Statins have far fewer side effects than believed

Large study finds level of intolerance to cholesterol-killing drug is at 9 per cent or lower

PPKDJA A statin tablet emerging from  a  marked weekly blister pack. Alamy
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Statins have far fewer side effects than people think, a large study has found.

The cholesterol-reducing drug is one of the most commonly prescribed drugs in the UK, with about seven to eight million people taking them to cut their chances of heart attack and stroke.

Research suggests that one in every 50 people who take statins for five years will avoid a serious event, such as a heart attack or stroke, due to the medicine.

Despite their coronary benefits, up to half of people stop taking statins cut the dose or take them irregularly due to issues with muscle pain or other side effects such as digestive problems, disrupted sleep and headaches. However, a study published on Wednesday in the European Heart Journal suggests incidents of statin intolerance may be overestimated and wrongly diagnosed.

In the new research, which analysed studies of more than four million people, experts put the true level of intolerance at 9 per cent or even lower, likely between 6 per cent and 10 per cent.

The 'nocebo' effect

Statins are a group of medicines that can help lower the level of low-density lipoprotein (LDL) cholesterol in the blood.

LDL cholesterol is often referred to as "bad cholesterol" and is linked to cardiovascular disease, which can increase the chance of stroke, heart attack and death.

In the study, led by Prof Maciej Banach, of the Medical University of Lodz and the University of Zielona Gora, Poland, on behalf of the Lipid and Blood Pressure Meta-Analysis Collaboration and the International Lipid Expert Panel, experts analysed 176 studies involving 4,143,517 patients worldwide.

People were typically aged about 60 in the study and 40 per cent were female.

Prof Banach said the findings showed that "statins can be used safely in most patients, which is critically important for reducing their cholesterol levels and preventing heart and blood vessel diseases and death"

The most important message to patients as a result of this study is that they should keep on taking statins according to the prescribed dose, and discuss any side effects with their doctor
Prof Banach

"Our findings mean that we should evaluate patients' symptoms very carefully, firstly to see whether symptoms are indeed caused by statins and secondly, to evaluate whether it might be patients' perceptions that statins are harmful — so-called nocebo or drucebo effect — which could be responsible for more than 50 per cent of all symptoms, rather than the drug itself," he said.

"These results clearly show that patients needn't be afraid of statin therapy as it is very well tolerated in as much as 93% [of users], which is similar or even better than other cardiology drugs, including ones for reducing blood pressure and clotting or blocking of blood vessels.

"What is more, patients need to know that statins may prolong their life, and in cases where side effects appear, we have enough knowledge to manage these effectively.

"The most important message to patients as a result of this study is that they should keep on taking statins according to the prescribed dose and discuss any side effects with their doctor, rather than discontinuing the medication."

The researchers found that people who were older, female, of black or Asian background, obese, or suffering from diabetes, underactive thyroid glands or chronic liver or kidney failure were more likely to be intolerant to statins.

People on some drugs, such as for high blood pressure, and those who drink lots of alcohol also had a higher chance of statin intolerance.

Updated: February 16, 2022, 12:05 AM