Statin (Cholesterol) Drugs: Benefits, Side Effects and Risks
Statins for Heart Health
Statin Drugs: Cholesterol Fighters
Statin drugs are important tools in a health care professional's arsenal in the prevention of heart disease, heart attacks and strokes. Along with recommended lifestyle changes, statins are the Number 1 weapon in Western medicine to lower LDL cholesterol levels.
Elevated cholesterol levels, particularly LDL cholesterol, contribute to arteriosclerosis that then may become atherosclerosis. Atherosclerosis leads to chest pain, heart attacks, strokes, and poor circulation to your extremities. Because prevention is preferred over treatment, successful cholesterol reduction can prevent chronic illness and death in the long run.
Treatment with statin drugs is likely to be a lifelong treatment regimen. Even if the medication successfully lowers your blood cholesterol levels to normal limits, you will likely need to continue the medication regimen that brought you success.
Some Pros and Cons of Statin Drugs
Statin Drugs: Benefits
The main benefit of statin medications is the prevention and treatment of atherosclerosis; this is usually accomplished by lowering elevated cholesterol levels. But, as MedicineNet explains, 35 percent of people who have had heart attacks didn't have high cholesterol levels but still had atherosclerosis.
Because the exact mechanism by which statins prevent and reduce atherosclerosis is not yet fully understood statins are often prescribed for people who are known to have other risk factors for heart disease, myocardial infarction, or stroke.
Ideally, beginning to take statin drugs is before high cholesterol levels have had a chance to cause harm to your body's organs and blood vessels. But lowering your cholesterol levels even after atherosclerosis or coronary artery disease has begun is still important in staving off even more chronic diseases -- and statin use not only helps to prevent further atherosclerosis, but also reduces existing plaque formation in your blood vessels.
There are some medical experts who believe that it is possible that widespread statin use in patients could lead to an overall decrease in heart attacks and strokes. Such consideration would have to be weighed against the potential for side effects and any increase in risk of other conditions in each individual.
Researchers who compiled data from the National Health and Nutrition Examination Survey, NHANES, concluded that the use of statin medications by a larger segment of the population from previous decades (from 5 percent to now 15 percent), had reduced the number of deaths by more than 40,000 and prevented 61,000 hospitalizations for heart attacks and 22,000 hospitalizations for strokes in one year -- 2008.
Monetizing the results, researchers determined that for individuals who had begun statin therapy between 1997 to 2008, a "consumer surplus" of over $974 billion was created just in the number of deaths reduced due to successful treatment of LDL levels.
Statins May Inhibit Muscle Repair
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Statin Drugs: Side Effects
There are few, if any, substance that you put into your body that don't have a potential to create side effects. Statin medications are no different and for the most part the potential side effects are mild. There is are two potentially severe side effects; both occur rarely but they have the potential to be deadly.
Potential Mild Side Effects of Statin Medications: Muscle and/or joint aches are the most frequently experienced symptoms. Nausea, vomiting, diarrhea, constipation, and weakness are also potential side effects of this class of medications.
Potential Severe Side Effects of Statin Medications: Liver damage and rhabdomyolysis. Sometimes the use of statin drugs causes levels of enzymes in your liver to increase. If that occurs, your health care provider will need to determine if the elevation of your liver enzymes is enough to warrant discontinuing the statin drug. If so, once the drug is stopped, your liver enzymes will return to their previous levels.
Rhabdomyolysis is a condition in which your muscle fibers actually begin to break down, releasing a protein into the bloodstream that causes kidney damage. Fortunately, both this condition and liver damage are rare occurrences, but if you experience muscle pain or continued muscle aches, consult your health care provider.
In Feb. 2012 the FDA has determined that this class of medications can now remove label warnings related to possible liver injury. The federal agency made this determination that serious injury to the liver is "rare and unpredictable in individual patients."
There are certain prescription medications that if taken together with statin drugs can increase your risk of experiencing the more severe side effects. Be sure your prescribing physician knows all the prescription and over-the-counter medications you are taking. One over-the-counter supplement in particular, niacin, is known to increase the risk of side effects when taking a statin medication.
List of U.S. FDA-Approved Statin Drugs
Statin Potential Drug Risk: Lung Damage
There are some preliminary research results, published in the American Journal of Respiratory and Critical Care Medicine, that links the use of statin drugs by people who currently smoke and people who are former smokers to lung changes called pulmonary fibrosis.
Further research will need to be done to determine if this conclusion is scientifically accurate.
Statin Drug Risk: Diabetes in Post-Menopausal Women
A study of the records of more than 150,000 post-menopausal women revealed that statin use is associated with an increased risk of new onset diabetes in this age group. Whether this risk occurs with the use of all statin medications or just certain statins and dosages was not determined by the particular study.
Kirsten L. Johansen, M.D. wrote that she believes the important implication of this research is that the increased risk of diabetes was the same in women who did and did not have a history of cardiovascular disease, something health care providers will want to take into consideration when balancing benefit/risk factors of statin use in post-menopausal women.
Statins and Cholesterol Management
Get Help with Lowering Your Cholesterol
Warnings Added To Statin Drug Class
Updated Feb. 28, 2012: The U.S. Food and Drug Administration announced that all medications in the statin class of drugs must begin to carry warnings regarding the possibility of memory loss and/or confusion and higher blood sugar levels.
The symptoms of memory loss or confusion have thus far been reported to go away when the statin medication is stopped.
An increased risk of developing type 2 diabetes is associated with the higher dosages of the statin drugs and is a small but real risk.
Cardiologists feel the small risks of side effects are far outweighed by the benefits statin drugs provide to individuals.
Potential Alternatives for Lowering Cholesterol
Drug-Drug Interactions Added to Statin Warnings
On March 1, 2012, the FDA added possible drug-drug interactions with the statin drugs atorvastatin, rosuvastatin, and simvastatin -- as well as renewing the same warning for lovastatin: These medications can interact with protease inhibitors.
Protease inhibitors are medications taken by people being treated for HIV/AIDS and/or hepatitis C. Combining these medications increases a person's risk for muscle injury, including rhabdomyolysis.
This is another reason to be sure you share with all of your health care providers all medications you are taking, including herbal preparations and over-the-counter medications.
Research Suggests Re-Start of Statins Better Tolerated
The Annals of Internal Medicine published results of a cohort retrospective study of more than 107,000 patients at Brigham and Women's Hospital and Massachusetts General Hospital who had all been on statin therapy.
Over a period of time, the statins were discontinued in more than half of the patients. Seventeen percent of those whose statins were discontinued were due to either side effects or clinical events such as abnormal lab reports. Approximately one-third of these people were again prescribed statins within a 12-month period.
Ninety-two percent of those who began taking a statin medication a second time were still taking the medication 12 months later. Nearly 3,000 of those who had statins begun a second time were on the same statin they had previously taken and 1,000 of them were on the same or higher dose of a statin.
Researchers believe the results of the re-start of a statin medication with no side effects or adverse clinical events suggest that some of the adverse effects assigned to the original statin medication may have had another cause, are tolerable, or specific to that particular statin, not the entire class of the drugs.
- Annals of Internal Medicine | Discontinuation of Statins in Routine Care Settings: A Cohort Study
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From Yahoo! News: FRIDAY, Jan. 13 (HealthDay News) -- Widely used cholesterol-lowering statin drugs cost about 400 percent more in the United States than in the United Kingdom, a new study shows.
- Wider statin use could be cost-effective preventive measure, study finds
A new analysis suggests that broader statin use among adult patients may be a cost-effective way to prevent heart attack and stroke. Using a popular test -- a screening for high sensitivity C-reactive protein, or CRP -- to identify patients who may b
- PLoS ONE: Statins Promote the Regression of Atherosclerosis via Activation of the CCR7-Dependent Emi
PLoS ONE: an inclusive, peer-reviewed, open-access resource from the PUBLIC LIBRARY OF SCIENCE. Reports of well-performed scientific studies from all disciplines freely available to the whole world.
- Statins: A Miracle Drug That Could Prevent and Reverse Disease? - Susan H. Scher - Health - The Atla
Long prescribed to reduce levels of cholesterol in the blood, high doses of statins might even end plaque build-up, according to researchers.
- Study: Statins linked with small diabetes risk - Yahoo! News
From Yahoo! News: A new side effect seems to be emerging for those cholesterol-lowering wonder drugs called statins: They may increase some people's chances of developing Type 2 diabetes.
- Medical News: Statins Tied to Lung Damage in Smokers - in Cardiovascular, Dyslipidemia from MedPage
Statin use appears to be associated with interstitial lung abnormalities among current and former smokers, researchers found.
- Statin use linked to more diabetes in women: study - chicagotribune.com
(Reuters) - Cholesterol-lowering drugs known as statins may be linked to an increased risk of diabetes in middle-aged and older women, according to a U.S. study -- but researchers said the benefits of the drugs still make them valuable for people at
The information provided here is not meant to refute or replace advice from a health care professional. This hub is informational only and not intended to diagnose or treat any health issue. Consult your health care provider with any questions or concerns you may have about your specific situation.