Saturday, July 14, 2012

Statins - Whoops!

In the late 1990’s my cholesterol was high and my doctor wanted me to take a statin to lower it with the idea of reducing my risk of a heart attack.  I was uneasy about this suggestion - in the past I had been put on drugs that were later un-recommended or taken off the market entirely.  (See “Statistics and the Twenty Year Rule” and “Stilbestrol and Me.”) – so I said, “Let me try diet and exercise instead.”  That is how I got started on a long-term health and fitness project and the creation of this blog.  My cholesterol is now low enough that no doctor would recommend a statin anymore.  In the meantime, the thinking about statins is changing: for people with high cholesterol but no heart disease statins have no benefit and some worrisome risks.

Late Sunday’s “Sound Medicine” featured an interview with science writer Sharon Begley in which she reviewed the latest research in this area. There was so much good information in that short segment that I went back and located the article on which Begley’s remarks were based, “The Cholesterol Conundrum.”  Statins are one of the most widely prescribed – and most profitable – groups of drugs sold in this country.  One-quarter of American adults over 45 take a statin and sales in 2009 were $14.3 billion.  In the case of patients who already have heart disease or have had a first heart attack there is no question that these medications reduce the risk of dying, having a second heart attack, or needing heart surgery.   

But medical practice made a logical leap from this situation, called “secondary prevention,” to the notion that, in healthy people with high cholesterol, statins could prevent a first heart attack.  Unfortunately, this turns out not to be true.  Begley cites recent research indicating that 60 healthy people would have to take a statin for five years to prevent one heart attack and 268 would have to take a statin for five years to prevent one stroke, not much of a return on the financial investment.  But it gets worse.  Statins may increase blood sugar levels and raise the risk of type 2 diabetes.  This group of medications can also cause muscle weakness and a recent animal study indicates that it may make it more difficult to exercise.  In addition, statins can cause cognitive changes, such as confusion and memory loss.  Some patients believe they are getting Alzheimer’s, when it is actually the statins that have caused the symptoms.  Fortunately, these normally go away when the drug is discontinued.

Given the new information, I feel fortunate that I stayed away from statins.  If I ever do get heart disease, that will be another story.

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