Sensible statin studies sought
November 25, 2010 4:58 AM Subscribe
I'm looking for some recent studies approachable for the common reader that compare the different cholesterol-lowering statins.
I've recently moved and just had my first visit with a new internist. He said that after looking at my labs, he might suggest changing my cholesterol-lowering medication from Lipitor to Crestor. The reason he's given is that Crestor can reverse plaque buildup.
Since I really like to be in control of my health I'm interested in reading about this and drawing my own conclusions. Googling statins and cholesterol brings out a bunch of results, but it's difficult to separate the wheat from the chaff. I'm interested in scientific studies, rather than anecdotes about results.
I've recently moved and just had my first visit with a new internist. He said that after looking at my labs, he might suggest changing my cholesterol-lowering medication from Lipitor to Crestor. The reason he's given is that Crestor can reverse plaque buildup.
Since I really like to be in control of my health I'm interested in reading about this and drawing my own conclusions. Googling statins and cholesterol brings out a bunch of results, but it's difficult to separate the wheat from the chaff. I'm interested in scientific studies, rather than anecdotes about results.
I can't point you to specific studies, but I've done a lot of personal research on PubMed. Link here. It's free to use, so I'd say it's worth a shot to do a few quick searches and see if anything comes up.
posted by pecanpies at 7:16 AM on November 25, 2010
posted by pecanpies at 7:16 AM on November 25, 2010
This might be more complicated than you want to deal with. For example, the answer may be modified by your kidney status / risks. A very good medical info resource is Up2Date, which provides a free patient-info version. The article on rosuvastatin (crestor) cites some of the clinical trial highlights of placebo controlled trials.
Here's a summary of head to head comparison.
posted by a robot made out of meat at 7:58 AM on November 25, 2010
Here's a summary of head to head comparison.
posted by a robot made out of meat at 7:58 AM on November 25, 2010
On an evidence-based medicine site I run, we discuss the "benefits" of statins (assuming you don't have known heart disease). If you have known heart disease, then the benefits do actually exist.
posted by gramcracker at 8:42 AM on November 25, 2010 [4 favorites]
posted by gramcracker at 8:42 AM on November 25, 2010 [4 favorites]
I would look for data as close to the studies as possible. Sometimes meta data seems to say different things than raw data. For example, the linked site shows ones chances for 5 years. But their source seems to indicate that 5 years is the mean length of time from the beginning of the study to the end. Those seem like different data that must be interpreted differently.
Frankly, I would ask your doctor to show you where that information came from.
posted by gjc at 10:01 AM on November 25, 2010
Frankly, I would ask your doctor to show you where that information came from.
posted by gjc at 10:01 AM on November 25, 2010
Best answer: I'm not a primary care doctor (and NYD) and as such don't start people on statins. However, I think this article does a pretty decent job of discussing the issue.
To summarize:
- Crestor is the strongest statin out there, so if a person is not responding to the usual/older/tried-and-true statins, then you could try to switch to Crestor for better results
- Crestor is the newest and thus the most expensive statin. So, insurance companies don't want people taking it, and drug companies will be trying to sell your doctor on the fact that it's the best, for for most people, the old/regular statins are fine.
- You want to get your LDL down, especially if you have other conditions like diabetes that put you at high risk for heart disease complications. So, the most important thing is to look at your numbers and see how you're responding to the statin therapy, and try to get your numbers where they need to be.
- The main side effect associated with all statins is muscle aches/breakdown which can range from mild to severe. This appears to be more so associated with the stronger statins. This is an easily noticeable side effect that usually stops right away when you decrease or stop the medication.
Hope that is useful.
posted by treehorn+bunny at 9:36 AM on November 26, 2010
To summarize:
- Crestor is the strongest statin out there, so if a person is not responding to the usual/older/tried-and-true statins, then you could try to switch to Crestor for better results
- Crestor is the newest and thus the most expensive statin. So, insurance companies don't want people taking it, and drug companies will be trying to sell your doctor on the fact that it's the best, for for most people, the old/regular statins are fine.
- You want to get your LDL down, especially if you have other conditions like diabetes that put you at high risk for heart disease complications. So, the most important thing is to look at your numbers and see how you're responding to the statin therapy, and try to get your numbers where they need to be.
- The main side effect associated with all statins is muscle aches/breakdown which can range from mild to severe. This appears to be more so associated with the stronger statins. This is an easily noticeable side effect that usually stops right away when you decrease or stop the medication.
Hope that is useful.
posted by treehorn+bunny at 9:36 AM on November 26, 2010
Response by poster: Thanks for the responses. This information gives me a bit more background for when I go back to see the doc. I've marked a best answer but am open to other information if it's available.
I'm aware of the skepticism about statins for healthy people in general. That said, I have a family history and physical makeup that puts me at higher risk, though I do not currently have heart problems, and am not diabetic.
So it's kind of a crap shoot either way.
posted by SteveInMaine at 1:53 PM on November 28, 2010
I'm aware of the skepticism about statins for healthy people in general. That said, I have a family history and physical makeup that puts me at higher risk, though I do not currently have heart problems, and am not diabetic.
So it's kind of a crap shoot either way.
posted by SteveInMaine at 1:53 PM on November 28, 2010
Please check out the Heart Scan blog.
Unless you've had a heart attack, statins don't reduce mortality. Even for those who have, there are FAR more effective interventions (less sugar, less grains, less vegetable oil, more fish oil) that have positive rather than negative side effects!
Also note that statins block CoQ-10 synthesis and promote muscle wasting. Since the heart is a muscle, I'd be extremely reluctant to use them.
posted by Earl the Polliwog at 6:15 PM on December 17, 2010 [1 favorite]
Unless you've had a heart attack, statins don't reduce mortality. Even for those who have, there are FAR more effective interventions (less sugar, less grains, less vegetable oil, more fish oil) that have positive rather than negative side effects!
Also note that statins block CoQ-10 synthesis and promote muscle wasting. Since the heart is a muscle, I'd be extremely reluctant to use them.
posted by Earl the Polliwog at 6:15 PM on December 17, 2010 [1 favorite]
This thread is closed to new comments.
(summary - If you already have CVD, statins will keep you alive longer; If not, they have no preventative effect)
posted by pla at 6:23 AM on November 25, 2010 [1 favorite]