Hi, Everyone,

I want to spread the word that diet and exercise are vital, but if you are on medications, especially statins (cholesterol-lowering drugs such as Lipitor, Zocor, etc.) DO NOT DECIDE TO STOP THEM until you confer with a WELL-READ PHYSICIAN. I am a typical 57-year-old woman who had been put on Lipitor (for high cholesterol) and Norvasc (for high blood pressure) several years ago--and also told to lose weight and exercise. I was doing well on my diet and exercise program and had no problems with the meds. I lost 30 pounds with only 15 more to go. In June, 2006 I went to a new internist. He felt that I was doing so well with diet and exercise that he told me to stop taking the medications. Three and a half months later I had a heart attack.

Fortunately, there was little damage, and I did not need stents or surgery. However, I was shocked, as many of you have been. I went to be evaluated by Dr. Karol Watson, an expert in women's cardiology and on the board of WomenHeart. To my surprise, she informed me that stopping the statins had probably precipitated the heart attack. She told me about the "rebound effect." Patients usually stop statins on their own--not under doctor's instructions. Sure enough I looked up the statin "rebound effect" and found the study right on the American Heart Association website. As Dr. Watson told me, the "statin rebound study" shows that patients who stop their statins can as much as TRIPLE their risk of a heart attack for at least six months after they stop. In fact, that is exactly what happened to former President Clinton! My heart attack fit the timeline just right.

Why didn't my internist know this or warn me? I don't know. Frankly, I am surprised that the statin drug makers don't really push familiarity with this study. Of course, as soon as I had the heart attack, the attending cardiologist put me right back on Lipitor and Norvasc, among the other post-heart attack meds. I am still eating right and exercising and determined to lose that last 15 pounds. But I will NEVER stop the statins. I am going to have to decide whether to tell my internist diplomatically or simply quietly choose a new one.

I promised the brilliant Dr. Watson that I would get the word out about "statin rebound" via WomenHeart. Although government guidelines recommend that if cholesterol and hypertension can be controlled by diet and exercise alone, it is preferable...don't take the risk! If you need the drugs, take them. Don't do a "Clinton" and decide to stop taking them on your own. And if your doctor suggests you stop them, get a second opinion by a world-class physician such as Dr. Karol Watson.

I hope this helps others. And please let us know if you think you may have been snared by the "statin rebound effect."

Wear Red on Friday.

Healthy Heart to all!

-- Susan

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13 replies. Join the discussion

I was put on Lipitor two years ago, as well as Plavix, Cozaar, Atenolol, and baby aspirin. I was lucky that the Carido Rehab nurses told me never, never stop the Plavix. They have seen it time and time again; patients stop taking Plavix and have a second heart attack or angina. So I haven't even stopped taking that. I did stop taking my Lipitor for a week last year and got my cholesterol checked at the same time. My total Cholesterol went up 80 points! My cardiologist said do not stop taking it. So I started to take it and got my cholesterol checked again and it had gone down that 80 points. I said to the nurse that stuff really works. So I totally agree, don't stop taking those types of medications...they are good for you and keep your heart and arteries functioning. Thanks for sharing.


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I'm new here, about 10 minutes new, and this was one of the first discussions I've looked at and I have to tell you...this is somewhere between depressing and upsetting. Not one doc ever told me that my meds would be forever. In fact, I told my primary care doc that my goal was to get off all meds in less than two years. I've been religious about diet and taking my meds. I lowered my bad cholesterol 90 points in five months and raised my good cholesterol to a very safe and healthy level in the same time frame. If I'm going to be on statins for the rest of my life what is the point of working so hard with diet and exercise? I can achieve the same results with 40 mg of statins instead of 20 mg, eat some almonds an avacados to keep the good stuff up, and bag the rest of the hard work.

Also, my heart surgeon said I would be on Plavix for one to two years max. Now you all are saying that this is forever too. It was my understanding that Plavix was to keep clotting from happening in my new stents only, not to keep everything clear.

To the poster that stopped taking Lipitor and her cholesterol went up 80 points... what would have made you cholesterol go up? Is it in your family health profile? Did you stay on a rigid heart healthy diet and exercise programs during that time? If it's not an inherited problem, did you ask your cardiologist why your numbers went up?

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I have read about the statins However plavix I haven't been told it was forever. Dr Raymond at the Cleveland Clinic wants me to take it for a year.No one has said any longer.

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Hi PamBeall,

That's what I heard too. I looked at the report that was mentioned above and, as I read it, it says statins should not be withdrawn on patients that have been HOSPITALIZED with heart/chest pain. I read that as, if I were taking statins before I was hospitalized that I should continue to take them during my admission.

My cardiologist reduced my statin from 20 mg to 2.5 mg after my hospital stay. My cholesterol continued to drop. I am now concerned about what is considered too low for LDL. My LDL was 65 and my HDL is 50 back at the end of November. This was achieved in a bit less than 5 months. If I continue to lower my LDL, at what point is it considered too low. I have checked and, yes there is such a thing as too low. You need cholesterol for connective tissue regeneration and estrogen/testostrone balance.

Does anyone know what number whould be considered too low?

Thanks for your input PamBeall

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Hi, all. I am the one who began this discussion. No one ever told me, either--that I would be on statins for the rest of my life--until I met Dr. Watson, after my heart attack. Yes, I was on a very stringent diet and exercise program (the Pritikin program, in fact) when I had my heart attack. Feeling this was good enough, my internist (now my ex-internist) stopped both my statins and high blood pressure meds--and this probably caused the "rebound effect" and precipitated my heart attack--according to Dr. Watson.

Here is a quote from Dr. Karol E. Watson, of the UCLA Women's Heart Center on this issue: "Most experts agree that when we start statin therapy we expect it to be for life, (or at least until something better comes along). When I start a statin I tell patiens that there is a well-documented "rebound" effect. The cholesterol levels go much highter than they were before the statin, then slowly come back down over the next several weeks to months. I also warn them about the "rebound" in cardiac events that has been seen. These are life-saving drugs, the benefits last for as long as someone takes the drug. When they stop they obviously no longer get the benefit, and they are likely putting themselves at more risk."

Why take the extra risk? As long I now know the risk, I am staying on the drugs. So far, I tolerate them fine.

I do not know why other doctors are not giving this same information. Furthermore, I am sure that Dr. Watson would not say you should ignore diet and exercise. Coronary artery disease is a complex issue, and all the factors contribute. To think you can just take the drugs and still carry extra weight and not eat healthy makes little sense. Besides, a heart healthy diet is shown to protect against other diseases such as diabetes and cancer.

Dr. Watson bases her comments on current research. Yes, I know the study technically said that the rebound effect was in patients that were HOSPITALIZED with chest pain. I had chest pain while taking the statins, but was not hospitalized. Perhaps I should have been! My doctor dismissed the pain as stress. I was on Pritikin, walking 2-4 miles a day, but when my internist stopped the statins, my cholesterol shot up (perhaps temporarily) but probably enough to trigger a heart attack. I was also under stress at work. So no one can point for sure to any one trigger with 100% certainty. You have to try and study all the pieces--and place your bets.

When I asked Dr. Watson why my internist would stop my statins in the face of the rebound effect (if he was aware of it), she said that technically, he was "following government guidelines...which say that if cholesterol can be controlled by diet and exercise alone, it is preferable." The government does not consider the possible rebound effect. All I can relate to you is MY experience--and I definitely experienced a rebound effect.

I had my heart attack in October, 2006. I am no longer on Plavix. I was having leg cramps that woke me up. These disappeared as soon as my cardiologist discontined the Plavix. Whether the Plavix caused the leg cramps...who knows? Dr. Watson feels that the Plavix is not necessary, as long as you are asymptomatic. But obviously, as her aforementioned quote shows, she feels differently about the statins.

I do know this: I am still exercising and only 12 pounds from my best weight. I take Lipitor, Norvasc and Vasotec. I take Metroprolol only at night, as when taking it in the morning, it made me very sleepy in the afternoon. Taking it at night only solved that. I feel great and feel that I am doing the best I can to help prevent a future event.

I consider my heart attack a blessing disguise. I learned that I do have coronary artery disease and do what I can to accept it and treat it. By the way, when I was put on stains and high blood pressure meds three years ago, that cardiologist never told me that I probably had coronary artery disease! He dismissed my abnormal ECG as a "false positive" common "in women." He told me to take the pills, lose weight and exercise. He was dismissive, and so was I. I thought that the purpose of the Lipitor and the Norvasc were purely preventative.

Looking at that "false positive" stress test which I saved, Dr. Watson pointed out that it "shows a problem in exactly the area" in which I eventually had the heart attack. There are no false positives; just doctors that do not want to look further. Fear of insurance companies? Dismissive of women? I don't know. I can't go back. But now I have all the pieces to look at, including the benefit of hindsight.

I will remain on statins the rest of my life (or until something better comes along, as Dr. Watson said). I also know how important diet and exercise are. No one can point to any one cause of your heart disease with 100% certainly, and if your doctor is doing that, I would question it.

Since the drugs do not bother me, I am going to keep taking them, keep exercising, keep eating tons of fruit, veggies and whole grains--and hope for the best. There are risk factors we can work with; there are others out of our hands: genes, luck and destiny.

Good luck to all,

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Hi again,

I'm still concerned about my meds. When this all started I was diagnosed with a blocked carotid back in July of 2006. At the time my blood pressure was vasilating between 120/80 and 150/80. For the better part of my life 120/80 (which I always had been) was considered normal. Not so now. "New studies show......"(well, you all know).

My LDL cholesterol was 150. Again, not so bad but obviously what I had was sticky and so I had the carotid cleaned out and was discharged as o.k. I was put on 20 mg of Lovastatin and 20 mg of Lisinoprel. In October I had a heart attack and the cardiologist (which I had never seen before) found one 90% block and two 30% blocks. I now have three stents. However, my cholesterol at the time of the heart attack was down to LDL 90 and HDL 38.

This time I was sent home with 2.5 mg of Lisinoprel as my cardiologist felt that my blood pressure was stabile at 120/60 and 40 mg of Lipitor plus Toprel and Plavix. I had a cholesterol check within a month and found I had gone from LDL 90 to LDL 65.

Both times, with the carotid surgery and the heart attack I was given blood pressure meds beyond what I was originally prescribed. The additional BP meds almost killed me both times. With the carotid surgery I spent 26 hours in the ICU because they couldn't get my blood pressure back up. They gave me too much for me just before my surgery. With the heart attack, I was transported from a meeting to the emergency room where I was given BP meds for heart attack and the additional meds sent my BP so low that I went into cardiac arrest.

What I'm trying to say here is that I'm feeling as if my health care is being determined by a chart on the wall. It feels as if every doc, no matter what their background and expertise may be, looks at me, sees someone over 60, checks the latest research, finds me on that research chart and determines my treatment from there. I'm an individual. I have my own beachmarks. It seems obvious to me, and to one or two of my docs, that I don't function well within the "norm" of the latest drug research.

At one time I was a nurse. I know how the medical people discuss us. We are the "kidney in room 201" or "the heart in room 319" We are not, for the most part, judged and treated as individual bodies, but instead are on a very long list of body parts to be treated as body parts.

I think my experience has proved that to me. Why wouldn't the medicos have looked at my heart when they did my carotid. I's not their body part focus. Why didn't the cardiologist have test done for my legs when they saw that I had carotid surgery for a cholesterol block four months before my surgery for cholesterol blocks in my heart. Again, the same reason, it's not their body part. I had to ask my primary care doc to set up that test after I was discharged from the hospital.

Now I'm asking what about these statins? As of three and a half months ago my bad cholesterol was continuing to tumble. Is there a too low point and what is that? Research says? Right there I start thinking this doctor is not treating me but backing my health care and long term wellness into that chart on the wall. It's not working for me. I question everything.

So, my new friends, I would suggest that if think something soesn't sound right or doesn't feel right for you as an individual, ask questions. And keep on asking questions until you get answers that are for you, not the collective. Be a pest, be a pain, be your own best advocate. Don't just blindly accept an answer that sounds like your being treated like "the heart in room 319". Your cardiologist should be your partner in wellness. And, yes, you should be stressing the wellness in discussions with your physicians. That's all about shedding the feelings of being a cardiac cripple and taking back the power in your life.

Bye for now

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Hello There is no evidence that plavix works or benefits after one year. Howver talk to your doctor about it. He may just keep you on it as a profalatic.Take Care Carrie

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Thanks for posting this. I am on a low dose of Crestor and have done extremely well with that in combination with diet and excercise. I will keep this in mind for the future.

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Dear Gottamovemore,

Glad you read this, and please do keep it in mind. I was also on a very low dose of Lipitor (only 10 mg.) when my doctor stopped me--and all hell broke loose. Please, please, all women reading this...if you are on statins and experiencing any problems, do not stop them on your own. They are life-saving medicines. Doctors do not yet know exactly why the rebound effect occurs but I am (luckily) living proof that it does. And so is former President Clinton.

So don't ever stop your meds until you talk to a KNOWLEDGEABLE CARDIAC SPECIALIST. And if your doctor has not mentioned the "statin rebound" effect to you, be sure that YOU bring it up.

If the Crestor is working, keep it up with diet, exercise and you'll be doing yourself and all you love a favor. Move, move, move! I am now up to 5-6 miles of walking a day and have never felt better in my life. If you experience any problems with the Crestor, just don't stop it till you talk to the doctor--and make sure you have a good one.

Remember what Dr. Karol Watson says: "Statins are life-saving drugs, and you should plan to stay on them for the rest of your life--or until something better comes along." And keep up the diet and exercise! It is foolish to imagine that the drugs alone will "save" you!

Good luck, gottamovemore! Keep it up!
Best to all,

Susan A.

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Hi Susan;
I take 5mg of Crestor. My PCP also put me on 100mg of CoQ10. I am having no problems with the statin. Clinton went off of his Zocor and he needed bypass. I was originally on Zocor and taken off when things got better and my LDL went higher than it ever was. I then went on the Crestor and lost 60 pounds putting me at a healthy weight now. I will definitely not go off this time without a lot of questions. It makes sense. Some of us need medication in addition to diet. I too move as well. I also follow the TLC which I got from the National Heart Lung and Blood Institute.

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Hi, Michelle,
I was on a radio talk show today discussing the statin rebound effect. People were calling in and expressing shock and dismay that their doctors never warned them about this. One said that she had stopped her statin on her own and noticed that her LDL did shoot up, but fortunately did not have a heart attack. Her physician never made the connection, but she went back on the statin, again on her own.

I can't figure out why more doctors do not tell their patients, male and female, the facts about statins. Perhaps some discount the study (as one person did on this site) but all I know is, I'd sure rather err on the side of safety than take a risk. It happened to Clinton; it happened to me--we must represent thousands of others. Why the word isn't getting out beats me! I think it is foolish to dispute the advice of a world-class cardiologist with the stature of Karol E. Watson, M.D., on the Advisory Board of WomenHeart and head of the new UCLA Women's Heart Center.

Congrats on losing the 60 pounds! That is the single BEST thing you can do, in addtion to the medication. You are right. Some of us need medication in addition to the diet and exercise. Yes, the site (the National Heart Lung and Blood Institute) is also a wealth of good information on women's hearts. Go and keep moving, Michelle!

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I have 7 stents, inserted in 3 separate procedures over the past 5 years.... I have also had 2 CABGs, 1982, 1995. (I was born with abnormal coronary arteries, and then inherited the family curse of CAD)

I was put on plavix after first stents, and my cardiologist said even though it usually was only continued for a month or two, he wanted me to stay on it forever, mostly as prophylaxis, considering my history.... (he would have preferred warfarin, but I refused it).

There is now some evidence that for those with drug coated stents, stopping plavix can precipitate sudden re-stenosis.. I can't find the original article I read, but my cardiologist confirmed it.....

Before this was published, I had to stop my plavix for three weeks, due to other surgery....

Three months later I had another heart attack, and this time it was one of the coated stents had closed. I don't dare stop my Plavix.

BTW, I also take 80mg/day of lipitor. Statins have benefits far beyond controlling lipid levels.

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Hi Susan;
A radio show is a great media outlet to share this with other Women. I happen to have a female physician who has been treating me for 20 years. When she advised me to get serious about following a low cholesterol eating plan; I shared the NHLBI with her and the material that is available to the public on Heart Disease, High Cholesterol and Hypertension. She asked for more informatoin, so I ordered her a catalogue, which she really appreciated. I am not going to say that I do not cheat sometimes, but most of the time, I am diligent with my plan. I still have 16 pounds to lose to reach a healthy weight and BMI.
I am so glad that I stumbled upon this site. There are so many women who share the same issues and can share their experiences. I plan to keep moving.

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