Statins: side effects and potential risks

Statins are one of the most widely studied groups of drugs and they are generally considered very safe. Hundreds of thousands of people worldwide are prescribed statins to reduce their blood cholesterol level. This makes it less likely that fatty deposits will build up on the inner surface of their arteries. In recent years, there has been a tendency for more people to take statins for very long periods, even if their risk of heart disease is not that high. This has prompted some experts to ask if statins side effects should be weighed more carefully against their potential benefits.

This article on statins is by Kathryn Senior, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites.

What are statins?

Most medical experts believe that high cholesterol levels increase your risk of heart disease and strokes. While the body needs a certain level of cholesterol to function, excess levels can cause a fatty build up on the inside of arteries. This can reduce the flow of blood and lead to blood clots. If these occur in the coronary arteries or in the brain, the results can be fatal.

Statins reduce the levels of low-density lipoprotein (LDL) cholesterol in the body. Lowered so-called ‘bad cholesterol’ can prevent atherosclerosis. It may be that statins also damp down inflammation, another key factor in the build up of fatty plaques in blood vessels. Several different statins have been developed and they work in a similar way. Some statins side effects vary, which gives doctors a second or even third choice for people who don’t get on well with their first statin.

Side effects on muscles

The most common statins side effects are muscle pain and weakness; research shows that between 1% and 5% of patients are affected. Many people experience statins side effects as aching shoulders, jaw pain, or aching legs, though these often go unreported as patients tend to put their symptoms down to getting older. If you experience muscle pains as statins side effects, you should consult your GP as these apparently minor symptoms could be a sign of something much more serious.

Statins side effects can cause muscles to breakdown, causing pain as the muscles become inflamed because of tissue damage. As the waste products from dying muscles are released, this can overload the kidneys and lead to a condition called rhabdomyolysis. A common early sign that rhabdomyolysis is developing is that the urine turns red or brown and this should be investigated immediately as it can result in complete kidney failure. Taking statins with vitamin B3 has been found to be particularly effective in lowering cholesterol, but this also increases the risk of muscle problems and subsequent kidney problems.

Side effects on memory

Other commonly reported statins side effects are cognitive losses, such as amnesia and poor concentration. Once again, these often go unreported as people assume they are simply getting old. Memory loss occurs in around 0.5% of statins patients and can vary from spells of unreliable memory to periods of complete amnesia that last for several hours.

The statins side effects on memory can take up to 60 days to appear after starting drug therapy, but can occur after as little as five days. Most people find that statins side effects on their brain are reversible, but a few may suffer permanent cognitive problems.

Other side effects?

As well as the major problems discussed above, there are a range of other, less frequent statins side effects, including:

  • Headaches
  • Constipation
  • Diarrhoea
  • Dizziness
  • Pins and needles, or burning sensations in response to touch
  • Mood changes
  • Sexual problems

Some of these symptoms may indicate nerve damage, which can arise because of statins side effects in people who are particularly susceptible. As statins can damage the nerves and muscles that control breathing and heart function, this is one of the most dangerous of all statins side effects and can have fatal consequences in a small minority of patients.

Side effects controversy

Statins side effects have been at the centre of one scare or another over the last few years, with news headlines reporting the latest research, usually without any context or balanced information. Recent statins side effects scares have included the claim that taking statins increases risk of type 2 diabetes; the results showed that 1 in 255 people treated with statins over 4 years would develop diabetes as a result of statin therapy. Another study suggested that one extra patient in a thousand would develop cancer. It is important to realise that these are real statins side effects but we also need to take into account that, without statins, more people might die of heart disease.

So are side effects worth it?

The British Heart Foundation gives the following advice: “There is overwhelming evidence that lowering LDL cholesterol through statins saves lives by preventing heart attacks and strokes. The benefits of taking statins greatly outweigh any potential risks.” This is backed up by the Royal College of General Practitioners, who issue a statement saying that despite the reported statins side effects patients should not stop taking these drugs. They do recommend, however, that it is sensible for GPs and patients are aware of statins side effects so they can be dealt with early.

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