If you hadn’t noticed that the statin bubble had burst, you were probably suffering a statin-induced fuzzy head and hadn’t managed to stay up with breaking news.
Over the past months a flurry of long-term studies have been emerging, driving the last nails into the coffin of one of the most profitable drug classes the pharmaceutical industry has yet seen. Or so it might seem.
Statins are prescribed for the purpose of reducing cholesterol levels which have long been viewed as a major risk factor for heart disease.
How many people know the long-term risks (or benefits, or otherwise) of statins before they take them?
While the scientific edifice for this assertion may largely have collapsed, major health authorities like the US National Institutes of Health (NIH) are much slower to retract their argument that high cholesterol in the bloodstream leads to clogging up of arteries and increased heart attack risk. This misinformed and greatly over-simplified view results in over-prescription of statins, with the US being the number one prescribing nation in the world and the UK the second biggest. Over a million statin prescriptions are filled each week in the UK.
Heart disease risk: so much more than high LDL
If they were talking about more sensitive measurements of C-Reactive Protein (CRP), sub-clinical low-grade inflammation, apolipoproteins profiles or oxidised fractions of very low-density lipoprotein (ox-VLDL), that would be an entirely different issue. But only doctors and practitioners really prepared to look at the totality of evidence, including emerging evidence, are presently using comprehensive cardiovascular risk profiles including some of these emerging markers. To top if off though, statin drugs themselves actually cause atherosclerosis and heart disease…
Pharma won’t give up on statins (and their profits)
Big Pharma, and its servants in health and regulatory authorities, don’t give up so easily. Even the US FDA, while being forced to admit and communicate more evidence of harm, still argues that purported benefits in reducing heart disease outweigh risks, be these kidney, brain, muscle or eye damage, or increased type 2 diabetes incidence. More than that, seemingly outlandish new claims for other ‘spin-off’ benefits keep emerging, helping offset the bad publicity about side effects.
Among the headlines generated recently are:
- “Statins can halve patients’ risk of dying from cancer”. These data were based on observational studies, they were publicised at a conference, generated headlines globally—and have since been contested.
- “Statins may reduce dementia by a third”
2. Common side effects include muscle damage, impaired heart muscle function, liver damage, muscle and joint pain, fatigue, impaired brain function, memory and cognition, loss of libido, depression, and reduced circulating levels of key nutrients such as coenzyme Q10, selenium, glutathione, these and other factors contributing to increased risk of atherosclerosis and heart disease
5. There is no compelling evidence to show any benefits of statins for the very elderly, even though these are among the group with highest rate of statin medication
6. The 2011 Cochrane Review of the evidence from 14 randomised clinical trials (RCTs) showed that only high risk groups might gain some benefit in quality of life, while “Caution should be taken in prescribing statins for primary prevention among people at low cardiovascular risk”.
7. Cochrane changed its conclusion with its review in 2014, recommending statins to all those with raised cholesterol, irrespective of risk. This revised conclusion was largely as the result of the influence of one trial headed by leading British statin advocate, Dr Rory Collins that was likely tainted by his Pharma interests. Additionally, Dr Collins has also tried his best, fortunately unsuccessfully, to bury the views of his scientific critics. The Cochrane review also discounts the importance of side effects—contrary to a gamut of evidence and clinical reporting over years, as well as the requirement to warn patients of such risks on product information leaflets.
8. The evidence that long-term use of statins significantly increases and approximately doubles the risk of type 2 diabetes is unequivocal. Brand new evidence from long-term studies also shows clear evidence that statin use increases the risk of acute and chronic kidney disease.
9. For those who have a low risk of suffering a heart attack, leading British cardiologist Dr Aseem Malhotra argues that a daily apple will do more to protect the heart than using statins.
10. Find out how you can reduce your heart attack risk without using statins by leading metabolic cardiologist, Dr Mark Houston, Associate Clinical Professor of Medicine at Vanderbilt University School of Medicine; Director of the Hypertension Institute and Vascular Biology; and Medical Director of the Division of Human Nutrition at Saint Thomas Medical Group, Saint Thomas Hospital in Nashville, Tennessee.