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Should you take statins?

Statins are certainly one of the most widely used drugs in the history of medication and they have reshaped the treatment of cardiovascular disease, with an estimated one billion people around the world prescribed them daily. Statins are guideline recommended and do play a role in treating patients with heart disease. It is however important to identify the patients most likely to benefit.

Recently, statins were the focus of a podcast by functional medicine expert Dr Mark Hyman. He was joined by Dr Aseem Malhotra, a UK cardiologist, who is a founding member of Action on Sugar and on the board of trustees for the UK health charity, The King’s Fund. Dr Malhotra’s has researched statins in depth and advises a more nuanced discussion between patients and doctors before prescribing statins.

His book – A Statin Free Life – challenges the idea that statins should be embraced as a panacea for preventing and treating heart disease. Partly because it’s not necessarily the case that LDL cholesterol – which statins lower – are always the problem and, also, because statins are not without inherent risks.

It’s essential that patients fully understand the benefits and risks about statins as well as an improved understanding of the role of statins in preventing and managing heart disease. But that they should also be aware that there is a further, possibly more powerful option, which is functional medicine.

The problem of cholesterol

Cholesterol is a type of fat, or lipid, made in the liver and circulated around our body through the bloodstream as it plays a vital role in how your body works and is essential for making and repairing cells.

However, fatty deposits can build up on the artery walls and lead to the arteries narrowing known as atherosclerosis. If the coronary arteries that supply the heart become blocked, then it can result in a heart attack.

The narrative for many years has been that there is ‘good’ and ‘bad’ cholesterol. Low-density lipoprotein (LDL) cholesterol is thought to be ‘bad’ because it carries cholesterol to your arteries where it may collect in the artery walls and lead to atherosclerosis. High-density lipoprotein (HDL) cholesterol was considered ‘good’ because it transports cholesterol to your liver where it was expelled from the body.

Statins are very effective at lowering LDL cholesterol which is why they have been so widely prescribed. However, an increasing number of studies show that HDL cholesterol may not be so beneficial as was previously thought and one recent study found that it correlated to a higher risk of heart disease in women.

Researchers have also found increasing evidence that high levels of LDL cholesterol are not always linked to heart disease. As Dr Malhotra explains: “It’s a useless biomarker in terms of predicting someone’s risk of heart disease and therefore we shouldn’t obsess about lowering it.”

Statins or lifestyle changes?

Statins benefits are stronger for those in the high-risk category, such as those who have already had a heart attack or those diagnosed with severe blockages. Yet most prescriptions for statins are not for these patients. They are used as preventative medication and the evidence points to minimal benefit in terms of life expectancy when set against the potential risks and side effects.

Taking statins also does not protect you from the consequences of unhealthy living and adopting real and effective lifestyle changes, including a healthy diet, being active and limiting stressors, should always be the first line of defence.

Confused? You are not alone. For more information on risks and benefits of statins and on a functional medicine approach to treating heart disease, call and book a consultation with Dr Konrad Grosser on 0333 444 1844 today.

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Younger women urged to check blood pressure

A study that has been carried out over a period of several years has shown that women who have high blood pressure in their 40s are significantly more likely to go on to develop heart problems than their peers.

This might not sound like a surprising statistic – we all know that high blood pressure can lead to heart problems – but what is interesting about the study’s findings is that the same cannot be said for men.

The gender difference

Interestingly, no one seems to have investigated previously whether there is a difference between men and women when it comes to the problems caused by high blood pressure.

This study looked at 12,329 men and women in Norway, with an average age of 41 when the study commenced in 1992. They tracked their blood pressure and heart health for an average period of 16 years, and the findings have surprised heart specialists the world over.

To begin with, far more men than women had high blood pressure – 35 per cent of men and 25 per cent of women had stage 1 hypertension, which is defined as a blood pressure of between 130/80 and 139/80, according to the American Heart Association.

When it came to stage 2 hypertension, which is defined as 140/90 or above, the difference was even starker: 14 per cent of women, compared to 31 per cent of men.

The women also generally had a much lower risk factor for heart disease as fewer of them were smokers, and they tended to have lower BMIs and cholesterol levels.

The impact of living with high blood pressure

The real surprise for the researchers came during the follow-up period.

Whilst overall fewer women than men – 1.4 per cent compared to 5.7 per cent – had died or been hospitalised with heart problems, there was an noticeable difference when it came to those who had been diagnosed with high blood pressure in their younger days.

For men who suffered heart problems, there was no significant statistical difference between those who had high blood pressure in their forties and those whose blood pressure was considered normal.

Amongst the women, however, those diagnosed with stage 1 hypertension in their forties were more than twice as likely to go on to develop heart disease than their peers.

Women and high blood pressure

Whilst the authors of the study admit it has its limitations, in that it covered a relatively small geographical area and the demographic was almost exclusively Caucasian, it should certainly act as a cautionary tale for women in their forties and their doctors.

The jury is out on whether women with higher blood pressure in their 40s should be prescribed anti-hypertensive drugs, as currently these are only prescribed to those with other conditions, such as diabetes, or those with stage 2 hypertension.

But it is certainly important to monitor your blood pressure from your forties onwards. Home blood pressure kits can be useful, but for a true reading you should visit a doctor – they will need to perform at least three checks in order to provide a diagnosis and can refer you to a specialist if required.

For more information or to book an appointment with Dr Konrad Grossier, please call us on 0333 444 1844.

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What may have caused Christian Eriksen to collapse on the field?

The world looked on in horror as Danish footballer Christian Eriksen collapsed during his Euro 2020 match against Finland.

At 29 years of age and unquestionably fitter than the vast majority of his peers, Eriksen is not exactly a poster boy for heart problems. So, what could have caused the footballer to suffer a cardiac arrest?

Heart attack versus cardiac arrest

We think of heart attacks as something that happen to older people, who perhaps lead a sedentary lifestyle, eat a diet rich in saturated fats or smoke. The collapse of an athlete at less than thirty, therefore, sent shockwaves around the world.

However, cardiac arrest is subtly different from a heart attack: In a cardiac arrest, the heart stops pumping blood around the body, which prevents oxygen flow to the brain, causing a sudden collapse.

Conversely, in a heart attack, it is the blood flow into the heart that is stopped, often because of a clot in one of the arteries.

Unlike a heart attack, cardiac arrest is not usually lifestyle-related, but is caused by a heart defect.

Common causes of cardiac arrest

  • Abnormal heart rhythm, also known as arrhythmia. Your heartbeat is controlled by electrical impulses. Usually, these impulses come in a steady rhythm, but for some people that rhythm is unusually fast or slow. This might not cause a problem in itself, but could be a sign of an underlying condition
  • Hypertrophic cardiomyopathy, or HCM. This is a condition which causes the muscles of the heart to thicken, making it increasingly difficult to pump blood around the body
  • Acute myocarditis. This is an inflammation of the heart muscle, often caused by a viral infection

Why didn’t screening pick up a health issue?

Footballers are subject to regular screening for heart conditions – this is not the first time a player has collapsed on the pitch, most famously Fabrice Muamba in 2012 – so some experts have expressed surprise that a problem was not picked up earlier.

Unfortunately, however, no test is infallible. The screenings are carried out every two years in the UK, between the ages of 16 and 25, so Eriksen already falls outside of the screening category in this country at least.

Sometimes the conditions mentioned above don’t present themselves until the player is in their late twenties, or sometimes – as with acute myocarditis – they occur as a result of infection.

At the time of writing, Eriksen was alive and well, but still in hospital undergoing several investigative tests to find out the cause of his arrest.

Get your heart rhythm checked

It may be worth contacting a doctor to find out if you are experiencing any of the following symptoms:

  • palpitations
  • dizziness
  • shortness of breath
  • discomfort in the chest
  • feeling as though you may pass out

As stressed above, this may be nothing to worry about, but it is sensible to be aware of it and to look into any possible causes. For more information or to book an appointment with Dr Konrad Grosser, please call us on 0333 444 1844.

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The ‘heart attack gender gap’: The dangers of CHD

Did you know that coronary heart disease (CHD) kills more than twice as many UK women each year as breast cancer?

Heart disease tends to be something we worry about happening to our husbands, fathers and brothers, but the reality is that it is just as deadly for women. Perhaps even more so because we’re not as aware of it.

In fact, CHD is the single biggest cause of death in women the world over. So why are so many women dying from something that we know is treatable and preventable?

Leaving it too late

Women tend not to recognise the signs of heart disease because they aren’t taught to look out for them. And heart problems can present differently in women compared to men.

So often, by the time a woman turns up in the doctor’s office or at A&E, it is already too late.

Heart attack misdiagnosis

Sadly, it’s not just women themselves who aren’t expecting to get heart problems – a woman is fifty per cent more likely than a man to get the wrong initial diagnosis for a heart attack.

Also, women who have had a heart attack are also less likely than men to be prescribed medication to prevent them having another one.

The medical profession clearly needs to do more to ensure that women get diagnosed and treated quickly, but what can women do themselves to ensure that their heart problems don’t go unnoticed?

Be aware of the warning signs

Heart attack symptoms don’t just differ between genders but can vary wildly from person to person. Which of course is what makes diagnosis so difficult.

Here are some of the most common warning signs to look out for. Be aware that you might not experience all of these, but if you have one or more, you should seek medical attention immediately:

  • Sudden chest pain – or a tightening feeling – that doesn’t go away
  • Pain spreading from your chest to your arm, jaw, back or stomach
  • Dizziness
  • Nausea
  • Shortness of breath

Preventing Coronary Heart Disease in women

Whilst it’s important to recognise the signs of a heart attack, the ideal situation is that you never need to use that knowledge. It is also worth noting that one in five people receive no warning signs at all.

So, what are the main causes of coronary heart disease in women, and what can we do to prevent it?

Risk factors include:

  • High cholesterol
  • High blood pressure
  • Diabetes
  • Obesity
  • Smoking

The good news is that most of these risk factors can be eliminated, or at least greatly reduced, by adopting a healthier lifestyle: giving up smoking, eating a healthy, balanced diet and taking up regular exercise will all give your heart a much better chance at staying fit and healthy.

Cardiac screening

If you are concerned or would like to find out more about your personal risk of CHD, Dr Grosser runs a cardiac screening service, during which factors such as your family history of heart disease, lifestyle choices, medications etc will be discussed.

You will then undergo a series of thorough physical checks to analyse your risk of coronary heart disease.

At the end of the screening process, we will provide you with a detailed report along with advice for both you and your doctor.

For more information or to book an appointment, please call us on 0333 444 1844 to arrange a consultation.

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European Society of Cardiology 2018 Update

I have just returned from the European Society of Cardiology meeting 2018 in Munich Germany and found it very useful. There are some very interesting studies and findings, which I hope to share with you in the next few months.

Read more

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