Why do doctors push statins?
Because many factors are involved, your cholesterol numbers may be considered normal and yet you may still be found to be at an elevated risk for heart problems. As a result, statin medications are now used to lower the risk of heart disease and heart events in most anyone found to be at high risk.
The new QOF incentives will be offered to GP surgeries for: Prescribing statins to patients with type 1 diabetes that are over 40 years of age or have had diabetes for over 10 years. The QOF rewards are in line with the controversial NICE guidelines on lipid modification.
There's a new drug called Nexletol, and it's used for people with the highest risk. That's people with genetic or familial high cholesterol or those who have heart disease and further need to lower their cholesterol. It's called bempedoic acid.
As with all drugs, statins may have adverse effects; these include musculoskeletal symptoms, increased risk of diabetes, and higher rates of hemorrhagic stroke.
- Fibrates. Mostly used for lowering triglyceride levels in patients whose levels are very high and could cause pancreatitis. ...
- Plant stanols and sterols. ...
- Cholestyramine and other bile acid-binding resins. ...
- Niacin. ...
- Policosanol. ...
- Red yeast rice extract (RYRE) ...
- Natural products.
And so, in general, although there are some potential side effects long-term for statins, in most cases, if your doctor has identified you as having high cholesterol and needing a statin, the risks greatly outweigh, or sorry, the benefits greatly outweigh the risks.
Researchers found that physicians who didn't receive industry money prescribed brand-name statins at a rate of almost 18 percent. Those who did take money prescribed brand-name drugs at a rate of almost 23 percent.
Fear of side effects and perceived side effects are the most common reasons for declining or discontinuing statin therapy. Willingness to take a statin is high, among both patients who have declined statin therapy and those who have never been offered one.
GP practices in England received an average of £155 per patient this financial year, official data has shown.
Atorvastatin or fluvastatin are usually recommended because there is no need to adjust the dose according to the glomerular filtration rate [28]. In patients without diagnosed atherosclerotic cardiovascular disease, it is indicated a moderate dose of statin, such as atorvastatin 20 mg daily [28].
What is the best cholesterol medicine that is not a statin?
Ezetimibe (Zetia)
It's one of the few non-statin drugs that can lower LDL cholesterol levels even more when added on top of statin. And, it's the only drug that, when combined with a statin, further lowers the risk of cardiovascular disease. It comes in tablet form and needs to be taken only once a day.
There are many non-statin medications your doctor might prescribe: Bile acid-binding resins, like cholestyramine (Locholest, Prevalite, Questran), colesevelam (WelChol), and colestipol (Colestid) stick to cholesterol-rich bile acids in your intestines and lower your LDL levels.
Fortunately, most side effects are mild and disappear promptly when the statin is stopped. In some cases, the problems will resolve simply by reducing the dose or switching to another statin, but care is required. Still, all in all, the statins are the safest and best tolerated of all cholesterol-lowering medications.
Controversy around the use of statins for the primary prevention of cardiovascular disease is once again in the news, with a new analysis suggesting that statin use in low-risk patients "may be an example of low value care (having little benefit and potential to cause harm) in these patients and, in some cases, ...
People who did take statins consumed more calories and fat over time, and gained more weight. The study also showed that statin users had a faster increase in body mass index (BMI) than those who didn't use statins.
If you're taking a statin medication to lower your cholesterol, you will need to keep taking your prescription, or your cholesterol will likely go back up. Stopping your statin can put you at risk of having heart disease and other preventable health problems like stroke and heart attack from high cholesterol.
Regardless of the type, shape or size, all porridge oats are wholegrains and they all contain a soluble fibre called beta-glucan, which can help lower your cholesterol level if you have 3g or more of it daily, as part of a healthy diet. (A 40g serving of porridge oats contains 2g of beta-glucan.)
In the analysis of 135 previous studies, which included nearly 250,000 people combined, researchers found that the drugs simvastatin (Zocor) and pravastatin (Pravachol) had the fewest side effects in this class of medications.
One alarming study of 28,000 patients found that 3 in 10 stopped taking their statins because they presumed the aches and pains they were experiencing were due to the drug. The result: 8.5% suffered a heart attack or stroke within just four years, compared to 7.6% who continued taking the drugs13.
Statins don't just lower cholesterol levels but also reduce the risk of fatty plaques breaking off from walls of your arteries, reducing the risk of heart attack and stroke.
Do statins clear clogged arteries?
A: Yes. There have been several clinical studies — many of them done here at Cleveland Clinic — that show statins can reverse plaque buildup. Two statins in particular, atorvastatin, which is sold under the brand name Lipitor, and rosuvastatin, which is sold under the brand name Crestor, are the strongest statins.
In some rare cases, statins can cause a small increase in high blood sugar in patients that have diabetes or obesity. Additionally, statin labels warn of possible confusion and memory loss while taking the drug, though larger studies have revealed none of these effects caused by statins.
The data the report was based on is something known as QOF (Quality and Outcomes Framework) which was a system set up in 2004 that started paying GPs for checking such biomarkers as blood glucose, triglycerides and cholesterol and then prescribing drugs to bring them down if they were over the official healthy level.
The FDA has approved statins for lowering cholesterol and reducing the risk for heart attack, heart failure and stroke, even in people without a history of heart disease.
If your 10-year risk of having a heart attack or stroke is greater than 10 per cent, you will be asked to consider taking a statin. Most doctors also recommend statins for people who have diabetes. The risks, as with all medicines, include possible side effects.
- Foods high in soluble fiber and plant phytosterols, such as legumes, avocados, broccoli and other fruits and vegetables.
- Whole grains, including oatmeal, quinoa and barley.
Studies show that about 5 percent to 10 percent of people are unable to tolerate statins, largely because of muscle aches and related side effects, including potential muscle damage.
The pattern holds true for 46 of the 50 drugs. On average, across all drugs, providers who received payments specifically tied to a drug prescribed it 58% more than providers who did not receive payments. Other research, including our own, has found a correlation between payments and overall prescribing.
GP funding
The average GP practice receives around £136 per patient per year to provide GP services.
NHS England is responsible for paying GP Practices for their services. GP practices are paid on the basis of the number of patients on their list. This is obtained from the registered patient list held by NHS Digital on behalf of NHS England.
Why should over 70s not take statins?
Compared to younger adults, older adults are more likely to suffer serious side effects from using statins. Statins can cause muscle problems, such as aches, pains, or weakness. Rarely, there can be a severe form of muscle breakdown.
After having their cholesterol tested, seniors should be given a number between 190 and 260. Healthy seniors should keep their total cholesterol below 200 and their LDL cholesterol around 100. If your elderly loved one's LDL cholesterol level is above 160, he or she must start making sweeping lifestyle changes.
According to a research review people who take simvastatin (Zocor) or pravastatin (Pravachol) may experience fewer side effects.
A person is considered at high risk for developing heart disease if their total cholesterol level is higher than 240 mg/dL, LDL levels are higher than 160 mg/dL (190 mg/dL is even higher risk), and if the HDL level is below 40 mg/dL.
The maker of cerivastatin, a popular cholesterol-lowering drug used by about 700,000 Americans, voluntarily pulled the medicine off the market yesterday because of numerous deaths associated with its use.
Serious side effects
you get unexplained muscle pain, tenderness, weakness or cramps – these can be signs of muscle breakdown and kidney damage.
ANSWER: Although a coenzyme Q10 supplement may be helpful for some people who take a statin medication, no research studies have confirmed that it has benefits for everyone who takes statins.
Federal regulators have approved the new drug Leqvio to be used to help lower cholesterol levels in some people. The medication is designed to be taken along with statins and a balanced diet. Leqvio is designed to be taken twice a year, which experts say should help people adhere to a medication schedule.
Atorvastatin (Lipitor) is known as a moderate-to-high-intensity statin, meaning it lowers your cholesterol more so than many other statins. And as with all statins, atorvastatin (Lipitor) can cause rare, but serious side effects, such as liver problems or severe muscle pain.
High cholesterol has no symptoms. A blood test is the only way to detect if you have it.
Can you refuse to take statins?
Before you refuse to take a statin or stop taking a statin, consult your doctor. He or she can explain why you may benefit from the drug or help you find a different statin if you experience side effects. We are constantly evaluating current methods for preventing and treating medical conditions.
Fear of side effects and perceived side effects are the most common reasons for declining or discontinuing statin therapy. Willingness to take a statin is high, among both patients who have declined statin therapy and those who have never been offered one.
While statins have been shown to significantly reduce cholesterol levels, they have also been reported to have negative side effects on skeletal muscle. Most statin-induced myopathy manifests in the leg muscles, which can lead to difficulty walking and exercising.
Grapefruit juice is the only food or drink that has a direct interaction with statins. Statins do not directly interact with any food but people taking statins should moderate their intake of saturated fats to help lower their LDL cholesterol and overall risk of cardiovascular disease.
Providers prescribe statins for people who: Have high cholesterol (LDL above 190 mg/dL) that exercise and diet changes couldn't reduce. Had a stroke, heart attack or peripheral artery disease. Have diabetes and an LDL of at least 70 mg/dL and are 40 to 75 years old.
Why have I been offered statins? Having a high level of LDL cholesterol is potentially dangerous, as it can lead to a hardening and narrowing of the arteries (atherosclerosis) and cardiovascular disease (CVD). CVD is a general term that describes a disease of the heart or blood vessels.
If you forget to take your dose, take it as soon as you remember. If you do not remember until the next day, skip the missed dose and take the next one at the usual time.
Adults age 75 and older may not need statins.
Many older adults have high cholesterol. Their doctors usually prescribe statins to prevent heart disease. But for older people, there is no clear evidence that high cholesterol leads to heart disease or death.
- Reduce saturated fats. Saturated fats, found primarily in red meat and full-fat dairy products, raise your total cholesterol. ...
- Eliminate trans fats. ...
- Eat foods rich in omega-3 fatty acids. ...
- Increase soluble fiber. ...
- Add whey protein.
According to a research review people who take simvastatin (Zocor) or pravastatin (Pravachol) may experience fewer side effects.
What to do if patient Cannot tolerate statins?
The first option is adding ezetimibe to a lower statin dose or ezetimibe monotherapy that decreases LDL-C by 20% and is usually well tolerated. Adding fibrates or resins may be considered if ezetimibe is not enough to achieve LDL-C goals.
