Taking Lipitor medication

[kazy180]

I have been precribed Lipitor to take for lowering choloresteral and after reading all the side effects it scares me very much.  I have a low fat diet and also enjoying drinking my red wine and hate the idea this medicine can effect my liver.  Is there any other way apart from strong medicine like this I can take.  My levels are not that high my Doc said if I start taking it now it will help reduce my chances of heart disease in 20-30 years.

[erijon]

It would help if we knew your actual numbers. Let us know and we'll try to help you as much depends on your current levels.

Jon
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[ed34]

20-30 years? I think he means it will start to reduce your risk in a few days. You don't have to be 70-80 years old to get heart problems. I had three bouts of MI at the age of 47.
Everytime my prescription is renewed, I read the leaflet with possible side effects which is a mistake because there are so many. However, when they run trials, you will be surprised how many people state new symptoms even when taking the placebo. If the leaflet stated "no side effects", I'm sure not many would get side effects.
There are some statins which seem to have more side effects listed than others, so if you feel one is giving you problems, you can be changed to a different brand.
Keeping cholesterol down to a minimum without medication is VERY hard and personally I think it wrecks your life. One of the enjoyments of life is eating, and to be restricted to rabbit food is taking away a lot of quality as far as I'm concerned. There is also the problem where in some people the Liver just loves producing cholesterol, whether you consume any saturated fats or not. The Liver can make fats from other substances you eat, it really is a highly developed chemist.

[kazy180]

Thank you for your answers and I understand all the comments on side effects and changing diet etc which I already have done.  My levels last year was 224 and my doctor said moderate with diet and I have brought them down to 205 this year which is minimum.

Kaz

[kenkeith]

My cholesterol was 180 and I was given medication to reduce further.  The next dr visit the chol is114, other lipid levels trig, HDL and LDL are all favorable as well.  I am beginning to wonder if the risk is greater than the believed benefits from the medication, and if I can improve with a better heart healthy diet...it has never been tried nor did the doctor suggest?!

I had always thought under 200 was properly effective, but there has been a push for further reduction below 200 as more favorable....I don't know if that originates from the drug companies or the medical community, but I am beginning to look skeptically at the matter...risk v. benefit.

[ed34]

I too have been more skeptical lately. When you take it every single cell in the body requries cholesterol to repair or copy itself, that must be quite an amount. There is also the brain which requires fat to ensure new connections (millions of new ones every day) are kept intact. It's no wonder people get memory problems when their cholesterol is too low and to me this shows there is a minimum that the body can reach before side effects show.
Cardiac rehab in the UK used to educate patients to get LDL to 114 or lower. Now it has been raised to 155 being sufficient.

[heartfluttersflyawayplz]

i take liptor and have had not one problem. its a great med for me.

[kenkeith]

I'm looking back at my 5/28/2004 report (Cardiac Rehab-Intilal Evaluation) and it states chol 132 (correction it wasn't 180), HDL 49, LDL 71.

With medication, chol 114, HDL 58, LDL 45.  

With all the possibilities of adverse side effects, known by symptoms or unknown without symptoms is not inviting.  For me, I don't think the benefit (if any) is greater than the possible risk.  

[oldie]

but Lipitor, so several sources say, is not only to bring down LDL but steadies heart rythm

and then..".Reducing concentrations of LDL cholesterol with statin therapy has resulted in reductions of 23% in cardiovascular risk for every 1•03 mmol/L (40 mg/dL) decrease in LDL cholesterol.1However, despite a reduction in LDL cholesterol with high-dose statins to 1•6 mmol/L in patients with stable coronary heart disease, and to 2•0 mmol/L in those with acute coronary syndrome, the risk of cardiovascular disease remains substantial at 8•7% after 4•9 years of follow-up,2 and 22•4% after 24 months' follow-up,3 respectively".  I regret Ididn't note the source for this

[erijon]

I base my decision on the results of the many, many studies that show a direct relationship between lower serum LDL and the Absolute Risk Reduction for cardiac event. Some of the proven results;

Reducing the risk of coronary events: evidence from the Scandinavian Simvastatin Survival Study (4S). 5

Patients with pre-existing CAD had a reduced risk of any coronary event of 27% on Zocor compared with placebo. Looking at actual LDL-C levels achieved, the 4 year event rate was:

1.10.8% with LDL-C level of 58 to 104 mg/dl
2.13.3% with LDL-C level of 105 to 126 mg/dl
3.18.9% with LDL-C level of 127 to 266 mg/dl.
This analysis shows a near linear relationship between LDL-C achieved and the rate of coronary events.

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The Anglo-Scandinavian Cardiac Outcomes Trial lipid-lowering arm: significant lipid and coronary heart disease effects. 3

Of the 19342 patients randomized to one of the two antihypertensive regimens 10305 were further randomly assigned atorvastatin 10 mg daily or placebo to form the lipid lowering arm of the study. Mean age of participants was 63 years and baseline blood pressure and lipid subtraction values were identical in the 2 groups. The study was stopped prematurely after median 3.3 years of follow up. Compared with placebo there was a 35% relative reduction of LDL-C in the atorvastatin group. The primary end point of the study (non fatal MI and a fatal Coronary Heart disease ) was significantly lower by 36 % in the statin group than in the placebo group.

There were also significant reductions in secondary endpoints such as total coronary events by 29% and especially fatal and non-fatal strokes by 27%. Previous randomized trials of statin use for lowering cholesterol have shown, on average, significant reduction in strokes in both primary and secondary prevention of about 15 to 30%. Hence the 27% reduction in stroke incidence is in keeping with the prior observations.

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Bottom line, there is a proven reduction in the risk of cardiac events with lower levels of serum LDL. In addition, statins have been proven to reduce levels of LDL by up to 42%, that's a huge number. Also keep in mind that the incidence of side effects are almost identical in the statin control group compared to the control group being given a placebo as part of Jupiter.

Again, life style changes should always be the first option, but in cases that have resistance to LDL reduction or a higher risk of CAD, statins make sense. There is currently a movement in the medical community to give high dose statins prior to heart surgery and stenting as well as most other major surgeries due to the anti-inflammatory properties of statins. Also, take some time to read the results of the PROVE-IT study, which proves there is a 16% decrease in the risk of cardiac events in individuals with acute coronary syndrome with high dose statin use.

Much to consider for sure.

[ed34]

I still can't understand how such trials can make those claims. Unless you are a seer and can see the future, how can you possibly predict such outcomes accurately?
For example, Mr X has severe atherosclerosis. He is told he is high risk of heart attacks and stroke. He is put onto statins and told he is now 16% less likely to have any of those things. How can you possibly know this? his disease will not go away with statins, so surely the risk is exactly the same? Who can accurately predict if he will have a heart attack without statins? If you take a lot of inaccurate figures, you can make statistics looks very attractive.
There could also be lots of other factors involved. Maybe a larger percentage of patients in the placebo groups are suffering from higher stress levels. This makes me more skeptical because you can ensure this before grouping people, giving the results you desire. To be absolutely honest, if a drug company offered me a few million dollars to run an independant trial, and asked me to ensure higher stressed people were in the placebo group, I would oblige.
I think the old fashion method of wait and see will produce some interesting results. Already numbers of Doctors complaining of patients with muscular and mental issues are rising. Now the links are being made, hopefully the truth, one way or another, will be revealed.

[erijon]

You really need to read the entire PROVE-IT study results. While it is true that no one can look into the future, the fact remains that during the study period the research team was able to show a 16% reduction in cardiac events with aggressive cholesterol reduction. Don't forget about Framingham as well, that study has been tracking individual results from 1948 and they clearly show a link between lower cholesterol and a reduction in the risk of cardiac events.

Also, these studies are not designed to determine if an individual will suffer a heart attack or not while on a statin. They are designed to determine if there is a link between statin use and lower levels of serum cholesterol. You must then look at studies that show a link between high levels of cholesterol and an increased risk of cardiac events. Too often the two are confused.

The concerns over statin side effects are not new, these issues have been bounced around the Internet since it was created. The bottom line is that the risk of side effects from statin use is 1 in 2,200 and less than .01% for serious side effects which is well below the risk of having an allergic reaction to penicillin.

I do agree, more time will tell the story, but I will stick with the less is better thinking until some one proves it wrong.

just my two cents................

[kenkeith]

Absolute risk is somewhat misleading when evaluating the effectiveness of a drug.  Relative risk is more appropriate.  Relative risk for statin medication or any drug for that matter, is aptly considered when compared to the alternative (placebo).  As an example for analysis a CAD group is given a placebo and the associated death rate is 4%, and the other CAD group is given medication (statin) and the death rate is 3%.  The relative risk is 1% , and that means there are 99 of every 100 who have no benefit but have a possibility fo a deleterious medical problem later.

All medication inhibits or retards the body chemistry,  and who really knows the outcome later and there is no way to assess and a gamble...Is better to be in the 99% group or the possibility to be the sole beneficiary of the medication?!

[ed34]

I totally agree with what kenkeith is saying but there are also some exceptions such as myself to consider. I have familial hypercholesterolemia. Without statins, nothing would help, not any kind of diet. Whether I eat any fats or not, my Liver will mass produce cholesterol. In cases like mine I don't think there is any choice. HOWEVER, I know if my cholesterol was just slightly high, or normal, or lower, I would not take the medication.
It's a bit like giving a child with healthy eyesight spectacles, in case their eyesight should get worse. If you don't need something, why have it.

[erijon]

I understand your point, but I prefer to look at endpoint results. In the case of the Jupiter study,  17,802 participants were randomized to receive either 20 mg rosuvastatin daily or placebo, for a planned duration of 5 years. The study’s primary endpoint was the occurrence of a first major cardiovascular event, including myocardial infarction, stroke, hospitalization for unstable angina or arterial revascularization, or death from a cardiovascular cause.

The primary endpoint was 44% less likely in the rosuvastatin group than in the placebo group, although the rates of events were low in both groups. Reduced risks of similar magnitude were present for each condition comprising the primary endpoint. There was also a modest reduction in all-cause mortality in the rosuvastatin group. At 12 months, the median hs-CRP level was 37% lower in the rosuvastatin group compared to placebo, from a baseline level of 2.2 mg/l, and median LDL cholesterol was 50% lower in the rosuvastatin group compared to placebo, from a baseline level of 186 mg/dl.

I do agree, lifestyle changes should always be the first line of defense for high cholesterol. However, in cases where that doesn't work, statins make sense. In my case, I started daily exercise and dietary changes in 2006 and have been fortunate to loose 70 pounds and even get off my BP meds. Unfortunately, it had little to no impact on my cholesterol levels. For me a statin is necessary to maintain what I feel is a healthy level of serum cholesterol. I do not agree in giving statins to individuals that have a low risk of heart disease and cholesterol levels below the current recommended guidelines but do feel it is a good idea if there is a high risk of future cardiac events, even in the case where cholesterol levels are normal.

Again, just my thoughts, there are several opinions out there and everyone needs to make their own educated decision.

Jon