Are statins worth the side-effects?

STATINS ar are the most commonly pre prescribed drugs in the de developed world. And chanc chances are, if you’re not alread already taking one, you’re bein being badgered by your GP to do so. There’s little doubt t that people who have already had a h heart attack or who have unstable a angina (sudden and severe chest pain pains) are safer taking a statin, says Dr A Aseem Malhotra, a cardiologist at Croy Croydon University Hospital. ‘We don’t kn know exactly why statins prevent furthe further heart attacks. But we know they do,’ he says.

But what if you’re n not in this high risk group? New guide guidelines state that you should take a stat statin if you have a 10% risk of a heart at attack in the next ten years.

Up to four out of 10 o of the adult population including mos most men over 60 and women over 65, ha have this degree of risk, it i is claimed.

But these new guidelines brought an un-precedented storm of protest from senior clinicians including the president of the UK’s Royal College of Physicians.

Doctors accused health officials of ‘medicalising healthy individuals while withholding the true level of side-effects’.

One survey showed six out of 10 GPs wouldn’t want themselves or their families treated with statins if they had the 10% / 10-year risk.

You can find out your risk of heart attack with an online calculator (go to

which involves entering basic information such as your age, family history of heart disease as well as blood pressure and cholesterol levels. If you are at 10% risk or higher, the next question is if you should go onto statins.

When deciding whether to take medication you need to consider something called NNT, the Numbers Needed to Treat.

The NNT for a statin is 104: that means to prevent just one heart attack, 104 people with your same risk will need to take a statin. For the other 103, the drug will make no difference.

That is too low a benefit, say many doctors, who point to the potential side-effects. According to the evidence-based medicine website,

thennt.com, statins carry a 10% risk of debilitating muscle damage and 2%risk of developing diabetes.

And there may be other risks: there is concern that drug companies, which have carried out most of the research on statin safety, may have withheld data on side-effects. The protests against statins have infuriated those who back their widespread use, including Rory Collins, head of the Clinical Trial Service Unit at Oxford University. He has said ‘lives will be lost as a result of health professionals misleading people over the safety of statins’ (though he’s since admitted his own findings were based on incomplete data).

The answer ultimately is about pitting the (unguaranteed) promise of future health against worries about side-effects.

‘When we offer statins, we’re less like doctors and more like a life insurance sales team offering occasional benefits, many years from now, in exchange for small ongoing costs,’ says Dr Ben Goldacre, an epidemiologist and medical writer.

‘People differ in what they want to pay now, in side-effects or inconvenience.’