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Statins for Primary Prevention of Cardiovascular Disease—With PREVENT, What’s a Clinician to Do? | Cardiology | JAMA | JAMA Network
For now, the PREVENT models represent the best risk prediction equations available that allow accurate and precise estimation of CVD risk in US patients aged 30 to 79 years. Estimates calculated for risk of ASCVD with PREVENT, as expected, are significantly lower (by approximately 50%) than estimates calculated with the PCEs because they were developed in a more contemporary derivation population with more recent examination years (1992-2022) compared with the PCEs (1968-1995).
Statin related muscle symptoms: is it time to move on | The BMJ
Myalgia was common among participants, regardless of statin use.7 The proportion of patients reporting muscle pain or weakness was 27.1% in the statin arm and 26.6% in the placebo arm. These event rates remained consistent across subgroups stratified by age, sex, ethnicity, history of vascular disease, diabetes, body mass index, LDL cholesterol concentration, and estimated glomerular filtration rate. The authors calculated that only 1 in 15 reports of muscle symptoms in statin groups were attributable to statins.7 Furthermore, the additional absolute risk of such events remained low across different intensities of therapy.7 Creatinine kinase activity, a more objective outcome than patient reported symptoms, was increased only minimally with statin therapy.
Patients taking statins experience similar side effects from dummy pills -- ScienceDaily
The team recruited 60 patients aged between 37-79 who were on statins, and had stopped their treatment due to side effects, from June 2016 -- March 2019. During the trial, which took place at Hammersmith Hospital, patients were given four bottles containing a statin, four bottles of a placebo and four empty bottles to take over a course of a year. Patients took identical tablets, blinded to statin or placebo for eight months, and took nothing for four months. The patients took these bottles in a random order and were required to score from 0 -- no symptoms -- to 100 -- worst imaginable symptoms- of any daily side effects they experienced, on a smartphone. Forty-nine of the 60 patients completed the full 12 months of the trial.
Tackling statin intolerance with n-of-1 trials (TaSINI) in primary care: protocol for a feasibility randomised trial to increase statin adherence. - PubMed - NCBI
INTRODUCTION:
Statins reduce the incidence of cardiovascular disease (CVD) and cause few adverse effects. Half of patients prescribed statins discontinue treatment due to perceived intolerance. Placebo-controlled (blinded) n-of-1 trials have shown people with perceived intolerance that the statin does not cause adverse events and most resume treatment. However, blinded n-of-1 trials are impractical to deliver in routine practice. Tackling Statin Intolerance using n-of-1 trials (TaSINI) will test the feasibility of a general practitioner (GP)-delivered behavioural intervention endorsing an unblinded n-of-1 trial to increase adherence to statins relative to usual care.
N-of-1 (Single-Patient) Trials for Statin-Related Myalgia | Annals of Internal Medicine | American College of Physicians
Eight patients (mean age, 66 years [SD, 8 years]; 88% women, all with high 10-year Framingham cardiovascular risk) participated in n-of-1 trials. Seven patients completed 3 treatment pairs, and 1 completed 2 treatment pairs. For each n-of-1 trial, no statistically significant differences were seen between statin and placebo in the VAS myalgia score, symptom-specific VAS score, pain interference score, and pain severity score. Five patients resumed open-label statin treatment, with a median posttrial follow-up of 10 months.
Statins, pain, glutamate (relates to leg pain post caffeine?)
The McMaster research team found muscle cells treated with statins released the amino acid called glutamate at much higher levels than muscle cells that were untreated. As glutamate is a potent activator of muscle pain receptors, this release was proposed to trigger the sensation of muscle pain.
Thomas Hawke, senior author of the study and a professor in pathology and molecular medicine at McMaster University said: "We found that statins were able to enter the muscle cells and cause oxidative stress. This resulted in the muscle trying to increase its production of antioxidants to combat this stress. The side-effect of this antioxidant production was the release of glutamate out of the muscle cells."
Cholesterol medication could invite diabetes, study suggests: Patient data shows association between statins and type 2 diabetes -- ScienceDaily
Statins are a class of drugs that can lower cholesterol and blood pressure, reducing the risk of heart attack and stroke. More than a quarter of middle-aged adults use a cholesterol-lowering drug, according to recent federal estimates.
Researchers found that statin users had more than double the risk of a diabetes diagnosis compared to those who didn't take the drugs. Those who took the cholesterol-lowering drugs for more than two years had more than three times the risk of diabetes.
"The fact that increased duration of statin use was associated with an increased risk of diabetes -- something we call a dose-dependent relationship -- makes us think that this is likely a causal relationship," Zigmont said.
