AACE Endorses New Lower LDL Targets and ApoB Testing

[ShottleBop]

The NNT: Statins for Heart Disease Prevention with Known Heart Disease.

According to The NNT, 83 people must be treated for five years to save one life.

[foxl]

The NNT: Statins for Heart Disease Prevention with Known Heart Disease.

According to The NNT, 83 people must be treated for five years to save one life.

Thanks, Shottle -- I NEEDED that. Went off simvastatin in January, due to horrible back pain ... LDL 280-something soon thereafter. I am now freaking out and wondering what to do, although I KNOW it is not to go back on a statin. I cannot take Niacin (messes with BG), and will not eat HCLF. But I need the reinforcement not to fall into worrying along with my docs!

[georgepds]

"According to The NNT, 83 people must be treated for five years to save one life."

Thanks, Shottle -- I NEEDED that. Went off simvastatin in January, due to horrible back pain ... LDL 280-something soon thereafter. I am now freaking out and wondering what to do, although I KNOW it is not to go back on a statin. I cannot take Niacin (messes with BG), and will not eat HCLF. But I need the reinforcement not to fall into worrying along with my docs!

Sorry, I don't mean to upset anyone here.

If your LDL is too high, there are other things you can do to reduce LDL besides Statin and Niacin. If diet and exercise do not do it for you, there are other meds see Hypolipidemic agent - Wikipedia, the free encyclopedia

For those who did not check, the NNT (not sure who this is) site noted, over 5 years

* 1 in 83 were helped (life saved)
* 1 in 39 were helped (preventing non-fatal heart attack)
* 1 in 125 were helped (preventing stroke)
* 1 in 167 were harmed (develop diabetes*)

Now the thing to keep in mind is most of us here already have diabetes. Rough numbers for incidence of stroke and heart attack are double among the diabetic population. So if you take heart in those numbers remember for us it is more like

* 1 in 41 were helped (life saved)
* 1 in 20 were helped (preventing non-fatal heart attack)
* 1 in 62 were helped (preventing stroke)
* we all have diabetes, what's it going to do, give it to us again

Now these are rough numbers only, if you want to get into risk, you have to address the other risk factors (diabetes, age, HDL, smoking, family history of heart disease, etc)

[georgepds]

The NNT ( number needed to treat) site looks informative, thanks Shottle. When you look at their recommendation for statins, they get the highest rating, a green light (other choices are yellow and red and caution)

Green: Benefits > Harms
Yellow: Unclear if Benefits > Harms, Need More Research
Red: No Clear Benefits, but No Clear Harms Either
Caution: Harms > Benefits

By contrast if you click on "Insulin for Glycemic Control in Acute Ischemic Stroke" you get a caution, the lowest rating

same caution for "Prostate Specific Antigen (PSA) Test to Screen for Prostate Cancer"

[Seagal]

As far as statins go and the damage they can cause, would it not have to do with the dose? Perhaps I haven't had any side effects because I am taking 1/4 of the 40mg. tablet? If one is taking 40mg. or 60 or 100, wouldn't that make a difference? I haven't researched this, just a thought. My blood pressure doesn't want to go down and the dr. has doubled my dose, so if you use that analogy, more medicine = more effectiveness and more side effects. BTW, cardiologist said my MI was more than likely caused by years of hypertension.

[Ela]

The NNT: Statins for Heart Disease Prevention with Known Heart Disease.

According to The NNT, 83 people must be treated for five years to save one life.

Thanks for the link!

And it's worth of posting other numbers from it as well:

In Summary, for those who took the statin for 5 years:
•96% saw no benefit
•1.2% were helped by being saved from death
•2.6% were helped by preventing a repeat heart attack
•0.8% were helped by preventing a stroke
•0.6% were harmed by developing diabetes*

And while it may seem that we shouldn't worry about diabetes as we got it already, logically thinking it probably means that statins may do something that messes your BG regulation and just don't think they help in any way to control it! But who cares about BG and a good control when we have cholesterol to worry about? (Rolling my eyes).

I think if we could see how cholesterol affects us badly and see it after meals elevated (or not) with a meter, THEN we could be certain that statins do help us to get healthy (not just to make our labs better).

Fact is, most diabetics (if not all) who got their BG under control do feel better. I don't think I ever heard from anybody that they feel better just by lowering their cholesterol (by any method), however I did hear people reporting feeling much worse after going on statins. And I strongly believe that side effects are under reported because most doctors dissmiss patients complains.

To me 96% means -almost everybody don't benefit.

[foxl]

georgepds, I of course am researching many other options. Currently my favorite is adding T3 back, into my T4 regimen. Seems that people who have a problem converting T4 to T3 tend to have high LDL! Curious to see if my endo is willing to try that.

[georgepds]

georgepds, I of course am researching many other options. Currently my favorite is adding T3 back, into my T4 regimen. Seems that people who have a problem converting T4 to T3 tend to have high LDL! Curious to see if my endo is willing to try that.

Are you talking about thyroid hormones? I've heard before they have an effect on lipids.

Best wishes in finding a method that helps you

[ShottleBop]

As far as statins go and the damage they can cause, would it not have to do with the dose? Perhaps I haven't had any side effects because I am taking 1/4 of the 40mg. tablet? If one is taking 40mg. or 60 or 100, wouldn't that make a difference? I haven't researched this, just a thought. My blood pressure doesn't want to go down and the dr. has doubled my dose, so if you use that analogy, more medicine = more effectiveness and more side effects. BTW, cardiologist said my MI was more than likely caused by years of hypertension.

According to what I've read (Dr. Graveline and Dr. Jay Cohen (author of What You Must Know about Statin Drugs & Their Natural Alternatives), dose is everything when it comes to side effects. Dr. Cohen recommends starting with one or two miligram doses and titrating up to as much as can be tolerated, noting that the great bulk of a statin's effect on lipid levels comes at low doses. Dr. Graveline recommends low-dose statins for those at high risk, noting that, at lower doses, one can achieve the anti-inflammatory benefits that he believes are the primary therapeutic effect of statins while minimizing the risk of side effects.

[Seagal]

Thanks Shottle, I have been to many sites and keep forgetting about SpaceDocs! Must have missed that discussion.

[foxl]

According to what I've read (Dr. Graveline and Dr. Jay Cohen (author of What You Must Know about Statin Drugs & Their Natural Alternatives), dose is everything when it comes to side effects. Dr. Cohen recommends starting with one or two miligram doses and titrating up to as much as can be tolerated, noting that the great bulk of a statin's effect on lipid levels comes at low doses. Dr. Graveline recommends low-dose statins for those at high risk, noting that, at lower doses, one can achieve the anti-inflammatory benefits that he believes are the primary therapeutic effect of statins while minimizing the risk of side effects.

Oddly, I had cut my simvastatin from 80 to 40 last summer. And my back pain began in Jan or December, after that. I had been on the 80 mg for over two YEARS. I was skeptical of Dr. G.'s experiences until I had side effects myself, too.