Are statins a miracle drug or a cholesterol busting con?

They’re the most prescribed drug in the UK, so why are statins still dividing opinion within the medical profession? Grace Hammond reports

Statins reduce cholesterol and the risk of heart attacks, but what are the side effects?

They can substantially reduce the risk of heart attacks and strokes, may stave off dementia, and could even boost your sex life. What’s not to like about statins.?

Well according to a group of leading clinicians, quite a lot. The president of the Royal College of Physicians and a former chairman of the Royal College of General Practitioners among others this week wrote to Health Secretary Jeremy Hunt after the National Institute for Health and Care Excellence (NICE) called for increased use of the drug.

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They not only claim the guidance is based almost entirely on studies funded by the pharmaceutical industry, but point to other studies which paint a rather less glowing picture, including one which shows statins can increase the risk of diabetes in middle aged women. It’s the latest chapter in a long running row which has polarised opinion. On one side sits NICE; on the other are the likes of GP Dr Malcolm Kendrick, author of The Great Cholesterol Con, who insist that statins are responsible for muscle and abdominal pain, irritability and skin problems. According to Dr Kendrick while the drugs “are moderately good at reducing the likelihood of dying from heart disease, in anybody else, the downsides outweigh any benefits”.

So what’s the truth?

Statins have certainly been found to significantly cut the risk of heart attack and stroke - the world’s largest study of cholesterol-lowering drugs at Oxford University concluded that taking a statin a day reduces such risk by a third. In April, Taiwanese researchers also found that patients prescribed statins were 22 per cent less likely to suffer dementia than those who never took them.

It’s also claimed that the drugs could ease some MS symptoms, and protect diabetics against cardiovascular disease . One US study even found they may even help men with impotency.

Professor Peter Sever, from Imperial College London’s International Centre for Circulatory Health, led one trial in which 5,000 patients took statins and 5,000 took a placebo. The statins group were found to have a third reduced risk of heart attack and a quarter reduced risk of stroke. He says: “Stroke and heart disease are the world’s most common cause of death and disability, and here we have a drug which is affordable, and cost effectiveness analyses have shown that it’s one of the best and effective interventions that we have in modern medicine.”

Like all medicines statins can cause side effects, but Dr Kendrick and many others fear the downsides have been underplayed. He says the most common adverse effects are muscle and joint pains, weakness and difficulty standing, but adds there use may also lead to irritability and anger, and cognitive effects which make concentrating and remembering difficult, possibly even mimicking the onset of dementia. Upset stomachs and abdominal pain can also occur, he says, as can skin problems, such as eczema, dermatitis and rashes.

“There’s a really wide spectrum of problems,” Dr Kendrick adds, “and I tend to tell patients that statins add 15 years to your life - they don’t make you live 15 years longer, but they make you feel 15 years older.”

He insists that adverse effects from statins are “extremely common” and claims that pharmaceutical companies don’t release data on the topic, while clinical studies are carried out on “artificial groups of people” who don’t reflect the type of patient who’d take statins in real life.

“If you’ve already had a heart attack or a stroke, or are at very high risk of them, then I think it’s worth taking a statin,” he says. “But be careful, and look for the adverse effects.”

“If people on statins do begin experiencing typical side effects, it’s quite likely that it’s the statin that’s causing it”.