Statins Debate

[cgv]

cgv

cgv

Ran across this article in Reuters:


Lipitor does not prevent narrowing in heart valve Thu Jun 9, 7:54 AM ET



The popular cholesterol-reducing drug Lipitor made by Pfizer does not prevent obstruction of the heart valve that leads to the aorta, the body's largest artery, according to recent findings published in the New England Journal of Medicine.

In a study conducted to determine whether the drug, also known under its generic name atorvastatin, did more than just reduce cholesterol, doctors found that Lipitor failed to prevent obstructions that can keep the heart from pumping blood adequately.

The condition, known as calcified aortic stenosis, occurs when a key heart valve narrows or becomes blocked, preventing the heart from pumping blood properly and can manifest itself in spite of reductions of cholesterol levels, according to the study.

Surgery is usually required to fix it.

Aortic stenosis affects 3 percent of adults over 75, making it the most common valve defect in North America and Europe and occurs gradually over several decades. By the time symptoms appear, surgery is typically needed to repair or replace the valve.

As part of the study, 155 volunteers with signs of calcified aortic stenosis were given a placebo or Lipitor, which like other drugs known as statins slow the narrowing of small heart arteries caused by heart disease.

After a little more than two years, the team led by Joanna Cowell of Royal Infirmary in Edinburgh found that the drug brought cholesterol levels down as expected but produced no real improvement as far as obstructions are concerned.

"Aortic stenosis progresses despite intensive reductions in serum cholesterol concentrations," the Cowell team concluded.

The study was funded in part by an educational award from Pfizer, a grant from the British Heart Foundation and the Welcome Trust Clinical Resource Facility in Scotland.

In an editorial in the New England Journal of Medicine, Raphael Rosenhek of the Vienna General Hospital in Austria agreed, saying that prescribing statins "is not justified" unless a patient has another, more established, reason for taking the medicine.

 

[tobagotwo]

Nice find, CGV! I'll bet Pfizer and GlaxoSmithKlineWellcome wish they hadn't funded that study...

I have mailed it to my cardiologist, who was already trying to convince me that statins will make my valve last longer. He wasn't getting anywhere anyway, as you could guess from my previous post.

I feel the odds are very high that the other statins will fall to reality on this claim one by one, assuming they are eventually studied.

Chances are good that there is another reason for the colon cancer findings, too. A random possibility: probably most people taking statins under a doctor's care have been advised to also take aspirin for stroke prevention (i.e. most people over 50). Antiinflammatories (such as aspirin) are known to reduce immune responses, which have often been considered a factor in cancers. Bet there was no cross-check or double-blind for aspirin or other actors in that original study either.

Best wishes,

 

[Karen]

and the debate goes on...

and the debate goes on...

I started a thread a few weeks ago concerning this subject, since my cardiologist started me on statins 15 months ago, and I wanted more information about the current thinking on this "new protocol." As it turns out, I quit taking Lipitor a week ago, with the encouragement of my PCP. The only reason I was prescribed the statins was on the hope that it would delay the need for valve replacement surgery. But about the time I was diagnosed with the bicuspid valve problem etc., I was diagnosed with costochondrtis. The past year or so I have taken vioxx and then Voltaren for the arthritis issues. When I developed an ulcer a month ago, I had to stop taking Voltaren (or anything else until the ulcer heals). The arthritis in my neck, wrists and hands were pretty awful. Reading posts here and in other places, I felt I had to test whether the Lipitor was contributing to the joint and muscle pains I had. I still have some muscle soreness in my arm, but I have to say that even in just one week, the difference in the pain I have had in my neck and wrists and fingers is pretty remarkable.

I guess my warning would be that the symptoms can actually be less severe than I expected them to be. And it is NOT necessarily evident in the liver function tests that the muscles are being affected. The way it was explained to me by my pharmacist, I felt that I was okay as long as the liver function tests remained normal. In visiting with the folks at Lipitor, if I remember correctly, there actually is another blood test that is a better indicator of muscle break-down.

I admit it's been a relief to know that the "arthritis" IS managable without heavy duty drugs in an of itself... And I guess I'm persuaded that the statins carry too much risk for the questionable benefits offered for those of us who do not have high cholesterol issues.

Thanks for the continuing dialog... I continue to learn much from this forum.

Karen

 

[Phyllis]

Thanks for the post, CGV. It makes us feel a lot better that Dick stopped taking the statin on his own accord. His cholesterol levels are normal and we just didn't buy the fact that the statin might reduce the risk of recalcification of the new valve.

 

[Phyllis]

Karen the blood test to see if there is muscle break-down while on a statin is Hs-CRP, a C-Reactive Protein test. I've never had one, but I could not tolerate higher doses of Pravachol and switched to a lower dose which I tolerate better, but think I may ask my doctor for this test in my next blood work.

 

[hensylee]

Ann, I am not familier with Precor but would like to know more about it.
We are fortunate (so far) with having pretty good prescription coverage.
We mail order for a ninety day supply at a time.
That usually runs about $30.
If General Motors goes belly up than we may have a problem.
But no we don't get that letter about Zetia.

Rich, my glasses weren't working that day - I read Precor and you said TRIcor. By its name, I expect it's for triglycerides. Sorry I misread.

I had a lipids check a week ago and called hospital today for results to be sent to me and the WON'T unless I go in and sign something! I forgot to do that when I was there with the vampires. This will tell me how well Zetia is doing.

 

[Rich]

Ann,
Now I understand, you had me stumped with that one.
I hope you have some luck with the Zetia.
My wife so far has had only marginal results, better than nothing I guess.

One other thing I like people to understand about statin drugs.
As mentioned they can cause a lot of muscle problems for some people.
Well please remember the heart is a MUSCLE!!

Rich

 

[hensylee]

Rich:

It's been about 2 years since I quit Lipitor and feel it's the best decision I ever made. Such pain and I was fading away just like your wife. I believe you are the one who alerted me to rhabdomyalysis (sp?) so I looked it up at that time. The things I read were so scary and were the final straw that urged me to quit. I feel that eventually the statins will come under much closer scrutiny because of the muscle questions. Tho now they are touting them for cancer prevention, but the jury is still out on that one.

I know Zetia isn't much good, but like you say, at least it's something. I am still trying to get my results of last week's test.

 

[Karen]

blood test

blood test

Karen the blood test to see if there is muscle break-down while on a statin is Hs-CRP, a C-Reactive Protein test. I've never had one, but I could not tolerate higher doses of Pravachol and switched to a lower dose which I tolerate better, but think I may ask my doctor for this test in my next blood work.

Phyllis, maybe there is more than one test for this kind of thing, but the nurse at Lipitor told me that it was the CPK test. I didn't have the test done, nor will I, because I've already stopped taking Lipitor and there's no question in my mind that my "arthritis" is much improved.

The difficult thing with all drugs is to KNOW what symptoms are caused by them, or if the symptoms are independent of the drug. There was no question that my constochondritis responded to the Vioxx and Voltaren when I could take them. But this past week was the second time in the past 4 months that I had not taken the pain medications (I had minor surgery in January for which I stopped taking Voltaren for a time as well). It made no sense to me that the arthrtis would worsen so much in so short a time, but still attributed the pain to arthritis. If it hadn't been for the muscle soreness that developed in my left arm, I'd probably still be assuming that it was only arthritis.

Good luck on your Pravachol....

Karen

 

[Phyllis]

Thanks, Karen. I am definitely going to ask for the test. It is so difficult to tell which aches and pains can be attributed to the statin or just arthritis. My knees always bother me and this winter, I developed muscle pain in my right arm which I attributed to the tight space in which I used the computer in FL, but it has only slightly improved since we came home. I think it's time to make sure it's not the Pravachol.