EP171: Angela Hartly Interviewing Doctor Warrick Bishop on Stents and Statins

Welcome to my podcast. I am Doctor Warrick Bishop, and I want to help you to live as well as possible for as long as possible. I’m a practising cardiologist, best-selling author, keynote speaker, and the creator of The Healthy Heart Network. I have over 20 years as a specialist cardiologist and a private practice of over 10,000 patients. Podcast Summary Introduction Dr. Warrick Bishop is a practicing cardiologist from Australia with a passion for patient education in heart health, hosted here by Angela from Healthy Hearties. In this episode, they address a common patient concern: whether statins are necessary after receiving multiple stents, particularly when patients experience side effects like lethargy and don't feel significantly better following the procedure. Key Takeaways: If you've had three stents but aren't feeling better, something may be wrong—consult your cardiologist to rule out stent problems, additional narrowing, heart failure, or other complications rather than assuming it's just the medication. Yes, patients who have had a heart attack, stroke, bypass, or stent placement should take statins because robust scientific evidence over 25 years shows that lowering cholesterol in these high-risk individuals reduces future cardiac events. While high cholesterol alone is not a precise predictor of who will have a heart attack, cholesterol-lowering is critical once disease has been identified and documented. The Odyssey trial found that 75% of patients who believed they couldn't tolerate statins were actually able to take them without side effects, meaning many people unnecessarily avoid therapy that could help them. True statin side effects affect approximately 25% of patients, but it's essential to be absolutely certain the statin is causing the problem before stopping it, as many symptoms may be coincidental. Statin intolerance is dose-dependent, not an allergy, so adjusting the dose, frequency, or switching to a different statin (such as from lipophilic to hydrophilic formulations) can often resolve side effects. Strategies to manage statin side effects include taking alternate-day doses, reducing frequency to 2-3 days per week, combining with complementary cholesterol-lowering agents like ezetimibe, or trying coenzyme Q10 supplementation. Different statin formulations—even generic versus brand versions of the same drug—can produce different side effects due to varying inactive ingredients and fillers. Dr. Warrick offers approximately 150 podcasts on heart health topics, available free through the Healthy Heart Network app, providing accessible education for patients wanting to learn more about their condition and treatment options.