Statins: why you shouldn't stop taking them if they're prescribed
Under 25 years ago, 58,000 Britons took statins - now it's 7 million. With so many people having a vested interest in them, it's hardly surprising the media is always looking for miracle or scare stories to make us sit up.
About 15 years ago, I had a medical rap over the knuckles. Apparently, according to my pharmacy team, I was too free with my prescribing of a group of drugs with 'limited or no proven clinical value'. The drugs were statins, and the only people I was giving them to were
Just a couple of years later, a study called the Heart Protection Study (1) came out. It showed that if you'd had a heart attack or stroke, taking a daily statin tablet a day could cut your chance of another heart attack by nearly one in five, and your chance of dying by 12%. Not long afterwards, other studies showed that many people with type 2 diabetes could cut their risk of heart attack or stroke by well over a third by taking a regular
How things change. Today, I could be successfully sued for medical negligence if I didn't offer every heart attack or stroke patient a statin. Apart from younger women (statins shouldn't be used in
Anyone could have a heart attack - it's just a question of how big your risk is. Your doctor or nurse looks at all sorts of factors, including your age, gender, family history, whether you smoke, your blood pressure and cholesterol. All these add up to a 10-year risk of heart attack or stroke. If this risk is higher than 10%, you'll be offered
The side effects of statins
Most people don't get side effects with statins - but, like every effective medicine, side effects do happen to some people. Estimates on how many people suffer vary wildly - largely because of the placebo (or in this case, the 'nocebo' effect - people who are told they might suffer a side effect are much more likely to complain of it).
For instance, in the landmark Heart Protection Study (1), participants were asked about muscle pain every time they were reviewed, and about 6% taking statins complained of muscle pain at any one visit. However, exactly the same number of people in the placebo group (who weren't taking any active medication but didn't know that) also complained of muscle pain. A later statin study showed a lower level of muscle ache, but again the same number of people in the statin and placebo group complained of it (2). Other studies have seen levels of 10-20%, but there were no comparable figures for patients taking
In the short term, the most common side effects include abdominal pain, diarrhoea, feeling sick, headaches and rash. Most of these are mild and settle within weeks. Most people who get muscle aches are mildly affected - very rarely, these can be a sign of a serious problem, so if yours are severe, do see your doctor.
It's important not to stop your statin if you have minor side effects. The media tells stories of the very rare people who get very severe side effects, including muscle pains and memory problems. But they often don't put these side effects into perspective - the side effects for many people from NOT taking statins are
Even if you are taking a statin, lifestyle changes can greatly improve your chance of avoiding a heart attack. The benefits of keeping your weight down; avoiding smoking; and taking regular exercise (aim
Diet can also make a big difference. A Mediterranean diet - lots of veg and fruit, more fish and olive or rapeseed oil, less red meat and full-fat dairy food - is ideal. While there has been
With thanks to 'My Weekly' magazine where this article was originally published.
1) MRC/BHF Heart Protection Study Collaboration Group. Effects of simvastatin 40mg daily on muscle and liver adverse effects in a 5-year
2) Hsia J, MacFadyen JG, Monyak J, Ridker PM. Cardiovascular event reduction and adverse events among subjects attaining low-density lipoprotein cholesterol <50mg/dl with rosuvastatin. The Jupiter Trial (Justification for the Use of Statins in Prevention: an Intervention Trial Evaluating Rosuvastatin). J Am Coll Cardiol 2011;57:1666-75.http://dx.doi.org/10.1016/j.jacc.2010.09.082
3) Sathasivam S.
4) Moriarty PM, Thompson PD, Cannon CP et al. ODYSSEY ALTERNATIVE: efficacy and safety of the proprotein convertase