Determining whether statins (cholesterol-lowering-medicines) are responsible for non-specific aches and pains can be difficult, especially in elders. Australian researchers explored this association in a group of nearly 400 patients above the age of 70 who were referred to a geriatric outpatient unit. 40% of them were taking statins and 50% of those took statins for primary prevention (to prevent a first heart attack or stroke).
Self-reported general pain was assessed on a 10-point visual analog scale. In the oldest group above the age of 80, having a pain score above 5 was associated significantly with statin use (risk increase four-fold). In the younger group no significant association was found (J Am Geriatr Soc 2014 Oct; 62:1900).
Two points emerge from this study:
First, many elders above the age of 80 are prescribed statins – even for primary prevention without having suffered coronary heart disease or similar previously. This observation suggests, well, a certain inertia or disregard of scientific studies, in such as many doctors fail to stop unnecessary medications. This is not only a problem down-under but as much in up-above Spain.
Second, although this study cannot prove causality, it supports the clinical impression of many medics that older patients are especially prone to musculoskeletal side effects of statins.
In that context one needs to remember the old proverb: an apple a day keeps the doctor away. There is a flaw though – nowadays apples seem to be EC-normed and consequently smaller and rounder for ease of transport around the world. When in pre-EC “old days” one apple was enough, the dose of modern apples needs to be increased to two apples a day!
Because 2 apples a day or the equivalent of 7 grams of fiber (1 cup of bran flakes or green peas for example) will significantly lower the risk for a first heart attack or stroke. Findings were similar for different types of fiber be this vegetables, fruit or cereal (BMJ 2013 Dec 20; 347:f6879).
As there is a dose-response pattern every 7 grams of fiber will lower the risk. Current guidelines recommend 30 to 40 grams daily.
I still wonder why the little white & round ones are so much more appreciated as compared to the orange tree in ones backyard.
Maybe one needs to adopt a little of the present Greek spirit and try and turn things upside down to get a different point of view from a different angle.
So: sell Sanofi, Roche and Merck shares and plant fruit trees instead. Attitude counts.
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