THE FUSS ABOUT STATINS…
My Weekly’s favourite GP from TV and radio writes for you
Statins are the most commonly prescribed medicine in the UK. That means lots of people are interested in news about them – good or bad. The newspaper editors know this, so they get far more bad publicity than they deserve.
Statins aren’t given just because your cholesterol is high – except in a condition called FH or Familial Hypercholesterolaemia, where you inherit a tendency to extremely high cholesterol. Without statins, people with FH die from heart disease in their 30s or 40s, even if they have no other risk factors.
For most people, statins are prescribed for one of two reasons. If you have had a heart attack or stroke or have long term conditions like type 2 diabetes or chronic kidney disease, doctors recommend statins no matter what your cholesterol is. For every 1mmol/l you cut your “bad” LDL cholesterol by (say, from 3 to 2) you cut your risk of having, or dying from, a heart attack by a quarter. All these conditions put you at high risk of heart attack and stroke – so the potential benefits are huge.
The other reason for prescribing statins is because you haven’t had a heart attack but your risk is high – more than a 10% chance in the next decade. This is based on lots of factors, including your age, gender, blood pressure, whether you smoke etc. The theory is that the bigger your risk of heart attack, the more you have to gain from statins. Let’s start with some of the concerns with a simple answer. Quite a lot of my patients have heard scare stories about statins and cancer. This one is simple –
STATINS OFTEN CAUSE BLOATING, WIND AND DIARRHOEA WHEN YOU START TAKING THEM – BUT THIS USUALLY SETTLES WITHIN A FEW WEEKS
statins don’t cause any kind of cancer. Yes, people on statins get cancer – but no more often than anyone else. Studies on millions have proved this.
Statins may increase your risk of getting type 2 diabetes. However, scientists who have looked at the risks and benefits are clear. If you’ve been prescribed a statin for any of the reasons I’ve talked about, the benefit from reduction in heart attack and stroke outweighs any negative effect from getting diabetes. Most folk who get type 2 diabetes on statins would have developed it anyway.
Then the big one – muscle aches. There have been hundreds of headlines about people crippled by muscle pain from statins. But don’t believe everything you read. It turns out that when people are given statins or a “placebo” (fake tablets with nothing in them) and don’t know which they’re taking, they complain of muscle aches at the same rate. But when warned they’re taking statins and might get muscle aches, the number of folk who complain of pain goes through the roof. It’s called the “nocebo” effect – if you think you’ll get a side effect, you will. Or, of course, every ache and pain you get (and most of us get them sometimes) is put down to the poor old statin. Would I prefer not to prescribe so many statins? Of course – all tablets have some side effects. I have to prescribe statins to people at high risk of heart attack and stroke. There’s no doubt that people with type 2 diabetes or a heart attack need them, as the benefits are huge.
But for many of my patients, lifestyle changes could cut their heart attack risk so that they didn’t need statins any more. I’d rather they gave up smoking, lost weight, started exercising and ate more healthily instead. After all, a regular walk in the park and ditching sweets and the deep fat fryer have no negative side effects! Next Week: Herbal remedies v HRT
IF YOU’RE WORRIED ABOUT YOUR STATIN, DON’T STOP TAKING IT WITHOUT SPEAKING TO YOUR DOCTOR OR YOUR PHARMACIST THE BIGGER YOUR RISK OF HEART ATTACK, THE MORE YOU HAVE TO GAIN STATINS’’ FROM