Statins Offer Wide Benefits, With Some Rare, Specific Risks

LEXINGTON, Ky. (March 20, 2012) - The following column appeared in the Lexington Herald-Leader on Sunday, March 18.

Statins offer wide benefits, with some rare, specific risks

Recent changes by federal regulators made to the warning labels on statins have caused concern among many Americans who take these medicines daily to help control cholesterol .

But should these changes cause alarm? The simple answer is no. Statins, a class of drugs that lower cholesterol, do so by inhibiting the enzyme that plays a key role in the production of cholesterol by the liver and other organs.

New labels warn of the rare but serious risk of liver damage, memory loss, confusion, type 2 diabetes and the possibility that statins are not equally beneficial for women. Some statins also can increase the risk of muscle weakness.

Statins are known to be superb in helping curb cardiovascular disease. The risk versus benefit is relatively small.

Studies show that the use of statins might be associated with one new diabetes event per 1,000 person years of statin treatment. On the other hand, during a four-year period, nine vascular events may be prevented with the use of statins for every one incident case of diabetes.

In addition, some studies have suggested that brain function improves and the symptoms of Alzheimer’s are lessened when people use statins regularly. However, this issue needs further observation and research.

Generally speaking, the longer a drug is used by a large number of people, the more anecdotal reports of adverse incidents will appear. Nevertheless, aggressive statin use where indicated by cardiovascular risk saves lives. Patients should speak to their physicians before making any decisions about changing their use of statins. Usage should not change as long as the benefit-to-risk ratio is assessed by the physician and discussed with the patient.

Patients always should be aware of warnings associated with any drugs. The new warning information simply highlights the importance of patients being alert to any symptoms that occur when taking a new medication. Patients also should talk with their doctors to make sure the only drugs taken are those that provide the chance of a substantial benefit, as all drugs have some degree of risk.

Recommendations for healthy cholesterol

• Women and men older than 20 should have their cholesterol checked by a doctor.

• Most people do not show any signs of having high cholesterol.

• Sometimes cholesterol can build up in your heart and cause chest pains.

• You can find out your cholesterol number by getting a simple blood test.

• Your total cholesterol number should be less than 200.

 Dr. Thomas F. Whayne Jr. is a professor of medicine (cardiology) at the University of Kentucky College of Medicine and a physician at the UK Gill Heart Institute.