Statins and the Media

100521expI wrote about statins a few weeks ago, that article was inspired by the pain my wife has been experiencing trying to get her familial hypercholesterolaemia under control. Her difficulty is convincing her GP to refer her for the right tests and make the right prescription. She has weighed up the evidence and decided that if they are appropriate she will take them.

All of that was thrown into disarray when the media recently picked up a small detail from a six month old medical report and published headlines along the lines of “Statins Kill 20% of those taking them”

I will now do my part to put the record straight. The original report was published by the BMJ in October 2013 but soon after it was published peers questioned the conclusions. This is normal, “peer review” is how every respected piece of research gains respect. And equally inaccuracies are highlighted and corrected.

The process worked perfectly in this case and in May 2014 the BMJ published this;

The BMJ and the authors of both these articles have now been made aware that this figure is incorrect, and corrections have been published withdrawing these statements. The corrections explain that although the 18-20% figure was based on statements in the referenced observational study by Zhang and colleagues—which said that “the rate of reported statin-related events to statins was nearly 18%,”3 The BMJ articles did not reflect necessary caveats and did not take sufficient account of the uncontrolled nature of Zhang and colleagues’ data.

You can read the original BMJ statement here.

It was this report, the retraction and correction, that the press picked up and drew its information from to create the “Statins Kill” headline. It is shocking that so many people who are making such a difficult decision over their own health are subjected to headlines like this from editors who are simply looking to sell more papers.

I encourage you all, do your own research, draw your own conclusions, and do not be distracted by shocking headlines.

Should I Fear Statins?

_50859996_m6251313-cholesterol-lowering_drug-splDoctors often prescribe statins for people with high cholesterol to lower their total cholesterol and reduce their risk of a heart attack or stroke. Most people taking statins will take them for the rest of their lives unless they can achieve normal cholesterol levels through diet, exercise, weight loss and nutritional supplements. This can make statin side effects more difficult to manage.

The UK NHS list many side effects of taking statins including;

  • nosebleeds
  • sore throat
  • a runny or blocked nose
  • headache
  • feeling sick
  • problems with the digestive system such as constipation, diarrhoea, indigestion or flatulence (passing wind)
  • muscle and joint pain (see below)
  • a raised blood sugar level (hyperglycaemia)

Uncommon side effects

Uncommon side effects of statins (which may affect up to 1 in 100 people) can include:

  • being sick
  • loss of appetite or weight gain
  • difficulty sleeping (insomnia) or having nightmares
  • dizziness – if you are affected by dizziness do not drive, or use tools or machinery
  • loss of sensation or tingling in the nerve endings of the hands and feet (peripheral neuropathy)
  • memory problems
  • blurred vision – if your vision becomes blurred do not drive, or use tools or machinery
  • ringing in the ears
  • inflammation of the liver (hepatitis), which can cause flu-like symptoms
  • inflammation of the pancreas (pancreatitis), which can cause stomach pain
  • skin problems, such as acne or an itchy red skin rash
  • feeling unusually tired or physically weak

Rare side effects

Rare side effects of statins (which may affect up to 1 in 1,000 people) can include:

  • visual disturbances
  • bleeding or bruising easily
  • yellowing of the skin and eyes (jaundice)

Thats quite a list but do the benefits outweigh the risks? Well researchers at Imperial College looked back at 29 trials involving more than 80,000 patients taking the cholesterol lowering drugs.

They concluded that the chance of experiencing debilitating symptoms like nausea and fatigue were slightly less among people taking statins than for control groups given a placebo.

Now the scientists are calling for drug companies to make it clear on packets that side effects are uncommon so that people are not wrongly dissuaded from treatment. Around seven million people take statins in Britain, a figure that could rise to 12 million under draft NHS guidelines, currently out for consultation, which will advise the majority of men over 50 and women over 60 to take the drug as a precaution.

Health experts have voiced concerns that the side effects could outweigh the benefits for healthy people and I would concur.

The starkly contradictory statements do not inspire confidence and I know from personal experience that many people refuse to take statins based on the many rumoured side effects and the claims you will have to take them for the rest of your life.

If you decide to take statins they take about six weeks to become effective and stabilise your cholesterol levels, the doctor who prescribed them should be checking your blood after about eight weeks to check they are working and that the dose is appropriate. Assuming all is well an annual check-up is usually sufficient to monitor the progress of the drugs and their effect on your system although your doctor may want to test more often if they suspect other problems like Cardio Vascular Disease.

Statins are rarely prescribed without advice that you should check your diet and exercise as these have a significant effect on your cholesterol levels and because of this it is possible to come off statins if your lifestyle has changed enough.

There is a huge amount of advice available to help you decide if you should fear statins and I would recommend you start with The British Heart Foundation.

Whatever you decide to do, stay healthy, do your research and make an educated decision.

P.S. All of the above refers predominately to people who are struggling with high cholesterol as a result of diet, fitness, smoking or drinking. In your research you may learn about “familial hypercholesterolaemia” or FH. Familial hypercholesterolaemia is a monogenic disorder associated with a greatly increased risk of coronary heart disease. Statins are first choice treatment for all patients with FH.

It is important you discover which cholesterol problem you have as it affects your chances that a change of life style of diet might allow you to come off statins at a later date. A good resource on FH is here.