Statins: Are They Safe or Not?

Depending upon to whom you listen, medications are either poison or miracles.  Personally, I think the truth is somewhere in between.  I believe there's a large but misguided attempt to label anything natural as better for you than something manufactured by Big Pharma.  After all, as I noted in a recent post earlier this week, would you wipe your behind w/poison oak or poison ivy just because it's natural?  Along those lines, there are those who believe red yeast rice is better & safer than dangerous statins as promulgated by those uninformed lackeys of Big Pharma, us physicians.  But if you read some of the recent literature on red yeast rice, you'll find that its manufacture leaves much to be desired in terms of safety & contaminants (which isn't to say that Big Pharma and even compounding pharmacies are blameless).

While I believe that physicians too easily pull out their pen or tablet/laptop these days to (electronically) prescribe medications, I also believe that some of the onus for the need for stronger & more powerful statins lies at the dinner table in front of the patient.  After all, we didn't become a nation of overweight & obesity by eating healthy.  Yet, when faced with the evidence before us that we need to change our lifestyles, too many of us would rather take the easy way out and pop a pill.  And those of us in busy practices too often find it easier to "treat 'em & street 'em", rather than take the time to explain (over & again) the impact of nutrition & physical activity on our health, cholesterol & atherosclerotic disease risk.

Of course, this makes us easy targets for others to point out the side effects of the poisonous statins we're prescribing: diabetes, elevated liver functions, muscle soreness/breakdown, memory loss, etc.  And so whenever there's an outcry about some new side effect, many patients stop their statins just like that, rather than considering whether the risk is worth the benefit (prevention of some cardiovascular, cerebrovascular or peripheral vascular event).  So it's good to the some good news come out of the statin camp in the form of a review & meta-analysis published online yesterday in Circulation: Cardiovascular Quality and Outcomes, in which the authors concluded that side effects of statins are not at all common.

In fact, the safety profile of simvastatin & pravastatin rank above the rest.  This isn't some small rinky dink study but rather the analysis of data from 55 placebo-controlled trials and 80 active-comparator trials involving 246,955 participants.  Admittedly, use of statins was linked to an increase risk of diabetes, liver function abnormalities and increase in liver functions.  But the overall benefit in terms of clinical outcome from this drug class outweighed the potential for adverse events.  As with all medications, take them as directed if you need them.  But if you can get away w/nutrition & physical activity, why not focus on lifestyle, save your money, & reduce your risk for side effects.

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