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Use statins? They do you more good than harm, says study

The risks surrounding the use of cholesterol-control drug statins have been exaggerated and users should be aware of the "devastating" consequences for those that have stopped using them, a study has found.

A major review of the use, safety and efficacy of statins, which are used to reduce "bad" cholesterol and anyone at risk of developing cardiovascular diseases such as heart attacks and strokes, found that the absolute benefits of statin therapy outweighed the risks of any adverse side effects of the drugs.

"Statin therapy has been shown to reduce vascular disease risk during each year it continues to be taken, so larger absolute benefits would accrue with more prolonged therapy, and these benefits persist long term," the review, authored by Professor Rory Collins from the University of Oxford's Nuffield Department of Population Health, said.

"The only serious adverse events that have been shown to be caused by long-term statin therapy—ie, adverse effects of the statin—are myopathy (defined as muscle pain or weakness combined with large increases in blood concentrations of creatine kinase), new-onset diabetes mellitus, and, probably, hemorrhagic stroke," the study noted, adding that the number of people potentially affected by adverse side effects was small.

"Statin therapy may cause symptomatic adverse events (that is, muscle pain or weakness) in up to about 50–100 patients (ie, 0•5–1•0 percent absolute harm) per 10 000 treated for five years."

The medical review, published in The Lancet medical journal on Thursday, stated that other scientific studies into statins had overlooked their positive effects: "Claims that statins commonly cause adverse effects reflect a failure to recognize the limitations of other sources of evidence about the effects of treatment."

A man holds an anti-cholesterol tablet.
BEN STANSALL/AFP/Getty Images
A man holds an anti-cholesterol tablet.

Statins work by inhibiting the production of an enzyme involved in cholesterol production in the liver which can lead to a hardening and narrowing of the arteries and cardiovascular disease (CVD) which can include heart attacks, angina, strokes and coronary heart disease.

The U.S.' Centers for Disease Control and Prevention says that 73.5 million adults in the U.S. have high low-density lipoprotein (LDL) or "bad" cholesterol and that fewer than 1 out of every 3 adults (29.5 percent) with high LDL cholesterol "has the condition under control." People with high total cholesterol have approximately twice the risk for heart disease as people with ideal levels, the center added.

Bad press

Statins have been the go-to tablet of choice to treat or prevent cardiovascular diseases associated with bad cholesterol, as well as doctors advising patients to make healthy lifestyle changes. Statins have received some bad press in recent years, however, with reports of side effects, ranging from muscle pain and memory loss to severe effects such as kidney failure, being reported by the media and attributed to statin use.

However, the study found that placebo-controlled randomized trials "have shown definitively that almost all of the symptomatic adverse events that are attributed to statin therapy in routine practice are not actually caused by it (ie, they represent misattribution)."

"Consequently, any further findings that emerge about the effects of statin therapy would not be expected to alter materially the balance of benefits and harms," the study continued.

In fact, the team behind the study found that the bad reputation of statins could be responsible for unnecessary deaths among people who have stopped using statins because of erroneous reports on their safety.

"It is, therefore, of concern that exaggerated claims about side-effect rates with statin therapy may be responsible for its under-use among individuals at increased risk of cardiovascular events. For, whereas the rare cases of myopathy and any muscle-related symptoms that are attributed to statin therapy generally resolve rapidly when treatment is stopped, the heart attacks or strokes that may occur if statin therapy is stopped unnecessarily can be devastating."

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