By Dr. Eddie Chaloner - Consultant Vascular Surgeon
While drugs can cause muscle, liver and kidney ailments, researchers say these are mild when balanced against prevention of heart problems
The benefits of taking statins outweigh the known side effects associated with them, according to a landmark study from the University of Oxford.
Statins are drugs which lower the level of cholesterol in a person’s blood and they therefore prevent potentially fatal cardiovascular medical emergencies such as heart attacks and strokes.
More than seven million people in the UK take statins every day and patients are often on them for life.
However, their use has been a controversial topic and there has been a long-running debate among experts as to whether the side effects of the ubiquitous drugs outweigh their upside.
A team of researchers from the University of Oxford and the University of Southern California analysed data from 62 studies, involving more than 120,000 patients, and found the pros of statins do exceed the cons.
They found that people on statins were more at risk of certain health conditions than people who do not take the medication.
For example, statins cause 15 more instances of muscle pain, eight more cases of liver dysfunction and 12 instances of kidney problems per 10,000 people. Research shows these figures mean taking statins increases a person’s risk of each condition by 6, 33 and 14 per cent, respectively.
Statins work by inhibiting a process in the liver where an enzyme creates the "bad" cholesterol.
By targeting this reaction at the source, the cholesterol is not produced, but studies have previously shown that interfering with the liver’s natural function can cause organ dysfunction in some patients.
The researchers in the new study say their findings back up previous research which found a link between statins and liver problems, and patients should therefore undergo routine monitoring to identify any signs of dysfunction.
However, the Oxford team said that the risk of side effects paled in comparison to the reduction in risk of a major cardiovascular event.
Figures in the study, published in the British Medical Journal, show statins prevent 19 heart attacks, nine strokes, and eight deaths from cardiovascular disease per 10,000 patients every year.
Analysis found the risk of these events was lowered by 28, 20 and 17 per cent, respectively.
‘Potential harms are small’
"Adverse effects were mild compared with the potential benefits of treatment with statins in preventing major cardiovascular events, suggesting that the benefit-to-harm balance of statins for primary prevention of cardiovascular disease is generally favourable," the researchers write in their paper.
"The absolute increases in the risks of these adverse events were small, and not comparable (numerically or clinically) with the reduction in the risk of major cardiovascular events achieved by treatment with statins.
"The low risk of adverse events caused by statins reported in this review should reassure patients and physicians that the potential harms of statins are small and should not deter their use for primary prevention of cardiovascular disease."
The academics add that the equation also depends on the patient's situation.
For people with existing heart disease, the benefits of statins far outweigh the risk of these effects, but when statins are used preventatively by people without a history of heart disease the balance of treatment might be less favourable.
Professor Sir Nilesh Samani, medical director at the British Heart Foundation, which funded the research, said: "This careful analysis of all available data shows that statins reduce the risk of heart attacks, strokes and death in people without pre-existing heart disease, and there is a low likelihood that they will experience side effects.
"The decision to take statins to reduce the risk of heart and circulatory disease requires a conversation between GP and patient, and the results of this study will help to inform this discussion."
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Published by By Dr. Eddie Chaloner, Consultant Vascular Surgeon
MA(Oxon) BM BCh FRCS(Edin) FRCS (Gen)