Stopping statins pt2 – Is it Safe?

Stopping statins pt2 – Is it Safe?

August 15, 2019 72 By Bertrand Dibbert


I’m doing a series on stopping statins. I
did another one recently on an article that just came out August of 2017
showing that patients who had a stroke and stopped their statin were much we’re
more likely to have another stroke within a year and to die from that
stroke. But there are there studies out there which indicate it may be safe to
stop statins. Why are we seeing this difference in the literature? some
saying it’s safes others & saying it’s not safe well there’s a pattern there…
let’s get deeper into it but let me just introduce myself it’s Ford Brewer with
PrevMed heart attack and stroke prevention and here we go. This is big
news this whole thing about stopping statins. CNN covered a headline on it and
they said statins what happens to patients who stopped taking them after
side effects well there’s actually a study on that. (There’s a study on anything, isn’t there?) But this
is an important topic researchers in Massachusetts looked at
28,000 patients and they found that 3 in 10 stopped their statins because of side
effects statins are not easy to take. They can make you feel bad. They can make
you feel muscle fatigue or soreness. Here’s what happened to them. 8.5% of
those that stopped their statin went on to have a heart attack or stroke
– or a cardiovascular event. 7.6 % 7.6% of those who stayed on their
statins had a heart attack or stroke and this is very significant given the fact
that it was so many patients 28,000 patients now many people would look at
that and some of my patients I think might look at that and say if that’s all
I’m getting for some of the side effects I’m having I’ll take the trade that’s just for events again the
difference between death rates for these two populations is similar about a 1%
increase in death rates for folks not on statins (who stopped their statins). now why would you want to stop
taking statins? I covered this in the other video. There are a lot of reasons
side effects is the most common one, the one covered in the the last slide, fatigue,
muscle soreness, things like that. I added a couple of other ones. Maybe you were
put on the statin for the wrong reason and need to get switched from one statin
to another. Cost, fear, frustration you just don’t like taking
medications. There’s been a major reaction around statins based on – a lot
of it came from 2 medical journals the British Medical Journal and Lancet I’ve
covered that in a couple of videos bottom line was – based on the headlines
coming out of that a lot of people stopped their statins. And there are studies
which show the ones that stopped their statins had a higher death rate and higher
event rate. now let’s look at this one this is back in2004 dr. Mary McGowan
of the New England Heart Institute in Manchester New Hampshire did a study
which was nested into the TNT study I’ll talk about the TNT study in just a
minute but the TNT study design required… – it was looking at, it changed the
standards for the targets for LDL lowering – but in order to look at that,
they had to take some people off of statins for at least a six week period.
so that’s what she did she studied those people that had to be taken off of their
statins for this study design and found that there was no increase
we’ll talk about it a little bit more now this is the TNT study it was
published in the New England Journal and yes it was a big deal. It’s treating two
new targets here’s the bottom line on this study. they looked at I think it was
hey there were two doses of a statin. The one they looked at was lipitor. up
till then the standards had been to get somebody below an LDL of 100. as a
result of this study I think almost all of us would agree you want an LDL below
70 even if you’re in that Bale – Doneen camp even if you’re I’m guessing Paul
Ridker who started all this about cardiovascular inflammation I’m guessing
he would agree you still want LDL below 70 and all of that’s a result out of
that landmark study TNT but this is a study that was part of it like I said
before dr. McGowan was looking at the fact that in order to participate in the
TNT studies a lot of people had to be taken off of their statins for a short
time period well like I said what they found was that it was safe for these
patients. Let’s go back and think about it again during the same time period 2002 2004, early 2000s there were still studies that were coming out and I think they’re
valid studies withdrawal of statins increases event rates in patients with
acute coronary syndrome why do we see the differences again
as we said before I think this all reflects biological reality. The studies
showing safety of stopping statins is with stable patients. And it’s a
time-limited thing. It’s not a permanent thing like you even saw with the CNN
coverage of the of the Massachusetts study with 28,000 patients. That was a longer term study and there was a decrease. OOPs, no an
increase in mortality and heart attack event rate when they went off their
statins. Studies that show hazard involve recent stroke heart
attack other cardiovascular event. Why is that?Well plaque instability is
systemic there’s no such thing as that single vulnerable plaque the vulnerable
plaque theory is on its last legs and again if you’ve got one or two or three
vulnerable plaques it’s a biochemical thing it’s a it’s what’s going on in
your bloodstream not in that specific area . In your entire arterial tree. So one
or two or three vulnerable plaques means that …most if not all of
your plaques are vulnerable and vice versa if you have stable plaque then
most of those plaques are probably going to be stable so again it just underlines
the concept. Plaque instability is a systemic issue not a local issue and if
you’re stable you can go off of these for a while can you go off of them
forever safely well I mean you can go off of them forever but you have some
you have to pay the piper in terms of safety
just like the the original study said your probability of having an event
and dying or increased thank you