so after my post the other week about heart issues, I’m going onto statins (and low dose daily aspirin) for the forseeable. Also to keep out of VO2 max zone and not get over my threshold too much..

So the track bike won’t be getting used (it’s now up for sale), but the Consultant, who is a keen road rider, reckons that regular mtb, road, gravel etc all good to continue as is, which is a relief. He was quite blase on the negatives around statins (he takes them too).

keen to hear of people experiences, good and bad please..

Statins have no effect on me other than to reduce the level of blood cholesterol. Don’t believe the hysteria over the side ejects. They are no more problematic than other drugs.

Interestingly that’s what the cardio consultant said too !

Been on statins for 3 months now. Cant notice any difference. Still fat and slow.

Yeah, mine will hopefully be preventative as have some narrowing and plaque…

I’ve been on Atorva and aspirin since July 2016 (MI on beach, dead, defib, air ambulance, stent etc.) plus a couple of other meds.
Had a 95% blocked artery (others were completely clear).
I run a lot more than I ride and my consultant said to definitely continue and keep exercising to get the heart back functioning normally. The MI caused a massive drop in ejection fraction (37% I think I was told – heart failure is somewhere in the region of 50-55%). After 3 months the EF was back up in the normal range so they put it mostly down to shock of the heart muscle.

Anyway, I’ve not really noticed any of the side effects of statins that get banded about, and to be honest they could be attributed to lots of things. I’m sure there is an element of people hearing what the side effects are, starting statins, feeling not quite right and linking the 2 straight away. It could be linked but it’s also equally as likely to be other things.
Some people say when they come off them that any side effects disappear, which again could be maybe put down to fact they know they are no longer on them and so wouldn’t get those side effects.
I’m not saying that’s not what happens as it is perfectly feasible, but what I would say is see how you go on them and if it is really debilitating, ask to switch brands and try another type.

I recently did London Marathon and pb’d again in sub 2:40 so you can still push yourself if you feel able.
Good luck and don’t let it hold you back. Know your body and work to what is comfortable for you but follow the advise of your medical professionals.

alan, that is really insightful, much appreciated. I have about 30% narrowing on one side and they reckon statins will as a minimum stop it developing and more likely reduce it, so seems a decent plan to me ! Slightly worried about recognising threshold and not going too far over it for long. Age 53 and can happily have average HR at 150 for an hour or so energetic mtb and peaking into high 170’s …whilst still talking, so not into VO2 max..

No worries Iain, I’m 44 now, was 41 when it happened. I took it easy for a good few months after before upping my activity levels but that was equally to do with the heart muscle recovering and not wanting to get out of breath.
If you can talk comfortably while exercising then I would say that you are well below VO2 max (I’m not a cardiologist though).
One of the things they mentioned at my cardiac rehab sessions was that if you get to a point where you can’t talk comfortably because you’re working hard, you’re working too hard.
I did stick to this for about 4-5 months before starting to get more comfortable and pushing a bit further, but not too far in one go. Small increases over time is what I aimed for.

Anyway, the upshot of all this is that I’m now functioning at a higher level than before, whether that’s due to the blockage being stented and removed or the better training I’m doing now, I don’t know, but again, don’t let it rule your life. Be sensible in what you do but don’t pass things up because of it. And as always, if you feel unwell or not right, Stop and re-assess.

alan, many thanks, you have cheered me up !

Had a TIA in 2011, been on Simvastatin and low dose aspirin since then. Times were getting a bit longer on my normal loop so thought I was losing muscle strength and visited GP but couldn’t find anything untoward. I eventually came round to the fact that it actually may be an age thing as I’ll be 60 next year…

Was put on BP tablets whendiagnosed, but they were affectingme as BP was getting too low and could feel it when playing 5-a-side and on the bike. So got taken off them and have been fine since. BP ok unless work causes stress.

Hi Iain
If I were in your situation I’d be asking my Consultant what the evidence is for not doing max efforts, so long as you slow down if you start to feel any chest tightness obviously.
I’m a doctor but not a Cardiologist.
I would take the statins but I would also question whether there is anything else I could do to reverse the atherosclerosis. For example, strength training is probably just as good as ‘cardio’ for improving your lipid profile, possibly better IMO. If you’ve been doing quite a bit of endurance type cycling and you still got atherosclerosis then I would seriously think about gaining strength and improving your body composition (not losing weight as a primary focus).

empirical, interesting, many thanks and will certainly ask him around these ideas. As he’s a pretty decent road rider I think he’ll be keen to express ideas.

Problem is most doctors know very little about sports science but feel that it’s within their remit so tend to base their opinions on handed down knowledge rather than evidence.
Check out Barbell Medicine website. They are doctors and athletes and really thorough at assessing evidence.

Im on statins after a bout of chest pain and a visit to AandE..no heart attack but sent for tests as belt and braces, they revealed less than 25% stenosis of mid lad and a calcium score of 2, all other pipes normal, so chest pain was not heart related..was 46 now 48..

Got suggested aspirin aswell but GP said aspirin can cause as much harm as good so i settled on just statins…was convinced i was stiff and achy at first especially sore shoulder tendons, but once i got over my huff and shock of being told i had to take a drug i dont think about it and and cant say i notice any issues..

I replied to another thread on here about it at the time as i was gutted, i was fitter than id ever and took it really personally and was terrified of iminent death…

Now i think im better off than those who have no idea they have some plaque and dont take statins to stablize it and maybe reduce it, as far as i can gather probably most of us will have some artheroma by the time we are 50, a GP told me that…

Never got told to watch my vo2 or not push it..basically they where not worried at all and said its preventative.

That’s helpful, many thanks. I am about 35% narrowing on 2 separate areas on right side, left clear and all else clear, and at 53 a good bit older. His rationale on the VO2 max is that it’s a high risk activity from the point of view of loosening a bit of plaque leading to a blockage. Consultant is a bit younger than me and on statins himself after similar chest pain on zwift a few years ago. He seems pretty relaxed about his plans for me !

I’m on atorvastatin as I’ve got highish cholesterol (I blame my mum – hers was scary high) and also on the T2diabetic naughty-step. No (known) artery narrowing though.

The statin has made no difference to my “athletic” performance; not even cramps/aching muscles.

Been on stations for about 15yrs (inherited high cholesterol) no side effects except for occasional leg aches late at night when I’m tired. Haven’t stopped pedalling until I’m knackered most days.
Good luck.

Problem is most doctors know very little about sports science but feel that it’s within their remit so tend to base their opinions on handed down knowledge rather than evidence.

As a doctor, I think this is generally quite accurate. The specialty of sports medicine applies a bit of science to this problem, but as you say, much of current dogma is anecdotal.

As you can appreciate, large scale studies of exercise in condition A,B,C etc are very difficult to do so most doctors are forced to rely on experience, ‘common sense’ and their own knowledge of physiology (which is likely to be based on an average human being at rest, not athletes). In addition, the vast majority of people who suffer a disease just want to get back to their home lives, and perhaps their job. Very few people actually want to do any exercise, let alone maximal efforts.

That said, we do know there are some conditions which have been studied well (E.g. post-myocardial infarction) and some others where intense exercise is clearly harmful (E.g. https://blog.bhf.org.uk/my-heart-soared-to-265-beats-per-minute-6b79b6cb262a). I support the approach of asking your GP or consultants what they know about exercise in your condition – you may be surprised at the number who actually know quite a lot (within the limits of an incomplete evidence base).

This paper is up to date. It’s worth bearing in mind that many of the recommendations are still only ‘expert consensus’ rather than evidence-based, but it’s probably the best summary you’ll get – at least for cardiac issues.

Can i ask the opinion of the dr’s on this thread with regards to stopping the build up or reversing it..

Ive read lots about it but the bhf say this

“The disease is progressive, and, unfortunately, current treatments can’t melt it away. However, there are things that can be done to slow its developmen and dramatical reduce the chances of a heart attack or stroke.”

Also an opinion on do all of us have some artheroma as we age?..or another way to put it if you as a dr had a small stenosis would you be alarmed

^^^ the cardiology consultant told me on Wednesday that if I get the bad cholesterol number down to below 3 it stops accumulating and if 2.7 ish then the plaque starts to reduce.

This thread is concerning and inspiring at the same time.

I’m 46 and over the last three years I’ve slipped into some very slovenly ways. As a consequence my fitness has nose-dived and I’ve put on some timber. Shoulder reconstructive surgery back in 2016 caused me to take up a sedentary interest that’s been to the detriment of my health.

In the last week or so I’ve resolved to get my fitness back. First step will be cocking my leg back over the bike for some steady rides and making lifestyle changes as I go along – improving eating and sleeping habits mainly.

I had a mid-40’s MOT test at my GP’s last year and all though the results weren’t spectacular I was given no real cause for concern. I was advised to drop my weight and cholesterol. I had an ECG back in 2015 which didn’t reveal anything abnormal.

Well, I shall crack on in the hope my exertions don’t dislodge some plaque, which puts an end to me – I guess there are worse ways to go.

Can i ask the opinion of the dr’s on this thread with regards to stopping the build up or reversing it..

Ive read lots about it but the bhf say this

“The disease is progressive, and, unfortunately, current treatments can’t melt it away. However, there are things that can be done to slow its developmen and dramatical reduce the chances of a heart attack or stroke.”

Also an opinion on do all of us have some artheroma as we age?..or another way to put it if you as a dr had a small stenosis would you be alarmed

Most people have some degree of detectable atheroma after the age of 40 (men) or 50 (women). In fact, there are autopsy studies showing atheromatous plaques in teenagers. In practice there is massive variation, though, with some 80 year olds having no (angiographically-detectable) disease and some 35 year olds having terrible disease in all their vessels.

To answer your last question – at my age (34) I would be a bit worried if a CT or angiogram found some disease. But if I was ~50 (and asymptomatic) I would be less concerned. I’d see what lifestyle measures I could improve, and I’d take a statin in a heartbeat. If a single stenosis is <50% (70% according to some) it’s not thought to be haemodynamically significant so exercise shouldn’t really be an issue. It’s important to note that the risk of plaque rupture and MI isn’t directly proportional to the degree of stenosis, and also that having a high VO2 max is shown to reduce the risk of MI and overall mortality. So I recommend exercise to almost everyone.

Disclaimer: I am a doctor but I’m not your doctor.

superficial, great post, appreciated !

suffered “exercise induced” stable angina some 4 years ago. 80% blockage RDA and 60% LAD.
Doc immediately stuck me on bisoprolol, 75mg aspirin and atvorstatin.
Bloods etc shows cholesterol at 2.1 total, bp 120/80. Stented both of these and had ramipril
added to the mix. fast forward a year and another angina session … 75% blockage in LCX as well.
Stented this too.
Cholesterol now 3 total and bp 95/60 with dizzies every time I stood up – ramipril was a knee
jerk to my stress (hate hospitals at the best of times) induced 140/85 post stent op #3.

Took my self off the ramipril and monitored back to 110/70 – 120/80 kind of range but have
spoken to the doc about this – he’s cool with it.

The beta blockes got stopped by me as I was getting cramps all the time – no issues since
and the doc said that the initial reaction wa just because of the symptoms and really should have
been re-assessed after the angioplasty 🙂

noticed increasing bouts of itchy skin/rashes/lethary and no, I don’t generally do the
whole searching for side effects so really had no idea until my wife checked up on the
statins ! given mine was quite low I stopped taking them but have had regular checks to keep
an eye on it. itcing/rashes/sweats no stopped and cholesterol 2.9 total when last checked.

52 when it first happened and now heading towards 57 – still riding as hard as the feebly
little pins will let me which equates to a max hr of 176 at the moment.

Iain, chill, you’re from ‘fermin’ stock and thus will live to a ripe auld age. 🙂

^^^^ aye, hoping so ! Selling the track bike mind… 🙁

Atorvastatin commences today ! Not ridden much in last week as trying to get my head round ‘non obstructive coronary heart disease’…. but some riding this weekend is planned – Consultant says ride sweet spot (top zone 3/bottom zone 4) and avid VO2 max stuff, so that’s the plan – gravel bike this evening 🙂

Should’ve came to doggers paradise for the sprockets edemo night last night, perfect for auld codgers wi dicky tickers mate! 💪🏻🤣

Haha 😆. Was working late otherwise would have popped down !

Well, a week in and no issues, apart from trying to get my head round coronary artery disease !

Quite a few rides and no side effects, though very early days…

Looks like my GP will be putting me on statins. Cholesterol is 7 ish after my recent MOT check, so need to go and see what he says next week. It’s been a bit raised for a long time, but I better not ignore it – diet is fine though. My mate recently had a heart attack on the bike, and died a few days later, so I better do as I’m told.

Everything else is OK,

aye, better to take preventative meds if at risk I reckon, or at least that’s what I’m doing, albeit with heart disease too !

Well, I’m on atorvastin from today. Explained I’ve cut diary (I drink loads of milk), alcohol and have ordered plant sterol tablets, but doc thinks it’s genetic and I’ll not get my level 7.5 down enough.

Missus is giving me a hard time, but I’ve absolutely no other health issues (other than old injury pains). Still hitting 180 bpm regular and 6 hours plus on the bike. Weight has crept up but that’s been work stress and drinking/not exercising.

Better safe than sorry as my mate recently dropped dead. No symptoms, felt ‘funny’ climbing a local hill, coasted home. Rushed into hospital, stent fitted. Let out literally next day. Chatted with him during week and he felt fine, if a little in shock. Then suddenly dropped dead on the following weekend.

My cholesterol LDL was only 3.2 at diagnosis so not really high, though it appears there may be a genetic root that skipped a generation. I can also ride at 180 plus and do long rides, but have been advised to keep below VO2 max efforts, which for me means HR of 165 max. Finding that ok on road and gravel but limiting on short steep stuff on MTB, when I am used to getting out the saddle and beasting up it, I now have to change down and spin slowly, seated…

I’ve been on Atorvastation and Clopidogrel since Feb and not noticed any difference to my fitness. I’m still able to commute on the bike most days, weather is the only thing that stops me doing it, 44km a day, takes the same time as it’s always taken. Also found out a few weeks ago I’ve got a patent foramen ovale (hole where it shouldn’t be in the heart) which I’ve had since birth. apparently fairly common but not known about  (10-20% of the population).

So even if you’re fit, don’t assume there’s nothing wrong, and do what the Dr’s tell you!