July 10, 2013
Statins Are Safe, Says Comprehensive Study
Brett Smith for redOrbit.com - Your Universe Online
A comprehensive study review has added to the growing body of evidence indicating the anti-inflammatory drugs known as statins have no significant side effects. The case for statin use is already strong, and some doctors are calling for its widespread use as a preventative regimen.Oxford University epidemiologist Rory Collins caused a stir last year with his presentation entitled, "The Case for Statins in a Wider Population" to the European Society of Cardiology, arguing that more people should be placed on a statin regimen similar to those recommended for aspirin.
The latest study, published in Circulation: Cardiovascular Quality and Outcomes, involved a review of 135 previous drug studies, including almost 250,000 subjects, to determine the safety of seven commercially available statins.
While they found that adverse events associated with the drugs are uncommon, the study researchers from the Netherlands and the United Kingdom did note a 9-percent increased risk of diabetes among long-term statin users. However, a previous study had shown only one diabetes diagnosis for every 250 patients treated with a statin, according to a press release from the journal publisher, the American Heart Association.
"I am concerned that patients may misunderstand this small increase in risk and stop adhering to their medications," said study co-author Huseyin Naci, a research fellow at Harvard Medical School's Department of Population Medicine.
He also added that the benefits of statin use far outweigh the "small increase in diabetes risk."
"Although the benefits of statins clearly outweigh risks at the population level, individualizing such benefits and risks is more difficult," he said. "This brings into sharp focus the importance of identifying the individuals who stand to benefit the most from statin therapy."
Despite mounting evidence showing the benefits of the drugs, some doctors have voiced skepticism about the extended use of statins.
Even Naci admits that "we don't know the long-term effects of statins. If we give it to everyone, then after ten or 15 years we don't know what the slight increased risk of diabetes will amount to."
Current national guidelines advise that patients be prescribed statins based on their cholesterol levels. However, ongoing studies are exploring the potential benefits for patients with chronically high levels of inflammation but low cholesterol levels.
"We already know that the risk associated with elevated inflammation is as large as the elevated risk patients have from having either high cholesterol or high blood pressure," said Dr. Paul Ridker, director of the Center for Cardiovascular Disease Prevention at the Brigham and Women's Hospital. "The question is, just as lowering blood pressure reduces risk, can we generate evidence that reducing inflammation reduces the risk of heart disease."
Most experts advocating the expanded use of statins appear to be focused on patients 40 years and older, yet the American Academy of Pediatrics has recommended increased monitoring of children's cholesterol levels as well, which could also lead to statin use in that population.