Raised cholesterol and statins......opinions please

[northender]

My mum is 70, a healthy BMI, relatively fit although she has chronic lung disease (moderate but well controlled). She had a cholesterol test a couple of months ago and her total level was 7.9 (don't know the split between HDL and LDL). It was a surprise really as her diet is pretty good. She was offered statins straight away but refused as she wanted to try diet first. 2 months later she has been retested and her level is 6.3 (again don't know the split have asked her to find out). She would like to continue with the diet, increase exercise (exercise level has been lower than usual due to her chest) but GP insisted on prescribing a statin.

She hasn't got the statins yet and I think that carrying on with the diet and exercise plan is a good idea based on the significant difference she has already made.

Does anyone have experience of this or opinions? Thank you for reading

Doctors don't generally prescribe medication if it isn't necessary. If your mother's GP is saying that statins are her best option then maybe the prudent course of action would be to take their professional advice.

Hi, the exercise and diet is obviously working well and you should continue this forever. As far as the Statins are concerned there is a bit more to it as Cholesterol reduction with Statins seems to reduce the risk of a stroke irrespective of the baseline Cholesterol. As I am sure you know, 150,000 people have a stroke here in the UK, 10% die in the first month and over 50% are damaged so your GP is advising something sensible. Hope this helps

Thanks for your replies. Sorry, I wasn't suggesting she never take statins but in view of the fact that she has no health issues apart from her lung disease (BP normal, blood sugar normal, no heart disease) I would've thought to carry on with her current regime and be monitored for another few weeks would be acceptable.

I understand the implications of stroke and would not wish that on anyone let alone my mum but when you look at the research behind statins there are still questions about giving them to people who have not had ischaemic heart problems and statins are not without their side effects. Having said that I haven't had chance to look at any of the studies more closely yet.

Just interested to hear opinions.

My mum was in a similar situation- reduced chol. by diet but never quite enough, not overweight, normal BP, but did have a possible TIS ( aged almost 80) and very relcutantly took statins. There is a bit of a drive to prescribe them I think- some people say everyone over 55 should take them regardless of health issues.

She goton well withthem until they took heroff the more expensive brand and gave her generic ( weaker) ones which don't seem to suit her too well- often feels very tired and you c an get muscle pains etc.

Not sure hat to advise but I'd google lots and find out all the pros and cons.

not TIS - TIA

Thanks pp that's really helpful. Mum's had a lifetime of meds but feels her health is better than it's ever been and doesn't want to go on something extra unless she really has to. Interesting about the effects of the generic statin though.

My dad's on them and is fine with them, but he's had a heart attack, has high blood pressure, is overweight and is an ex smoker.

I do think there is a tendency to over prescribe ?? govt targets and GP payments related to health screening and preventative health care.

Yes, wrt to your last sentence, but the clinical evidence for prescribibg statins is really pretty convincing. Your Mum's age is relevant here as well as her cholesterol, BP and BMI. I would recommend she takes the statins (not a doctor myself, just bossy) and make herself familiar with symptoms of stroke and TIA. Glad to hear she's taking good care of herself, that's the most important thing. Now about your Dad...

Have spoken to mum again, she is going to find out the results LDL/HDL. The GP at the time also did a cardiovascular risk calculation which uses age, BP, smoking history, sex and chol level to predict your chance of developing CV disease in the next 10 years. She came out at a 3% risk.

Having read more now, the GPs have financial incentive to reduce the cholesterol levels in their patients through the Quality Outcome Framework. This imho makes them more likely to prescribe statins at an earlier stage rather than a lifestyle change, wait and see approach. The dietary advice offered by the GP was purely to cut down butter, cheese and red meat. Nothing about foods that have a more positive effect like pulses, oat bran etc so that hasn't helped my slightly stance.

If she can't reduce her levels any further through lifestyle means then she will take them.

I respect her decision and feel enough still myself not to get bossy with her yet!

One other option is for her to also exercise as well as watch what she eats.

70 is not too old to start a senior keep fit class or aquarobics etc with her GPs okay.

The link between high cholesterol and CHD is not as black and white as some would have us believe. The more you look into it the more it is vague.

Mu mum took it after a TIA as I said, and very reluctantly. she thinks they make her very tired but at 82 it could just be age anyway.
Originally she was on Lipitor which is one of the best according to research I did, but due to costs she was put on a generic version which is 50% strength so she has to take 2x as much. she believes it gives her more side effects though ghe GP won't believe this. she offered to pay for Lipitor privately but couldn't.

Her chol was always just over 5 and with strict diet etc managed to get it below 5.

It's a hard decision for you/her and I think there are more political/financial implications than we are being told of.

Thanks pp those are my feelings exactly. She does go to a gym and she runs a walking group which does 5-6 mile walks but she hasn't done as much as normal over the past 2-3 months so is trying to step it back up now.

at the idea that we should all just do what the doctor tells us?

Of course, cholesterol levels aren?t solely determined by diet, there are other factors at play too, including genetic ones but I think given the success your mother has had with her dietary changes coupled with her plan to step up her exercise regime, she is well within her rights to wait a little longer before going on medication.

OH has taken a statin for 18 years and has been lucky enough to avoid most of the side effects, so not against them in principle, but then he?s high risk. I don?t think there?s any rush given your mother?s health profile.

Thanks mattellie. As I said she's not saying never but certainly not yet. I think given one thread ongoing at the moment it's clear Dr's advice should not always be just accepted.

Both DCs have serious medical conditions so I?ve learnt to be well-informed myself and to ask lots of questions.

Many doctors are wonderful; a few aren?t. The problem is that it?s difficult to tell which is which if you don?t ask them questions?

at her age? avoid. It can take a while to find the brand thaT AGgrees with you.

Cardiovascular risk factors are usually assessed on cholesterol levels, blood pressure,whether you smoke and if you're diabetic.

On a personal level (non-medical opinion), statins and beta-blockers have kept FIL's cardiovascular system going for the poast 10 years, but have allowed him to live long enough for dementia to develop. A fatal MI years ago would have been much, much koinder than the hell he currently lives in.

TBH, if it was me, I'd want to discuss it with a consultant cardiologist, not GP.