights, key points, comments / links.

Statins aren't a wonder drug

reposted from: http://www.theguardian.com/commentisfree/2014/mar/23/statins-not-wonder-drug-major-diseases?commentpage=2
crabsallover highlights, key points, comments / links.


Calculate risk of having a heart attack or stroke within the next 10 years - use QRISK2

It takes seconds to calculate your risk: http://www.qrisk.org

New draft NICE guidelines may be ratified July 2014 recommending use of Statins if your risk of having a heart attack or stroke within the next 10 years is 10% (cf. currently 20%).

See the great interactive 'how statins work'. viz

  1. Cholesterol is produced mainly in the liver. There is good cholesterol and bad cholesterol. Too much bad, LDL-cholesterol, however, can cause hardening of the arteries. 
  2. The liver contains an enzyme called HMG-CoA reductase, which produces cholesterol ...
  3. Statins replace the HMG-CoA that exists in the liver, thereby slowing down the cholesterol production process ...
  4. The 'inhibition' of HMG-CoA enzyme by the statin has other effects, on top of reducing the amount of cholesterol produced. It also increases the production of LDL receptors, proteins which 'catch' the bad cholesterol and draw it into the liver cells to be broken down.
Modified by Chris Street from Guardian Feb 2014 http: //goo.gl/DRAo2R

Whilst NICE and Rory Collins are recommending use of Statins with 10% 10 year risk of heart attack or stroke, John Abramson, a clinician working at Harvard medical school claims his BMJ published analysis showed statins did not significantly reduce mortality in the 20% or 10% risk groups. (Guardian Feb 2014).