I cannot advise you on whether or not to take a particular medicine, of course.
With that said, assuming you don’t smoke or have high blood pressure, based on your other numbers your estimated 10-year cardiovascular risk is less than 2%, which is less than the threshold typically used in practice for initiating treatment with statins.
Thank you to the link to the calculator. My systolic BP is 133. So I’m 133/83. According to the calculator my risk of hart attack 2 out of 100 doesn’t go down if I start statins. So maybe just keep hitting the gym and forget about taking them.
Austin, I sometimes read that while statins can lower the risk of CVD, they are less successful at lowering all cause mortality and that statins can have muscle damage as side effects, at least in some cases. What’s your view on these claims?
The mortality piece is quite complex, and depends on numerous factors including primary vs. secondary prevention, all-cause vs. disease-specific mortality, and importantly, the duration of follow up in a particular study. CVD is a very long-term disease process, and you are unlikely to see substantial effects in a short-term data set in a primary prevention situation, for example. For more information on this stuff, I’d start here: http://www.onlinejacc.org/content/72/10/1141 https://www.lipidjournal.com/article…14)00274-8/pdf
True “muscle damage” (i.e., biochemical evidence of CK elevation or rhabdomyolysis, not just muscle aches) from statins is a rare adverse effect, and – if it does occur – is often related to inappropriate dosing (e.g., prescribing Simvastatin 80 mg) and/or drug-drug interactions (e.g., related to the CYP450 system or P-glycoprotein) that excessively boost blood levels of the drug.
According to Mancini et al., about 70–80% of statin-treated patients are tolerant to treatment, while 20–30% are initially suspected to be statin intolerant. ~92% of these patients subsequently tolerate re-challenge with different statin medication.
In cases of suspected statin intolerance, Banach et al. recommend a careful history & exam, assessing risk for drug interactions, excluding risk factors and conditions that might increase the risk of statin intolerance, including ‘psychologically conditioned symptoms as a result of expectations due to achieved knowledge of drug-related side effects’ (i.e., nocebo from your lifting buddy or strength coach). They estimate that this thorough evaluation yields a diagnosis of complete statin intolerance in only 2–3% of patients.
