There is a wealth of evidence supporting the use of statins to reduce the risk of atherosclerotic cardiovascular disease (ASCVD). Based on this, the American College of Cardiology/American Heart Association issued new cholesterol guidelines in 2013. They recommend statins as a preventive measure for people ages 40 to 75 years with elevated LDL-cholesterol levels and a higher 10-year risk of developing ASCVD.
There were initial concerns that the new guidelines would result in millions of new patients taking statins and suffering adverse side effects. Fortunately, the risks related to statins are usually not severe, and for most patients the benefits likely outweigh the risks.
Here are some common side effects and what to consider if you are thinking about taking statins to keep your cholesterol readings at healthy levels.
Muscle-related side effects
Muscle symptoms such as pain, soreness and weakness commonly are reported by patients taking statins. More severe side effects, such as myopathy (muscle weakness) and rhabdomyolysis (a breakdown of muscle tissue that can cause kidney damage), occur infrequently and are rarely serious or life-threatening.
Although statin use has been associated with an increased risk of developing diabetes, the incidence is low. While a meta-analysis evaluating 90,000 patients showed that treating 255 patients for four years resulted in one additional case of diabetes, the same statin therapy prevented 5.4 vascular events. These events included nonfatal MI (heart attacks) and death from coronary heart disease.
The Food and Drug Administration (FDA) has stated that cognitive symptoms such as memory loss, forgetfulness and confusion are generally not serious and go away when a patient stops taking statins. Systematic reviews have failed to find an association between statin use and cognitive impairment, and some data suggest a decreased risk of dementia.
Increased liver enzymes
Although liver enzymes can be elevated during statin therapy, the FDA has concluded that these effects are transient, normalize when statin therapy ends and very rarely result in liver injury. Statins also can be safely prescribed for patients with pre-existing, mild hepatic (liver) impairment and nonalcoholic fatty liver disease.
What should you do?
Given evidence supporting the use of statins to lower ASCVD, it is reasonable for people to take statins if they have elevated cholesterol levels and a higher 10-year risk of developing ASCVD.
Although statins do have side effects, they are rarely serious or life-threatening.
If you are currently taking statins and you experience any of the side effects outlined here, be sure to talk to your health care provider. He or she will investigate further and might consider changing the dose of your medication, switching to a different statin or taking you off statins altogether.
If you aren’t taking statins but are a candidate based on the cholesterol guidelines, talk to your provider and decide your next step based on your medical history, background and beliefs. If you don’t have a provider, Providence can help. Look for a provider in your region here.