Are heart statins safe?
By PROFESSOR RORY COLLINS, Daily Mail - Last updated at 18:13pm on 7th February 2006
They're the wonder drug some believe could eradicate heart disease. But are statins safe
enough to hand out to millions of new patients?
Professor Rory Collins, British Heart Foundation chair of medicine and epidemiology, says:
Statins save lives - it is as simple as that. And the news that they will be prescribed to an
extra two million people is very exciting.
The NHS - which already spends more than £2million a day on these cholesterol lowering
drugs - has been told by the National Institute for Clinical Excellence (NICE) to give them to
people who have a 20 per cent or more risk of developing heart disease in the next ten years.
In real terms, this means the number of people on statins will double - and the number of lives
saved will increase. It's a big step forward for heart health in this country.
In the past, doctors would measure one risk factor and target treatment at that one risk alone.
Each risk factor was assessed on its own merit, rather than part of the bigger picture.
But what we now know is that lowering low-density lipoprotein (LDL) cholesterol has massive
benefits, whether it is high to start with or not, and regardless of other factors.
There are two types of cholesterol in the body. LDL - so-called 'bad' cholesterol - and high-
density lipoprotein (HDL), or 'good' cholesterol. LDL dumps fat in the coronary arteries, where
it narrows the gap through which the heart's blood supply passes. Once the artery is blocked,
a heart attack can occur.
HDL, on the other hand, mops up fat and transports it to the liver, where it is broken down.
Cholesterol is measured in units called millimoles per litre. It tells you how many millimoles of
fat there are for every litre of blood.
Guidelines recommend getting total cholesterol below 5mmols per litre and bad cholesterol, or
LDL, below 3mmols. For every one mmol drop in your LDL cholesterol, you reduce your risk of
heart disease by a quarter.
So if you cut your LDL from 5mmol per litre to four, the relative reduction in risk is the same
as if you reduced them from 3mmol to two. In other words, the important thing is to get bad
cholesterol down, not just aim for a 'safe' level.
Statins work by blocking an enzyme involved in the creation of LDL cholesterol - in effect,
helping the liver to break down and dispose of harmful fats in the blood.
Based on your cholesterol levels, blood pressure, weight, family history and diet, a doctor can
work out your risk of suffering a heart attack or stroke in the next ten years.
You may be put on a statin, depending on the results. But now some patients could be put on
a statin without any need to check their cholesterol.
Let's say a GP is treating someone for cardiovascular disease, or they are at risk of it because
of age, obesity or high blood pressure. It's likely they will benefit from a daily statin, without
having a blood test.
Over the counter
It's also possible to buy statins over the counter. Pharmacies sell one statin, called Zocor
Heart-Pro, at a low dose of 10mg a day. You must fill out a questionnaire before a pharmacist
decides if you can have it or if you must see a GP.
Over-the-counter pills are aimed at those at moderate risk, such as all men over 55 and
younger men - those aged 45 or over - with at least one risk factor, such as obesity. Women
over 55 with one of more risk factors can also buy the drugs.
It's true that statins can cause muscle problems. But there's no convincing evidence that other
side-effects, such as nausea or diarrhoea, are caused by the drugs.
Statins are incredibly well tolerated by the body, they are simple to give and they do not need
doctors to constantly monitor the patient.
They are extremely cheap - prices vary from £5.99 to £12.99 for a month's supply. NICE itself
says they can save the NHS money by cutting costs of treating heart disease.
As with all drugs, it's up to doctors to balance the potential risks against the known benefits.
But giving statins to millions more people is certain to further reduce the death toll from
cardiovascular disease. I'm all for them.
I too took statin drugs (lipitor) combine with (zetia) which works with lipitor but targets the
stomach area where food is broken down rather than the liver as lipitor. I have taken statins
for over two years. Bottom line; all my levels where excellent and I added 5 more years to my
life according to my doctor. However, the bad part is I had extreme muscle weakness and
fatique in legs and all over. The problem with these statins whether lipitor or whatever - there
all statins which do the same thing, they block a very important enzem (coq10)which is
present in every cell in the body. I have tried taking a coq10 supplement 100mg, which are
very expensive supplements to say the least. It didn't really help. So I stop taking the statins
and zetia all together and poof all muscle pain and weakness started to immediately sudside.
On the bad side all my cholestrol levels have increse again and I lost 6 years of life but pain
free. It all boils down to this; quality of life.
- John Monaco, Ballston Spa
Statins affect the muscles and somtimes make it painful to walk.I used statins last year from
February to May and it did lower the level to 3.7. I gave it up until September 2005 but the
level went up to 5.5. My blood pressure is stable with drug and diabetes is diet controlled.I
have again started statins. But it is affecting the legs.
- Jiwan, Luton, UK
I have been trying to raise awareness of the reason for the many side effects of statins for the
past 3 years, but my words have fallen mainly on deaf ears. I took statins for 4 years and was
so badly damaged that I was getting near the end, when I discovered that CoenzymeQ10,
essential in every cell in the body to give access to its energy needs, particularly the heart and
liver, is also lowered besides cholesterol.I have taken supplementary Q10 ever since, buying it
myself. Nice were not aware of this in their latest committee report, even though Merck got 2
patents for dealing with it, and did not publicise them, I have made sure that NICE has a copy.
Q10 naturally reduces with age, statins accelerate the ageing effect, causing failure of
production of necassary substances,eg Carnitine, Insulin?, and causing heart muscle
weakness. This is well known in certain quarters in USA and some work is in progress here,
but it does not get drug company funding, could it harm their sales ??
- Ray Holder, Bournemouth UK