Statins May Offer Benefits Beyond Cholesterol Control
You may take a statin to help improve your cholesterol profile, but research suggests that there may be additional benefits, as well as some potential risks, to go along with these widely prescribed medications.
Statins work by inhibiting an enzyme that controls the rate of cholesterol production in the body. The drugs also help aid the liver in removing low-density lipoproteins (LDL or “bad” cholesterol) currently in your bloodstream. In addition to cholesterol control, some researchers contend that the antioxidant and an-ti-inflammatory qualities of statins may help protect against some types of cancers and conditions such as Alzheimer’s disease.
There are those that believe that statins should be taken by most adults, regardless of their risks for heart disease. However, statins’ apparent role in the prevention of cancer and cognitive decline has not been definitively shown in the kinds of studies that would rule out any other explanations. Statins may have some chronic, low-grade anti-inflammatory effect, but the future of this field will depend on randomized, placebo-controlled trials on extravascular conditions (i.e., how the statins’ anti-inflammatory properties affect organs or body systems other than the heart and blood vessels).
At this point, most doctors agree that statins should be used only in patients who have a demonstrated need for the drug, and are not otherwise precluded from taking statins (such as those who have already demonstrated a statin intolerance, for example).
“Statin medications have been very efficacious and clinically effective in lowering the risk of fatal and non-fatal cardiovascular events for men and women with established cardiovascular disease as well as otherwise healthy individuals with one or more cardiovascular risk factors,” says cardiologist Gregg Fonarow, MD, co-director of the UCLA Preventative Cardiology Program. “The benefits of statin medications for most individuals exceed the potential risks.”
Statin side effects
One of the most common side effects of statin use is muscle soreness, though most patients who take statins do not experience such problems. But some research and anecdotal evidence in recent years has shown that some individuals taking the drugs experience some cognitive dysfunction, though a direct cause-and-effect has not been proven in a clinical trial. The label warning notes that the rare memory-loss reaction to statins is seldom serious and usually disappears if the patient stops taking the medications.
“It is unclear that there is actually statin-related memory loss or what the frequency may be, as this has not shown up in the tens of thousands of patients enrolled in carefully controlled trials,” Dr. Fonarow says. “However, there have been occasional reports of memory loss with statins to the FDA, so this warning was added. In these reports the symptoms have generally not been serious and have fully re-solved with stopping the statin. Patients who believe they are experiencing memory loss should discuss this with their physician.”
Statin use has also been linked to changes in blood glucose levels, but Dr. Fonarow explains that any in-creases in blood glucose levels are minor and patients who developed diabetes after starting statin therapy were most likely individuals who already had elevated blood glucose levels in the pre-diabetes range.
“In the majority of individuals prescribed statins there is no discernible change in blood sugar levels,” he says. “In approximately one in every 250 persons treated with a statin there may be an increase in blood sugar that tips them over to a diagnosis of diabetes. Even among apparently healthy men and women, the benefits in terms of cardiovascular event reduction with statin treatment is four to five times greater than the risk of developing diabetes with a statin.
“Even in these individuals that develop diabetes, they have a substantially lower risk of developing a heart attack, stroke, or premature cardiovascular death from statin therapy and are better off.”
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