By Alice Park
A new review confirms the benefits of cholesterol-lowering drugs in lowering heart disease risk, and finds that side effects and risks of the medications are exaggerated, discouraging many who might need the drugs from taking them
Statins have been a major boon to treating the leading cause of death among Americans, heart disease. The drugs, almost all of which are now off patent and available for as little as a few dollars a month, not only lower cholesterol in the blood but may control levels of inflammation that can contribute to heart attacks and stroke.
In a new review of the evidence on statins’ effectiveness, researchers led by Rory Collins, professor of medicine and epidemiology at the University of Oxford, report in the Lancet that concerns about the side effects of statins may be overblown, and that appreciation of the drugs’ benefits are under recognized.
It’s possible, however, that people who are prescribed a statin may also begin exercising, since their doctors likely discussed their heightened risk of heart attack, and some of the perceived muscle pain was simply due to soreness. Studies that reported as many as 20% of statin users reporting muscle pain were also observational, which meant they relied on reports from patients. In the more gold standard trials that compared people on statins to those on placebo and their reports of side effects, those taking the drugs did not report any significantly higher rates of problems than those on the dummy pills. “When doctors say, ‘Look, you can get muscle problems with these drugs, and if you get them come back and we’ll test your blood, lo and behold patients came back and said, I’ve got some aches and pains,” he says.
In reviewing the available data, Collins says statins reduce risk of heart events by about 25% for each unit drop in cholesterol levels, each year the drugs are taken, compared to people not on the medications. He calculated that for people who have already had a heart attack or heart disease, taking statins over five years would lead to 10% fewer heart events while those who are at high risk of having a heart attack but haven’t had one yet would enjoy 5% fewer events over that time.
Collins says that the adverse events associated with statins are real — people have reported not just muscle problems but some memory issues and diabetes as well. These are rare, and while the diabetes risk is the most concerning, doctors need to balance these side effects with the real dangers of heart attack, stroke and other heart-related problems if people don’t take statins and their cholesterol levels remain high.