Statins: Risk of side effects is low, say experts
For most people who take statins to lower cholesterol, the risk of side effects is low compared to the benefits, according to a recent scientific statement.
The American Heart Association (AHA) statement applies to those who — according to current guidelines — are at risk of heart attack and ischemic strokes, which are strokes arising from blood clots.
Statins are drugs that reduce low-density lipoprotein (LDL) cholesterol by blocking an enzyme in the liver.
Around a quarter of adults over the age of 40 years old in the United States use statins to reduce their risk of heart attack, ischemic stroke, and other conditions that can develop when plaque builds up in arteries.
However, up to 1 in 10 of individuals taking statins stop using them because they assume that the drug is responsible for symptoms that they experience, although that may not be the case.
"Stopping a statin," says Dr. Mark Creager, who is director of the Heart and Vascular Center at Dartmouth-Hitchcock Medical Center in Lebanon, NH, and former president of the AHA, "can significantly increase the risk of a heart attack or stroke caused by a blocked artery."
The journal Arteriosclerosis, Thrombosis, and Vascular Biology carries a full report on the research that went into the statement.
Within guidelines, 'benefits outweigh risks'
The statement's authors say that trials have proved that statins have had a major effect on reducing heart attacks, strokes, other cardiovascular diseases, and associated deaths.
Further to this, they reviewed a large number of studies and clinical trials that have evaluated the safety and potential adverse effects of statins.
"Over 30 years of clinical investigation," the authors write, "have shown that statins exhibit few serious adverse effects."
They point out that, apart from a few exceptions, it is possible to reverse the adverse effects of statin use. This should be compared, they argue, with the fact that heart attacks and stroke damage the heart or brain permanently, and they can kill.
They list the exceptions as "hemorrhagic stroke and the possible exception of newly diagnosed diabetes mellitus and some cases of autoimmune necrotizing myositis."
"Thus," they conclude, "in the patient population in whom statins are recommended by current guidelines, the benefit of reducing cardiovascular risk with statin therapy far outweighs any safety concerns."
According to the AHA, the current guidelines recommend the use of statins for the following groups:
- Those who have experienced heart attack, stroke, transient ischemic attacks, or who have a history of cardiovascular conditions such as angina and peripheral artery disease.
- Adults aged 40–75 years old whose LDL cholesterol is in the 70–189 milligrams per deciliter (mg/dl) range and whose risk of having a heart attack or stroke in the next 10 years is 7.5 percent or above.
- Adults aged 40–75 years of age who have diabetes and whose LDL cholesterol is in the range 70–89 mg/dl.
- Anyone aged 21 years and older with a very high LDL cholesterol level of 190 mg/dl and above.
