Truth behind statin miracle
Docs give mixed reactions on the effects
In recent times, cholesterol-lowering statins have been the subject of intense scrutiny and controversy with several studies coming out with contrary findings regarding their efficacy and safety.
A recent study found that statins can stimulate atherosclerosis and heart failure. But cardiologists and doctors from other specialities recommend taking claims of these researchers with a grain of salt. They say that countless large-scale trials in the past achieved a significant reduction of bad cholesterol in patients, decreasing their vulnerability to develop heart disease and stroke. They say side effects manifest in those patients on a very high dose of statins (but doses used in India are pretty low).
However, they agree that statins don’t play a key role in primary prevention of cardiac conditions even though they work well in cardiac patients and people with other co-morbid conditions such as diabetes and hypertension.
Although the body needs cholesterol, too much can lead to plaque buildup on the walls of the arteries.
Apart from stabilising plaque in arteries and preventing them from rupturing, statins inhibit a particular enzyme in the liver and control cholesterol production. Over time, this is expected to decrease cardiovascular disease risk.
Dr D.M.R. Jagannadha Raju, an interventional cardiologist from Varma Heart Care Centre, said only a
fraction of patients taking higher doses of statins may experience some side effects.
“The raging debate over the cholesterol hypothesis and statins starts from the Western countries, where patients are placed on a relatively higher dose of statins compared to India. In my opinion, statins hold no role in primary cardiac prevention in patients with borderline elevated cholesterol levels. However, they play a role in cardiac care management in cardiac patients as well as patients with family history of cardiac disease or highly elevated levels of cholesterol,” said Dr Raju.
Dr K.P. Hema Malini, assistant professor at Department of Cardiology, King George Hospital/Andhra Medical College, said there was no firm evidence in the ongoing studies against the usage of statins.
“Several studies came out with variable conclusions which cannot be believed. Statins are typically very well tolerated. The benefits of statins are manifold in reducing the risk of heart attacks and strokes,” said Dr Hema Malini.
Dr D.K. Baruah, an eminent interventional cardiologist at the Apollo Hospitals in Visakhapatnam, explain ed saying, “The role of statins in lowering the cholesterol cannot be ignored.”