Full disclaimer: I’ve been on 10 mg of Lipitor (atorvastatin) for over 25 years because of high LDL and total cholesterol levels and every single one of my well-meaning doctors, who I really do believe actually like me (I may be wrong but if I am, I don’t want to know) and want to look out for me, are constantly pushing me to increase my dose dose of Lipitor to lower my LDL count even more than it’s been lowered (which wasn’t really all that much, to be honest), a tactic they push on me based on conclusions (which they always show me on their computers) from several cardiac “risk” detectors which all seem to conclude that a higher statin dose would lower my potential for a heart attack and stroke even more than my 10 mg has lowered it till now.
But I have steadfastly refused to accept those risk detector conclusions (and the recommendations from my docs) and I have never increased that dosage from the day I started on this drug.
So who’s right?
Hard to tell although I recently got a bit of ammunition for my side of this argument.
According to a study known as ALLHAT, statins may be a waste of time in seniors, even if like me, they also have high blood pressure and abnormal cholesterol levels.
In ALLHAT, seniors (that’s anyone over 65) with high blood pressure and high cholesterol levels taking a statin drug did not have fewer heart attacks or fewer heart “events”, and did not live any longer than seniors who didn’t take the drug.
So to repeat and re-emphasize (can’t help that: I’m a Jewish parent and grandparent): in ALLHAT, seniors with pre-existing high risks for a heart attack or a stroke did not get any benefit to that risk from taking a statin drug although many did, of course, suffer the side effects and complications from taking that seemingly unnecessary medication, and of course, the older one gets, the higher those latter risks such as interactions with the many other drugs seniors are so regularly prescribed (and very curiously, there was a small trend to a higher death rate in very old seniors taking statins; could just be a statistical fluke but needs looking into for sure).
Now it could be argued that in ALLHAT, the dose of statin used by most seniors wasn’t high enough, that the statistics were jumbled because some of the seniors in this study ended up taking statins that doctors outside the study prescribed, or that the seniors in ALLHAT didn’t take the right statin, and on and on.
Perhaps those criticisms are all true, but the one clear thing that does seem to emerge, I’d say, is that if statins in usual doses are beneficial to seniors (and I do believe they can be), those benefits are smallish at best (there were none in this study), and they likely accrue to only a few people who take them.
One important caveat: no one should ever stop taking a prescribed medication without talking to their family doc first.
Anyway, has ALLHAT convinced me to stop taking my low dose of atorvastatin?
Nope. Or at least not yet.
I don’t seem to have any side effects from the drug, and well, you never know: maybe I’m one of those lucky few who does get an actual benefit from the drug.
But then I also believe the Canucks will win the Stanley Cup before I die.