Statins for over 50's

[jeral Profile]

In the news today it is suggested that people over 50 could be at risk and some would be eligible for/benefit from them as a preventative measure. Here's a Daily Mail link (first one that popped up on Google): http://www.dailymail.co.uk/health/artic ... ds-newsxml

Sounds like a terrible idea to me although I personally don't believe we should put any pills into our mouths (especially ones with side effects) without necessity. But what they (the other side of the coin) is saying is that it's not good to shut the barn door after the horse has bolted.

I suspect personal hereditary history bears a big part in the decision-making process of both doctors and patients. That aside, the cost of "pills for everyone" must surely take funds away from critical need medicines but needless to say costings come under NICE, although this quote: "However, a commentary in the Lancet says most over-50s are likely to be at higher risk of cardiovascular disease, and so it would be ‘pragmatic’ to use age to prescribe statins instead of costly medical tests." unquote, surely is tantamount to a future GP saying "Take a few of these and come back in a month or two, or don't", possibly our worst fear of GPs.

What do you think?

[Tatihou Profile]

The thought of mass issuing of drugs that have a significant effect on the body is pretty horrifying, I think. But it's not going to happen anyway because it would have to be monitored by GPs or at least by blood tests, presumably at least twice a year and I doubt that surgeries could cope.

Additionally, I thought statins were (at least potentially) the cause of some fairly serious reactions (negative ones!) in a significant minority of people who are prescribed them?

ETA after a quick Google...
http://www.livestrong.com/article/141760-contraindications-statins/

[Suelle Profile Website]

The cost to the NHS of generic statins for all over 50s, plus the necessary monitoring for side effects, is far less than the cost of treating the heart attacks, strokes and other circulatory problems that they hope to avoid.

Emergency admittance to hospital, then in-patient hospital care, plus the subsequent cost of rehabilitation, time off work sick etc, if the patient doesn't die, adds up to far more in real terms.

But even when all that is taken into consideration, I'm not in favour of blanket drug prescriptions for everyone. Far better to routinely test an individual's risk factors at 50 and prescribe if necessary.

[hungryhousewife Profile]

I seem to remember everyone being told that statins were going to be prescribed to everyone - when Gordon Brown was PM. I know I am cynical, but I was sure it was because he had struck a deal with the American drugs company that makes them - it was at about this time that my mum was put on them, and she had a severe liver reaction to them.

HH

[Nigeepoo Profile Website]

The cost to the NHS of generic statins for all over 50s, plus the necessary monitoring for side effects, is far less than the cost of treating the heart attacks, strokes and other circulatory problems that they hope to avoid.

Emergency admittance to hospital, then in-patient hospital care, plus the subsequent cost of rehabilitation, time off work sick etc, if the patient doesn't die, adds up to far more in real terms...

Your evidence to support these statements is...?

Here's a rather different view:- Statins for healthy people? Hang on a minute…

[karadekoolaid Profile]

I haven't got a clue what "statins" are.
Am I going to die?

[Global_Worming Profile]

Here you go triple K

[jeral Profile]

@ karadekoolaid, of course you're not going to die; you'll be immortal like the rest of us, well unless you either do or don't take statins that might be prescribed for you.

@ Nigeepoo, thanks for the article. I guess it won't receive the same prominence in newspaper headlines. Then again, headlines disappear in a puff of smoke in 24 hours - it remains to be seen whether the ashes will continue to smoulder.

[Suelle Profile Website]

Your evidence to support these statements is...?

Oh - what the BBC and Guardian tells me, of course!

[hungryhousewife Profile]

Hmmmm - Gordon Brown, The Guardian and the BBC - all singing the same tune! Interesting!!
HH

[Mrs Vee Profile]

The concept of mass-medicating people horrifies me; it sounds like something from “Brave New World”. The ‘benefit versus hazards’ figures outlined in The Lancet just don’t seem good enough to me to justify mass-medication.

These tablets already seem to be given out like Smarties with no regard to the genuine need for them. I have several friends who have been prescribed statins and who have had to give up taking them because they just couldn’t handle the horrendous side effects.

I have high blood pressure controlled by medication; both my parents had heart disease. When statins were casually mentioned by my GP as something I might like to consider, I told him in no uncertain terms that he can prescribe them if he likes but I will NOT be taking them so he may as well not bother.

Given that I won’t live forever and I’ll have to die from something, I’ll just carry on as I am and take my chances.

[Stokey Sue Profile]

i am not 100% convinced that mass-medicating everyone over 50 is the way forward

The idea is that statins are lower the amount of cholesterol in the blood, and so stop plaque formation in the blood vessels

Plaque is what bungs up your arteries and increases your risk of stroke or heart attacks

The idea of prescribing for all over 50s is that everyone (even people with normal to low cholesterol) has some arterial damage as they get older, and giving statins would stop it getting worse, and when it gets worse is when you have the problems.

The idea comes from an article in the Lancet, based on good research, but it hasn't been reviewed yet by NICE the body that makes recommendations on prescribing in the UK; they would have to strongly recommend mass prescribing for it to happen, and they look at both the directly medical issues and the "pharmacoeconomic" effects - the sort of cost/benefit analysis that Suelle mentioned. The senior cardiologist I heard on Today wasn't keen, which is interesting,

BBC News report for those who haven't read it

http://www.bbc.co.uk/news/health-18091708

[karadekoolaid Profile]

most over-50s are likely to be at higher risk of cardiovascular disease,

That's a pretty bland generalisation, especially from the Lancet
It's like saying " You'll probably get samonella, e-coli or botulism if you eat street food"

Plus, of course, you could end up with muscle weakness, diabetes, kidney disease, headaches and depression

I think I'll stick to beer and ciggies

[Stokey Sue Profile]

most over-50s are likely to be at higher risk of cardiovascular disease,

That's a pretty bland generalisation, especially from the Lancet
It's like saying " You'll probably get samonella, e-coli or botulism if you eat street food"

Well, no, it sn't. the risk analysis is quite different, everyone wears out their arteries, and usually if you put an older person's artery and a younger person's artery under the microscope it is easy to tell which is which, though you can't tell the age accurately. as we wear them out at different rates

The distribution is like tha tfor grey hair (I am not saying they are linked, just that the pattern is similar, and as you can see grey hair it may be a good analogy)

Some people (not many) go completely grey before they are 30 (and some people clog up their arteries by then too)
Some people die at a an advanced age, with almost no grey hair (though none at all would be very rare) - and some people at an advanced age have very little arteriosclerosis - but at least some is usual

Most of us are in the middle for both hair & arteries

[hungryhousewife Profile]

Good analogy Stokers! I was hoping you would get in on this one!
What do you make of my conspiracy theory then?
HH

[Joanbunting Profile]

Thank heavens our new GP is just as keen on alternative medicines as conventional drugs. She was however really quick off the mark with a friend's cancer. Having reviewed all the indicators she has pronounced that, while perhaps a little more exercise might be a good thing, she will not prescribe anything other than the natural remedies/precautions we have taken long before we met her and the odd pain-killer for the arthritis she said I had under great control (rosehip if anyone is interested) At last a French doctor does not send you off with prescriptions for carrier bag loads of medicines. She is not trusted by the local oldies

On the other hand our friends who use another doctor have a list of pills to take every day that make the mind boggle; statins, blood pressure, anti this and anti that but no help on life-style or diet which would possibly do the job.

I too am really concerned about what amounts to mass medication - M's mum came a huge cropper with statins.

[Nigeepoo Profile Website]

Plaque formation in arteries is multi-factorial. See Cholesterol And Coronary Heart Disease.

So yes, statins somewhat reduce plaque formation. Whether this is due to a reduction in serum cholesterol is debatable, as other drugs that reduce serum cholesterol (e.g. Lapaquistat, Ezetimibe, Torcetrapib etc) have zero effect on CHD risk (some actually worsen CHD risk!). It's probably due to anti-inflammatory effects, from inhibition of the non-sterol synthesis pathway. Unfortunately, inhibition of the non-sterol synthesis pathway also reduces Co-enzyme Q10 levels, resulting in muscle pains & an increased risk factor for congestive heart failure. Oops!

Vitamin D3 5,000iu/day & fish oils have anti-inflammatory effects, without messing up any pathways. Vitamin K2 has an anti-calcification effect, which reduces CHD risk. That's what I take.

[Renée Profile]

I take 5,000 iu of vitamin D3 every day. I bought them whilst in Florida. I didn't know about vitamin K2. Isn't vitamin K in green vegetables, Nigel?

[Nigeepoo Profile Website]

I take 5,000 iu of vitamin D3 every day. I bought them whilst in Florida.

Excellent! You can get them on-line from VitaCost.com. 365 mini-gelcaps cost about £7.50 if you order 2 pots at a time.

I didn't know about vitamin K2. Isn't vitamin K in green vegetables, Nigel?

Green vegetables contain K1. K1 doesn't reverse arterial calcification or reduce CHD risk. See Vitamin K

[Sakkarin Profile]

I shall have to investigate this subject further, as I am well into my 50s and have absolutely no idea what a "statin" is. Or a "free radical" for that matter, another lurgey which gets mentioned regularly.

The concept of mass-medicating people horrifies me

It's been going on as long as I can remember, in the form of fluoridation of water, which I've never really questioned, however this article reckons it is extremely dangerous.