For Heart Health, Consider Statins

Cardiologist Scott Shurmur, M.D.

Statins, also known as Hmg CoA Reductase Inhibitors, have been in widespread clinical use as cholesterol-lowering drugs in the U.S. since their introduction in the late 1980s. Within the past 10 or so years, it has become popular, in non-credible publications to criticize statins, citing safety concerns as well as questioning effectiveness. Let’s examine the facts.

There are old notions still being bandied about that statins are dangerous to the liver. This is completely untrue. Statins pose no danger to the human liver and in fact are safer than recommended doses of acetaminophen, which most people know as Tylenol.

Statins can in 10 to 15% of individuals cause muscle achiness, and certain statins are worse than others in this regard. Lovastatin and simvastatin, two of the earliest available statins, have the highest rates of muscle-related complaints. This is likely because they “compete” for metabolism with many other drugs, causing elevated blood levels of these two statins. Supplementing vitamin D will often ease statin—associated muscle aches. A naturally occurring antioxidant known as Coenzyme Q10 or CoQ10, which is often taken for this purpose, has never been shown in a clinical study to be effective.

Statins can increase the tendency for a given individual to become diabetic. However, this is generally in those who are at high risk for diabetes and are already pre-diabetic. In fact, it is likely that statins simply “move up the date” of the diagnosis of diabetes, and the actual effect on blood sugars is quite mild. And, in an odd coincidence, no group derives more benefit from taking statins, in terms of prevention of heart attack and death from heart attack, than those with diabetes. Virtually all individuals with diabetes over 40 years of age should in fact take a statin.
Diabetics of course, are not the only group that benefits from statins. In people who already have suffered heart attacks, statins cut the risk of a second attack nearly in half. Stroke risk is reduced with statin therapy as well, both in those who’ve already had a stroke, and those with no such history.

The American Heart Association and the American College of Cardiology recommend that, among adults aged 40 and older with no prior history of heart attack or stroke, the 10-year “projected risk” of such an event be calculated. This can be done during an office visit to your health care provider. Any individual with a 10-year predicted risk of 7.5% or higher, it is recommended, should then be placed on a statin, to prevent the first occurrence of heart attack or stroke.

So, it appears that, in sum, the benefits of taking statins far outweighs the bad. Talk to your health care provider about whether or not a statin may be right for you. And if one is prescribed, by all means, take it.

Dr. Scott Shurmur is a cardiologist at the Texas Tech Physicians Center for Cardiovascular Health and chief of cardiology at Texas Tech University Health Sciences Center.

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