Why, and How, I Started Taking a Low-Dose Statin (For Now)
While on my health journey, I have not taken any prescription drugs. This has been a point of pride for nearly two decades. However, I had one blip on a recent yearly medical exam, and this blip has forced me to reevaluate my staunch resistance to prescription meds. The blip was a slightly lower-than-normal reading on one aspect of my electrocardiogram (ECG) test. This was unusual given my exercise regularity and general good health. My regular physician, who administered the test, tried resetting the sensors on my chest and legs but the results were the same. He said he’d like me to see my cardiologist about this and that it “might be nothing,” but this finding warranted a second, deeper look. He asked that I do this within the next 30 days, which I did.
The cardiologist couldn’t replicate those results on her ECG, saying it was showing normal readings. But she said it had been 2½ years since my last heart scan and stress test and that, just for safekeeping, it would be a good idea to do both. She also mentioned that for most patients who presented a small amount of arterial plaque in one heart vessel (this had shown up on a previous scan, which I wrote about in my book), she would typically put them on a statin. In deference to my avoidance of prescription drugs and my own success in managing my blood lipids without drugs, she didn’t prescribe a statin back then.
New Results
The results of this latest round of tests were mixed. Happily, the artery that had shown the plaque on the previous scan showed no increase in plaque, and my carotid arteries showed zero plaque. However, my overall calcium score for all the heart arteries had increased slightly, even though it was still in the low-risk category.
The stress test, on the other hand, showed remarkable results, which I wrote about recently. It showed a METS score of 15.1 (VO2 max of 53), which is in the top 2% for 50-60 year olds, despite my current age of 75. It also showed a steady heart beat up to 155 beats per minute (bpm), the maximum for the test, and my heart slowed down to 110 bpm within a minute of stopping the test. Thankfully, the ultrasound also showed no irregularities.
So, putting all this into the diagnosis basket, my cardiologist advised me to start taking a low-level statin. She knows about my life and my book and how passionate I am about living healthily and longer. She said the statin would support that effort, helping me stay alive and healthier into my 90s. I was hesitant and told her I would think about it, but I accepted her prescription for the drug.
More Research, More Opinions
Should I take this statin—a prescription drug I might need to take for the rest of my life? This was not an easy decision. As I mentioned earlier, I had prided myself on not taking any drugs. But I really didn’t have an answer for myself without seeking more advice. I asked my primary physician, who administered the original ECG, and he concurred with the cardiologist, which I expected. I then asked a physician in London whom I had seen, who was much more inclined to avoid drugs, and we had a really good, long discussion about the pros and cons, which helped me decide.
She said, first of all, that the choice was mine to make. She explained that statins, in addition to keeping LDL (low-density lipoprotein) cholesterol in check, also had a pretty good track record of lowering the inflammation that comes with aging, so-called inflammaging. I remembered reading about this in Peter Attia’s book, Outlive: The Science and Art of Longevity, but had disagreed with his statin recommendations at the time. I now had to reconsider them given my circumstances.
One area of concern was potential side effects. In a low percentage of people, statins can cause stiff or sore muscles to a heightened degree. I mentioned this to my London doctor and joked that, given the amount of exercise and movement I do, I probably wouldn’t notice the difference, as I am always slightly stiff or sore somewhere in my body. She suggested a small initial dosage that would allow me to see if I experienced any changes in muscle stiffness. In the end, I followed her advice and have been on the statin for over 2 months now.
Follow-up Blood Test
Statins work by causing the liver to produce less cholesterol, particularly LDL cholesterol, the type that is most likely to adhere to artery walls and cause plaque build-up. As such, it is important to get a blood test after a month or two on the statin to see if it is working to reduce LDL and to see if the liver is experiencing any stress with the new biochemical regime.
My previous LDL reading was 91, which is considered normal but not low (over 100 is considered the level where risks get higher). My just-concluded blood test report shows an LDL level of 46, or roughly half of the previous level, and puts me in the low or optimal category. Two doctors both gave me a big thumbs up on the results and said no further action was needed.
So, for now, it is likely I will stay on this low-dose statin and see how things progress. I am not yet sure if I’m getting any “inflammaging” benefits, but those are less measurable. The main message here is that medical recommendations can be managed, as well as accepted or rejected. The choice is yours. A balanced health regime concentrates mainly on prevention but respects modern medicine as well. With my own highly developed preventative health practices as a baseline, to make an informed decision I needed to do my own research, enlist two second opinions, and confront my own resistance to taking any prescription drugs. I’m now glad I did.
