New evidence about the effect of statins on women came out this week in a meta analysis in the Archives of Internal Medicine. The study suggests ‘there is no benefit of statins on stroke or all-cause mortality in women’.
So why is it so many of us women are still automatically put on them as soon as our cholesterol creeps up higher than the magic number of 5? (A totally arbitrary figure incidentally!)
Let me explain my obsession with statins. A couple of years ago I had a stroke completely out of the blue whilst sunning myself on holiday in Corfu. It was a scary experience-one minute I had gone to sleep replete with a nice Greek Salad and a nice glass of wine-the next I awoke to find myself paralysed down my left hand side.
In Greece, doctors don’t talk about cholesterol as a risk factor for stroke-they talk about stress. So no statins were prescribed in the little hospital in Corfu just plain blood thinners. However I had written enough features about strokes to know once I returned to the UK it would be a very different story.
Sure enough when I saw my GP once he had ascertained I had no other risk factors he measured my cholesterol level and I was put on statins. My cholesterol was 5.7-around average for a woman of my age.
Now, I admit I am a bit of a cynic about the whole cholesterol story. I have been writing about health for far too long to believe in its new found status as the bogeyman of the health world.
I remember when cholesterol was the good guy and have written countless articles about the wonder of this amazing substance which as far as I know is essential to every cell in the body. Nevertheless since I had just had a terrifying event which could potentially have left me paralysed for life, I wasn’t about to argue. So I went along with the madness.
It is very hard to argue against statins because the experts whose judgement you trust, bandy about statistics which are designed to scare the living daylights out of anyone who disagrees. So I gave in without a whimper clutching my prescription for Simvastatin.
Within days of taking the drugs I was suffering from nightmares, muscle cramps and general tiredness. I went back to my GP who joked that quite a few of his patients couldn’t tolerate Simvastatin. Simvastatin is the cheapest statin and so is routinely prescribed as the first line of treatment. I was put on Atorvastatin.
Although the nightmares improved, this time I had dizzy spells and generally felt unwell and actually I was downright miserable about the fact I had to be on drugs I felt I really didn’t need.
Instinctively I felt sure that the reason cholesterol levels rise after the menopause might be some protective mechanism against heart disease rather than a dangerous precursor of cardiovascular risk.
Obviously I had no evidence for this but I decided to look into whether any research had been done into women and statins.
Trawling the internet I came across Dr Malcolm McKendrick’s book The Great Cholesterol Con http://drmalcolmkendrick.org/about/ where he suggests that the protection provided by statins women is so small as to be not worth bothering about. I spoke to him recently and he seems like a reasonable chap. It seems that this latest research backs up his theories.
The review published this week pooled the results of several statin studies to see if there was any difference between results obtained in women compared to men.Whilst there were reductions in heart attacks, strokes and overall risk of death in men there was no statistically significant reduction in the risk of stroke or overall death in women.
Ah, but as the doctors pointed out I had already had a stroke and was therefore at a greater risk of having another one. In fact a 1995 study in the Lancet looked at 450,000 people over a period of 16 years who had suffered a total of 13,000 strokes between them. It concluded that ‘there was no association between blood cholesterol and stroke’.
McKendrick goes further and points out that lowering cholesterol to below 4, particularly over the age of 50 is actually dangerous. He cites another study in the Lancet in 2001 which showed that ‘in elderly people with low serum cholesterol, low cholesterol concentration actually increases the risk of death.
The conclusion of the study was quite clear: ‘Our data casts doubt on the scientific justification for lowering cholesterol to very low concentrations’. So why are women routinely prescribed a drug which could be doing them harm and at best do them no good at all? Ah, because statins also protect against inflammation. Of course…silly me!
During this time, I decided to write about my stroke for a national newspaper http://www.telegraph.co.uk/health/8581956/Sun-sand-sea-and-a-stroke.html in the hope that I might find out more about why I was being kept on the dreaded statins. I interviewed top stroke expert Professor Tony Rudd at St Thomas’s Hospital.
One of the first things he suggested was that I have a ‘bubble’ test to check if I had a type of hole in my heart known as a patent foramen ovale-sometimes implicated in strokes where there is no known cause. It turns out I was a textbook case for the condition! I was offered an op to close the hole. Then apparently I could carry on with life as normal-as if I had never had a stroke!
Hoorah! At last-the chance to flush the wretched tablets down the loo! But wait. No. I was told to keep taking the tablets-just as a precaution you understand? Against what?
Again, I was too scared of all the horrid statistics which were being thrown at me should I dare to come off the statins.
In a recent tweet, outspoken Glasgow-based GP, Dr Margaret McCartney urged NICE to look at emerging and existing evidence on statins for women. ‘We need to be honest about the limitations of our knowledge and make best informed decisions on that’ she says.
My gut instinct tells me these drugs are not the miracle workers they claim to be. I see no reason to continue taking a drug which may be doing me harm and according to the latest research has no real benefit. So, with the support of my GP’s I am coming off statins and am on a mission to research other methods of lowering my cholesterol.