Statin Side Effects and Risks, Can You Name Them?
Statins are among the most widely prescribed drugs on the market today, and loudly touted for their ability to lower "bad" LDL cholesterol, among other possible benefits. But according to the results of a new survey from St. Louis University School of Medicine, a significant number of patients stop taking statins because of adverse effects. Indeed, statins are associated with serious side effects and potential risks--can you name them?
Statin use is widespread
Approximately 32 million adults age 45 and older take statins, according to the "Health, United States, 2011" report from the National Center for Health Statistics. That's equivalent to about one in four people in that age group, but if you look at the subgroup of men age 65 to 74, one in two take statins.
The new survey, entitled the "Understanding Statin Use in America and Gaps in Education (USAGE) evaluated the attitudes, beliefs, and behaviors of 10,138 individuals age 18 and older (average age of participants, 61): 8,918 (88%) current users and 1,220 (12%) former users. Here's a breakdown of the findings:
- Muscle-relate side effects were reported by 60% of former users and 25% of current users
- Nearly 50% of all survey participants had switched statins at least once
- The main reason for switching statins among current users was cost (32%)
- The main reason the 1,220 former users had stopped taking the statins was side effects (62%), followed by cost (17%) and lack of effectiveness (12%)
- Muscle pain or weakness was reported by 29% of all the participants, both current and former statin users
- Among current statin users, 70% said they had not missed a dose within the last 30 days
The authors of the survey noted that previous research has shown that at least half of patients stop taking statins within one year of starting treatment, and that consistency of use worsens over time.
Side effects and risks of statin use
The Food and Drug Administration (FDA) has stepped in on more than one occasion to issue warnings about the use of statins. For example:
- In June 2011, the FDA warned doctors to no longer prescribe simvastatin (Zocor) at the highest approved dosage of 80 mg because it was linked to an increased risk of muscle damage
- In February 2012, the FDA added warnings to statin labels regarding an increased risk of elevated blood sugar levels and of being diagnosed with type 2 diabetes. A 2010 Lancet study reported that statins can raise the risk of diabetes by 9%. However, a subsequent study published in 2011 reported a 12% higher risk when individuals took intensive-dose statin treatment compared with moderate dose therapy.
- The February 2012 label change also reflected the possibility of statins causing cognitive problems, such as memory loss and confusion.
In addition, other common side effects (occurring in more than 2% of patients) associated with statin use include joint pain, runny nose, insomnia, muscle spasm, nausea, heartburn, pain in the extremities, and urinary tract infections.
In a new study appearing in the June 11, 2012 issue of Archives of Internal Medicine, researchers at the University of California San Diego (UCSD) School of Medicine reported that patients who took low doses of simvastatin reported fatigue and energy as "much worse" after taking the drug. Author Beatrice Golomb, MD, PhD, associate professor of medicine at UCSD, stated in a media release that "occurrence of this problem was not rare--even at these doses, and particularly in women."
The push for more statin use
There's no shortage of studies promoting the cardiovascular benefits of statins, and others have noted that the drugs may have other benefits, such as help prevent cataracts. In addition, there's a push for adding many more people to the list of those who "should" take statins, beyond those who have high cholesterol.
Researchers with the JUPITER study, for example, estimated that more than 11 million older Americans could be eligible for statin therapy because they have elevated levels of hsCRP (C-reactive protein), an inflammatory marker associated with the development of coronary artery disease.
In 2008, the American Academy of Pediatrics revised their guidelines concerning medication use in children with high cholesterol, recommending statin use in kids as young as eight years old. And perhaps the most unusual suggestion of all: in a study published in the American Journal of Cardiology, experts at Imperial College London suggested fast food customers be given a free statin with their meals to help offset the damage from eating fatty foods.
For many people who have high cholesterol, a concerted effort to make lifestyle changes regarding diet, exercise, and stress management could eliminate their need to take statins and thus avoid the side effects and risks, which come from two sides: taking the drugs and being pushed into taking them with the emergence of new markets.
Cohen JD et al. Understanding Statin Use in America and Gaps in Patient Education (USAGE): an internet-based survey of 10,138 current and former statin users. Journal of Clinical Lipidology 2012; 6:208-15
Daniels SR, Greer FR. Lipid screening and cardiovascular health in childhood. Pediatrics 2008; 122:198-208
Preiss D, Sattar N. Statins and the risk of new-onset diabetes: a review of recent evidence. Current Opinions in Lipidology 2011 Dec; 22(6): 460-66
Sattar N et al. Statins and risk of incident diabetes: a collaborative meta-analysis of randomised statin rials. Lancet 2010 Feb 27; 375(9716): 735-42