NVanHiker, the Zetia assists the Statin so you don't need as high a dose to lower the cholesterol. Without the Zetia, you'd have to take a higher dose of the Statin to have a similar effect.

Straight from the official Zetia web site:

Adding ZETIA to a statin is proven to help reduce cholesterol more than a statin alone. Unlike some statins, ZETIA has not been shown to prevent heart disease or heart attacks.

Which is because lowering cholesterol numbers to reduce heart disease risk is a fraud. Statins do all sorts of things to your body, some possible good such as lowering heart attack risk-- more so for those in a high risk category -- and LOTS of bad things which is why they are a really bad idea for those with moderate or low risk. It is likely that statins reduce heart attack risk by mechanisms other than lowering cholesterol numbers.
https://www.drjohnm.org/2012/01/cw-do...-level-matter/

And there's a huge amount more out there.

Don in Austin

You know .... there is clinical experience, there is belief, and then there is science. If you have been on the knife side of the table because of an arterial blockage, then I will take the muscle aches, memory loss, or whatever other side effects one may experience, and be thankful that I am breathing and I will do whatever it takes to keep my ldl/hdl numbers in check. If you are in a different risk category, then you owe it to yourself and most importantly those who may survive you, to do the research of the science literature and find out if stains are appropriate for you. Maybe they are, maybe they are not, but look at the science ... there are a lot of folks and docs who believe or not, but it really is not about belief it is about the science of risk factors, the effectiveness of statins in relationship to risk factors and what chances you are willing to take if you don't lower your numbers, however you do it ...

You do know that the science you want people to investigate is no more than statistics?

Once you go beyond the physics and chemistry, there is no science. The statistical analyses that parade as science also include a bottom-line factor for the drug companies.

I also thought it remarkable that the drug companies were spending huge amounts of money to promote their statin products, as I observed while in the US.

Evidence based medicine. It is a critical review of all the literature, and a summary of the findings about a specific subject or product. I got involved with this process in my profession for a couple of years before I retired.

This is a good site for critical evidence reviews.
https://www.cochrane.org/search/site/statins

All good points...

But I would not go so far as to say lowering cholesterol to reduce heart disease is a fraud...

There is a connection. If nothing else, cholesterol is one of the main ingredients that make up the plaque that clogs the arteries. And, when people reduce it with statins, the risk of heart attacks decrease.

But to add to the controversy over whether simply lowering LDL cholesterol numbers is helpful (using Zetia), there is now a new controversy building:

For years it was believed that raising HDL cholesterol was beneficial. But, when they raised it in people with already low LDL cholesterol (using CETPs), it didn't help. In fact, it sometimes even increased heart disease!

Now, they are starting to ask: "Are there different types of LDL and HDL molecules?" and "Are some better than others?"

Modern medical science is still not very far removed from VooDoo.
... But it's the best we have...

Actually, modern medicine is as much an art as it is a science.

When the young folks of today are our age, they will be astounded by our lack of knowledge and understanding...
... And they will probably be REALLY angry with us for creating virulent strains of antibiotic resistant bacteria...

Don in Austin

I'm unsure if you interpreted my stating "has a similar effect" as meaning lowering risk of heart attack or not. What I meant in saying "similar effect" was in the lowering of cholesterol. With Zetia+Statin, you don't need as high a dosage of the Statin if you used the Statin alone.

You can find lots of articles stating some drug treatment is effective and you can find probably as many stating a drug treatment isn't. We must remember, even though statistically it may be effective, we are individuals and some may not benefit at all. We also are going on what we know now and that may change. Science and medicine change with new discoveries and new data. In the sciences, you know things aren't absolute and that what you know now may be not correct in the future.

It is very questionable that targeting cholesterol numbers reduces heart attack risk, hence the disclaimer Zetia is forced to provide. Statins are though to reduce inflammation and hence heart attack risk -- most effectively for those in the high risk category. If you make good lifestyle changes LDL cholesterol numbers typically go down. But that does not establish that LDL was the problem, LDL is probably an indicator of the good lifestyle changes. The LDL/Cholesterol/heart attack connection is based on an awful lot of biased "evidence" financed by big pharma.

For several decades there has been a war against high cholesterol numbers and animal fats. The results of that war don't seem very impressive.

Don in Austin

Just giving some additional information, not debating, but the threshold(cholesterol numbers for recommending treatment) for diabetics, which I am, is far lower than in non-diabetics. For diabetics, diet and exercise don't or can't always do it. In my case, cycling has eliminated the need for one of the meds I used to take and cut the other med dose in half that I still take, but, as far as the guides go, I still need the medication to reduce cholesterol numbers. In the future, the cholesterol which is more responsible for heart disease may be identified and more precisely targeted through a specific medication, probably yet to be developed. I could just decide it's all hogwash and not worry about it, but statistically, I'm better off taking the medication--especially since there is heart disease in my family.

Has anyone here gone Vegan to control cholesterol? Like Dr Esselstyn diet or Dr Ornish. https://www.heartattackproof.com/

Yes, it's true that Zetia (Ezetimibe + Simvastatin) lowers cholesterol more than the statin by itself.

But, in the ENHANCE trial, they were shocked to find out that adding Ezetimibe to Simvastatin did nothing to improve atherosclerosis. In fact, it made it worse! To the best of my knowledge, they still haven't figured out why and they're still scratching their heads...

But this was a major financial blow to Merck who had already made many billions selling this drug.

Cholesterol is bad. We must eliminate cholesterol from our diet. The main culprit is those dastardly eggs. If you eat only egg whites, you will avoid the cholesterol. Your body needs cholesterol. Eggs are an excellent source of protein. Eating only egg whites eliminates all the nutrients in eggs. People with high cholesterol are ice cream eating fatties. 80% of your cholesterol level is genetic and diet will have minimal effect. Lipitor is a wonder drug that will repair your cardiovascular system. Everyone should take it regardless of cholesterol levels. Lipitor is poison to many and causes elevated liver and pancreatic enzymes. Statins should be a last resort after diet changes and implementation of an exercise program.

Any of these sound familiar? I have heard them all and read them for years. Pick whichever you decide and run with it.

+1 I've been on Lipitor for years and was on Zocor initially, but changed because Lipitor was less expensive.
Statins are known not only for their cholesterol lowering properties but also for reducing stroke risk.
Those having problems with one statin should ask their doc to try another, IMHO

.

I believe what they're allowed to claim is that they may prevent risk of second heart attacks or strokes.

I was on simvastatin for quite awhile, and it destroyed my grip. Some came backj after stopping, but is seriously deficient. I know several others in the same boat, and they had the exact same experience.. Statins are bad medicine....

My current Doctor has switched me to Fish Oil, and Red Yeast Rice tabs, and they are controlling better than the statins. worth asking your Doc about.....

Red Yeast Rice contains Lovastatin.

I haven't seen a sentence that openly Cartesian, and by someone who wasn't kidding, in a long time.

To paraphrase Gilson, one might be excused for having been Descartes, but there is no excuse whatsoever for being a Cartesian.

If you have no idea what I just said, you shall read The Unity of Philosophical Experience and thus do penance.

Anyway, not to derail the thread, but a Descartes joke before I sign out.

Old Rene headed over to the bar to philosophize and down some cognac.

Near closing, the bartender calls out, "Closing time. Mr. Descartes, may I get you one last drink?"

Descartes replied, "I think not", and promptly vanished.

That is all.

I like the joke .... Since Rowan responded to my post, I will only add the fly fishing metaphor that came to mind as I read it ... sometimes a poor imitation floats by and it is better to wait for something that better resemble reality before rising to the bait....

Merck to pay $688 million to settle Enhance lawsuits
https://www.reuters.com/article/2013/...91D0R520130214

The ENHANCE trial was a full blown trial designed to prove that Vytorin which is a combination of Simvastatin and Ezetimibe actually worked better than the statin alone...

They were making a fortune selling that drug (about $12Billion). But got scared when the trial showed that it was no more effective than Simvastatin by itself. While it did reduce LDL better, it had no effect on reducing atherosclerosis and related heart disease.

So, what did they do? They concealed the results of the trial for 2 years while they continued to sell their drug. They didn't release the results until the FDA and congress threatened an investigation.

So, now they are settling the law suits with the investors who felt they were defrauded...
... Yep, you can trust the drug pushers (to make money).

BTW: They are still selling their snake oil:
https://www.vytorin.com/ezetimibe_sim...umer/index.jsp

(Yes, I know that ezetimibe enhances the effect of statins. One works in the gut, the other on the liver. Did it sound like I didn't know this or that I was asking for medical advice?)

Like Stapfam, I have lost most of the male members of my family to heart disease due to the overproduction of cholesterol in the liver and resulting clogging of the arteries. Never met my grandfathers. My dad succumbed at 52, his brothers at 48 and 62. Like Stapfam, despite a lifetime of exercise and eating right, I still had to have a quad bypass at 59 to relieve the blockages. Those of us with familial hypercholesteremia chuckle at the oatmeal-and-cinammon crowd - we're well aware of all foods and supplements that help, and most of us do take them. Unfortunately, their effect is marginal. After 6 years of taking my drugs, I'm still getting clean stress-test results. In fact, last year the doc noted that my readings were akin to someone who has never had a cardiac event. As a commercial driver who has to pass a DOT medical every year, this is very important to me.

The internet is filled with forums where the postings go something like this: "I quit taking {blood pressure medication/insulin/my AIDS drugs/lithium/blood thinners/etc.** and man, I feel so much better! No more side-effects and giving money to Big Pharma, dude! The drug companies don't want you to know this, but organic __ in your tea every morning will control your condition with no side effects!"

Let's get back to discussing 23 vs 25 tires and old guys telling us how women complemented their legs in bike shorts.

You seem to feel that you know all that you need to know. I guess that's good. But even the (better) physicians know that they don't know enough.

In any event, if you don't like these threads, then don't read them.

But please don't complain at those who find them valuable, helpful, informative and interesting and who find that they compliment the exercise they get from cycling.

I concur 100% easy to say " I am not taking it.... I had cardiac arrest at 57 (2 Years ago)while laying on an operating table getting a hip spur removed.... yeah no meds of anykind going in, since then statins and Plavix, I am not complaining, still riding and no muscle pain and aced every stress test since then...my view on modern medicine is slightly different then most posters, nothing like standing by the big door and saying "f... it, Iam not ready"

I also concur. My parents are long dead of heart attacks, my mother in her 30s and my father in his early 60s. His first heart attack was in his early 40s. I've taken a statin since I was in my early thirties. I am now 58 and so far so good--no cardiac events. FWIW. I have no idea if the statins made a difference. There is no way for me to know. But given my cardiac risk profile the potential benefits of the statins seem to outweigh the risks. And what I eat seems to make no difference in my lipid levels. Not a whit. Losing 50 pounds didn't make a difference either. I don't know what I would do if I had obvious side effects. Fortunately I do not.

There might be a tendency for people who have had issues to post about them and people who have not had issues don't bother. So, the anecdotes (which aren't evidence anyway) may tend to create the impression of a greater problem than there actually is. And, statistics are a tool of science, are part of the scientific method.

From what I've read and heard from some respectable alternative practioners, RYR works the same way in the human body as _____statin(s). It is a product of natural processes, and does have some of the same side effects (liver, muscle, etc.) as _______statin(s), although to a different degree; however YMMV. If _____statin is prescribed for me, I would try Red Yeast Rice first (with a stricter diet added to my cycling addiction, and if I could find a reputable manufacturer), prior to taking a man-made statin drug.
A google search will lead you to https://en.wikipedia.org/wiki/Red_yeast_rice, and thousands of other pages. It seems this product sits on the divide between supplement and drug and has had a rather tumultuous decade.