High Cholesterol - Statin Drugs

JPKII

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I've battled high cholesterol for as long as I can remember (I'm 50 yo). My doc has always tried prescribing a statin drug to help manage the number (I've resisted). If it matters, I am 281 mg/dL, triglycerides 162, HDL 53, LDL 192, non HDL cholesterol 228. Average weight (207 lbs, 5' 10") with no history of diabetes. When I'm religious with exercise and diet, the lowest I recall my cholesterol is 217. My family (Dad's side) has extensive history with heart disease.

This morning I had a CT heart scan done to measure calcium build-up in my arteries. From the test results (lower numbers == no build-up):

Your Coronary Artery Calcium Score is: 2

Left main 2
Left anterior descending 0
Left ci rcumflex 0
Right coronary 0
Posterior descending 0
Total Score: 0

Percentile Score: 50th That means 50 percent of the males at the ages from 46 to 50 will have a
higher calcium score than you .

Diagnosis :Minimal identifiable calcified plaque burden

Impression: Probability of significant coronary artery disease is very unlikely less than 10%.
Implications for cardiovascular risk are low


So, I've resisted the Statins because I feel like my cholesterol number is specific to me. Meaning, just because, statistically, my number is "high", it doesn't mean the my individual risk of plaque build-up is any more significant as my body likes to "run" at 281. I feel like this CT scan further confirms that line of thinking. Just because someone tests "high" does not mean they are likely to have more plaque build-up in their arteries. Correlations does not imply causation. It's a good indicator but other tests should be performed to further understand the extent of the potential.

So, my question: Am I nuts? Do I continue resisting Statins? Keep working on my fitness and avoid taking these things? Is my theory of an individual's ability to process cholesterol (and implied plaque build-up) solid? Or am I nuts?

Lastly, yes, I hate prescriptions. I take nothing now. Aside from daily vitamins and supplements.
 

03Sssnake

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I made a post on this late last year.. in the same boat with you bud. In my forties and have had high cholesterol since I was a kid. I am in great shape and still wear 32” jeans.

Post from vaccine thread..
IMG_7918.jpeg

 

JimCSHO

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I've always had fairly low cholesterol even with a family history of high (both Mom and Dad). But this past year in my late 60's suddenly I had a spike. Heart is fine, no blockages, probably similar to you.

Doctor prescribed atorvastin and within a month or 2 my cholesterol is way down.

The thing that I miss though is grapefruit. Can't have it with atorvastin. I don't know if that is common across all statins.
 

IA Shelby

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My opinion: I used to be a regional manager for Merck. Zocor and Mevacor. The 4S trial is the gold standard that supports use of a statin. The evidence does suggest use of a statin is beneficial from reduction of heart attack, stroke and death in general.

The issue with the interaction with grapefruit is related to how the drugs are metabolized (CY P450 pathway as I recall). It uses the same pathway as grapefruit. Essentially, the fight for space on the freeway and as a result statin levels can be backed up and cause issues.

A cardiologist who I worked with closely used to say that he has never seen a guy with an HDL over 50 have a heart attack. Personally I Believe that is the most important marker (more than TC or LDL) to pay attention.

I am not a doctor and it has been 20 yrs since I have worked for the pharma companies so don’t take my comments as medical advice.

Personally I take a medium dose statin and my levels are very low. I also have had the calcium scoring done and had no issues.

If you do decide to take a statin, they are more effective if taken before bedtime.
 

JPKII

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My opinion: I used to be a regional manager for Merck. Zocor and Mevacor. The 4S trial is the gold standard that supports use of a statin. The evidence does suggest use of a statin is beneficial from reduction of heart attack, stroke and death in general.

The issue with the interaction with grapefruit is related to how the drugs are metabolized (CY P450 pathway as I recall). It uses the same pathway as grapefruit. Essentially, the fight for space on the freeway and as a result statin levels can be backed up and cause issues.

A cardiologist who I worked with closely used to say that he has never seen a guy with an HDL over 50 have a heart attack. Personally I Believe that is the most important marker (more than TC or LDL) to pay attention.

I am not a doctor and it has been 20 yrs since I have worked for the pharma companies so don’t take my comments as medical advice.

Personally I take a medium dose statin and my levels are very low. I also have had the calcium scoring done and had no issues.

If you do decide to take a statin, they are more effective if taken before bedtime.

So is it plausible to get an HDL under 50??? Doc prescribed a 20 mg dose of Simvastatin. Obviously everyone is different but is it reasonable to think that someone with a hereditary predisposition for high cholesterol will be able to take (any amount) of a statin and reduce their levels by, in my case, 80+%??

I'm not against this at all. I just want to be sure I understand all my options before I commit. One way or the other. I'm a stubborn jackass and want to make sure I'm not substituting one evil for another. Where neither are having, at this point, a measurable or quantifiable impact on my longevity. In either case we won't know until I take a dirt nap. In that scenario y'all can send a card to my funeral that says "you shoulda took the statin".

Follow-on question: Is the only side effect (that we are concerned about) of high cholesterol plaque build-up in our veins? Or does high cholesterol also impact other areas of our body?
 

JPKII

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I've always had fairly low cholesterol even with a family history of high (both Mom and Dad). But this past year in my late 60's suddenly I had a spike. Heart is fine, no blockages, probably similar to you.

Doctor prescribed atorvastin and within a month or 2 my cholesterol is way down.

The thing that I miss though is grapefruit. Can't have it with atorvastin. I don't know if that is common across all statins.
Not a problem. I think grapefruit is the devil reincarnate. lol. Not a fan.
 

Weather Man

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Big meta study released a year or so ago. It asked the question: do statins actually reduce death, heart attack and stroke. The answer was no.

I was on statins and researched and researched and was thinking of stopping them. When I started having horrible leg cramps at night, it was an easy decision to stop taking them. My personnel opinion after spending years looking at this is that Big Pharma doesn't have MY best interests in mind.

Since I won't let them put me back on a cholesterol medication, I'm tagged.

1705696659701.png
 

CobraBob

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I had high cholesterol back in my 30s and 40s. I was active with a not-so-great diet. At 50, I had a heart attack. Plaque buildup in three arteries. I had stents put in three arteries. Since then, I've been on a statin (Pravacol and Zetia). Over the past 20+ years I've been on the statin prescription with no issues. Cholesterol is now lower than normal. I've had stress tests with stress echocardiogram. The 5 that I've had (most recently October of 2023) have showed no issues. If I had not taken a statin, I probably would have had a second and more serious heart attack. That said, I would find it hard to stay on a low fat, low cholesterol diet. I do, though, stay active with weekly gym visits.
 

JPKII

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This certainly seems like a topic that has many sides and perspectives.

Where I am at, if my decade or more of high cholesterol showed up as moderate or worse plaque build-up, I'd be inclined to take the drug and manage the side effects of that drug.

But it doesn't add up. According to that CT scan I have almost no plaque build and less than a 10% chance of long term effects. I can't wrap my head around the justification to take statins. Had my results been different, I'd be all over it.

I think each person processes this differently. I feel like a blood test to determine cholesterol levels shouldn't be the only criteria to justify putting someone on a drug.

I also believe pharma does not have our best interest in mind. Our health (or lack of) is a direct revenue stream. Folks are incentivised to sell more drugs and perform more procedures.
 

Weather Man

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This certainly seems like a topic that has many sides and perspectives.

Where I am at, if my decade or more of high cholesterol showed up as moderate or worse plaque build-up, I'd be inclined to take the drug and manage the side effects of that drug.

But it doesn't add up. According to that CT scan I have almost no plaque build and less than a 10% chance of long term effects. I can't wrap my head around the justification to take statins. Had my results been different, I'd be all over it.

I think each person processes this differently. I feel like a blood test to determine cholesterol levels shouldn't be the only criteria to justify putting someone on a drug.

I also believe pharma does not have our best interest in mind. Our health (or lack of) is a direct revenue stream. Folks are incentivised to sell more drugs and perform more procedures.

Basically, what they are treating, isn't what is killing people, but they make a **** ton of money off it.
 

03Sssnake

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If you do take one, ask your doc for Rosuvastatin, its one of the better tolerated statins and its hydrophilic. Rosuvastatin has better/safer side effect profile.

hydrophilic/water-soluble statins (i.e., rosuvastatin and pravastatin) are less likely to cause muscular side effects than lipophilic/fat-soluble statins(e.g., simvastatin or atorvastatin) due to lower passive diffusion into muscle cells.
 

JPKII

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If you do take one, ask your doc for Rosuvastatin, its one of the better tolerated statins and its hydrophilic. Rosuvastatin has better/safer side effect profile.

hydrophilic/water-soluble statins (i.e., rosuvastatin and pravastatin) are less likely to cause muscular side effects than lipophilic/fat-soluble statins(e.g., simvastatin or atorvastatin) due to lower passive diffusion into muscle cells.

Pro-tip. Thank you. Will do.
 

IA Shelby

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Big meta study released a year or so ago. It asked the question: do statins actually reduce death, heart attack and stroke. The answer was no.

I was on statins and researched and researched and was thinking of stopping them. When I started having horrible leg cramps at night, it was an easy decision to stop taking them. My personnel opinion after spending years looking at this is that Big Pharma doesn't have MY best interests in mind.

Since I won't let them put me back on a cholesterol medication, I'm tagged.

View attachment 1825506
A meta study and randomized prospective placebo controlled study are two radically different things….
 

IA Shelby

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So is it plausible to get an HDL under 50??? Doc prescribed a 20 mg dose of Simvastatin. Obviously everyone is different but is it reasonable to think that someone with a hereditary predisposition for high cholesterol will be able to take (any amount) of a statin and reduce their levels by, in my case, 80+%??

I'm not against this at all. I just want to be sure I understand all my options before I commit. One way or the other. I'm a stubborn jackass and want to make sure I'm not substituting one evil for another. Where neither are having, at this point, a measurable or quantifiable impact on my longevity. In either case we won't know until I take a dirt nap. In that scenario y'all can send a card to my funeral that says "you shoulda took the statin".

Follow-on question: Is the only side effect (that we are concerned about) of high cholesterol plaque build-up in our veins? Or does high cholesterol also impact other areas of our body?
You want your HDL to be over 50. Higher is better.
 

snakecharmer

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Statin drugs are pure evil. I could talk for hrs about the side effects I had on them, and the more I read about them I will NEVER take one again. There is a data as well to suggest they may help promote Type 2 diabetes in some. I'm one of them. One that my dr put me on absolutely annihilated my short term memory while I was taking it.

Ask about getting on a PCSK9 inhibitor. I was in the clinical trial for Praluent, and still take it. ZERO side effects and my numbers are way better than they ever were with the statin shit. I've seen one study that suggests that PCSK9 inhibitors may actually help remove atherosclerotic plaques. Big bonus for me is that it is a shot. I take it once a month. Downside of the drug is the cost and getting insurance to pay for it. I'll pay out of pocket if it ever comes to it before I pop another ****ing statin drug.
 

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