Nav: Home

Statins have low risk of side effects

December 10, 2018

DALLAS, Dec. 10, 2018 -- The cholesterol-lowering drugs called statins have demonstrated substantial benefits in reducing the risk of heart attacks and strokes caused by blood clots (ischemic strokes) in at-risk patients. Since statins are associated with a low risk of side effects, the benefits of taking them outweigh the risks, according to a scientific statement from the American Heart Association that reviewed multiple studies evaluating the safety and potential side effects of these drugs. It is published in the Association's journal Circulation: Arteriosclerosis, Thrombosis and Vascular Biology.

According to the statement, one in four Americans over the age of 40 takes a statin drug, but up to 10 percent of people in the United States stop taking them because they experience symptoms that they may assume are due to the drug, but may not be.

"In most cases, you should not stop taking your statin medication if you think you are having side effects from the drug - instead, talk to your healthcare provider about your concerns. Stopping a statin can significantly increase the risk of a heart attack or stroke caused by a blocked artery," said Mark Creager, M.D., former president of the American Heart Association and director of the Heart and Vascular Center at Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire.

The one exception is if you suddenly begin to pass dark urine, which can be a sign of a very rare problem in which serious muscle injury, called rhabdomyolysis, can result in acute kidney failure. If you see this sign, you should stop your statin and call your healthcare provider immediately. The current review of research included in this statement shows that rhabdomyolysis was seen in less than 0.1 percent of patients on statin therapy.

The most common side effects that patients report are muscle aches and pains. Analyses of multiple double-blind randomized controlled studies of all currently available statins -

at up to maximum recommended doses - have shown that no more than one percent of patients develop muscle symptoms that are likely caused by statin drugs.

While many statin-treated patients do attribute any muscle symptoms they develop to their statins, muscle aches and pains are common among middle aged and older adults and have many causes. Because patients may be uncertain about the cause of these symptoms, and because the patient's belief that their symptoms are caused by their statins could prompt them to stop taking them, elevating their risk for a cardiovascular event, healthcare providers should pay close attention to their patients' concerns and help them assess likely causes.

If there is uncertainty, healthcare providers should consider measuring a patient's creatinine kinase levels, a marker in the blood that could indicate muscle damage. If the creatine kinase levels are normal, the patient may be reassured that muscle damage has not occurred. Not having enough Vitamin D can also cause muscle aches and pains and its levels can be easily measured.

There is another reason that people who are being treated with statins may experience muscle pain - the "nocebo effect" - the expectation of harm from the therapy based on reporting of muscle problems attributed to statins in the press, warnings provided by healthcare providers and in drug package inserts.

Symptoms related to the "nocebo effect" can be severe, and they should never be dismissed by the clinician. The statement suggests trying a lower dose of the same statin drug or trying a different statin drug to see if the patient's symptoms improve. Even so, teasing out the reasons a patient is experiencing symptoms can be difficult.

Statin therapy may slightly increase the risk of diabetes, especially in people who already have risk factors for it, such as a sedentary lifestyle and obesity. However, the absolute risk of new patients being diagnosed with diabetes due to statin use in major trials has been only about 0.2 percent per year.

For people who already have diabetes the average increase in HbA1c (a measurement of how much glucose is in the blood) when taking statins is small and not considered a reason not to prescribe these agents. While diabetes is a major risk factor for heart attacks, heart failure and other cardiovascular events, statin therapy substantially reduces the risk of such events and may be appropriate for patients who already have diabetes.

Although the statement notes no increased risk of a first hemorrhagic stroke with statin use, there may be a slightly increased risk of a hemorrhagic stroke in people who have already had that type of stroke (caused by a rupture in an artery). However, the absolute risk is very small and the benefit in reducing overall stroke and other vascular events generally outweighs that risk.

The authors also reviewed the scientific evidence on other possible statin side effects and safety concerns including liver damage, neurological effects, peripheral neuropathy, cataracts, tendon ruptures and others but found little evidence that statins were associated with a greater risk of these conditions.

Statin drugs work to lower the amount of low-density lipoprotein (LDL) cholesterol - known as "bad" cholesterol produced by the liver. There are many different statins available in the United States, including low-cost generic versions. To determine if statins are appropriate for a patient, the American Heart Association recommends that patients work with their healthcare provider to evaluate the risk of having a heart attack or stroke in the next ten years, using the American Heart Association/American College of Cardiology Risk Calculator.

Depending on a patient's risk score, the patient and healthcare provider should discuss ways to lower it if it is elevated, including lifestyle and diet changes. Statin therapy might be appropriate for you if you fall into one of the following groups:
  • Adults 40-75 years of age with LDL (bad) cholesterol of 70-189 mg/dL and a 7.5 percent or higher risk for having a heart attack or stroke within 10 years.
  • People with a history of a cardiovascular event (heart attack, stroke, stable or unstable angina (chest pain), peripheral artery disease, transient ischemic attack, or coronary or other arterial revascularization).
  • People age 21 and older who have a very high level of LDL (bad) cholesterol (190 mg/dL or higher).
  • People with diabetes and an LDL (bad) cholesterol level of 70-189 mg/dL who are 40 to 75 years old.
-end-
Co-authors are Connie B. Newman, M.D., Chair; Terry A. Jacobson M.D.; Vice-Chair; David Preiss F.R.C. Path. Ph.D.; Jonathan A. Tobert M.D., Ph.D.; Robert L. Page II, Pharm.D.; M.S.PH.; Larry B. Goldstein, M.D., Clifford Chin, M.D.; Lisa R. Tannock. M.D.; Michael Miller, M.D.; Geetha Raghuveer, M.D., M.P.H.; P. Barton Duell, M.D.; Eliot A. Brinton, M.D.; Amy Pollak, M.D.; Lynne T. Braun, Ph.D.; and Francine K. Welty, M.D., Ph.D.

Additional Resources:

The Association receives funding primarily from individuals. Foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations and health insurance providers are available at https://www.heart.org/en/about-us/aha-financial-information.

About the American Heart Association

The American Heart Association is a leading force for a world of longer, healthier lives. With nearly a century of lifesaving work, the Dallas-based association is dedicated to ensuring equitable health for all. We are a trustworthy source empowering people to improve their heart health, brain health and well-being. We collaborate with numerous organizations and millions of volunteers to fund innovative research, advocate for stronger public health policies, and share lifesaving resources and information. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

American Heart Association

Related Diabetes Articles:

The role of vitamin A in diabetes
There has been no known link between diabetes and vitamin A -- until now.
Can continuous glucose monitoring improve diabetes control in patients with type 1 diabetes who inject insulin
Two studies in the Jan. 24/31 issue of JAMA find that use of a sensor implanted under the skin that continuously monitors glucose levels resulted in improved levels in patients with type 1 diabetes who inject insulin multiple times a day, compared to conventional treatment.
Complications of type 2 diabetes affect quality of life, care can lead to diabetes burnout
T2D Lifestyle, a national survey by Health Union of more than 400 individuals experiencing type 2 diabetes (T2D), reveals that patients not only struggle with commonly understood complications, but also numerous lesser known ones that people do not associate with diabetes.
Type 2 diabetes and obesity -- what do we really know?
Social and economic factors have led to a dramatic rise in type 2 diabetes and obesity around the world.
A better way to predict diabetes
An international team of researchers has discovered a simple, accurate new way to predict which women with gestational diabetes will develop type 2 diabetes after delivery.
The Lancet Diabetes & Endocrinology: Older Americans with diabetes living longer without disability, US study shows
Older Americans with diabetes born in the 1940s are living longer and with less disability performing day to day tasks than those born 10 years earlier, according to new research published in The Lancet Diabetes & Endocrinology journal.
Reverse your diabetes -- and you can stay diabetes-free long-term
A new study from Newcastle University, UK, has shown that people who reverse their diabetes and then keep their weight down remain free of diabetes.
New cause of diabetes
Although insulin-producing cells are found in the endocrine tissue of the pancreas, a new mouse study suggests that abnormalities in the exocrine tissue could cause cell non-autonomous effects that promotes diabetes-like symptoms.
The Lancet Diabetes & Endocrinology: Reducing sugar content in sugar-sweetened drinks by 40 percent over 5 years could prevent 1.5 million cases of overweight and obesity in the UK and 300,000 cases of diabetes
A new study published in The Lancet Diabetes & Endocrinology journal suggests that reducing sugar content in sugar sweetened drinks (including fruit juices) in the UK by 40 percent over five years, without replacing them with any artificial sweeteners, could prevent 500,000 cases of overweight and 1 million cases of obesity, in turn preventing around 300,000 cases of type 2 diabetes, over two decades.
Breastfeeding lowers risk of type 2 diabetes following gestational diabetes
Women with gestational diabetes who consistently and continuously breastfeed from the time of giving birth are half as likely to develop type 2 diabetes within two years after delivery, according to a study from Kaiser Permanente published today in Annals of Internal Medicine.

Related Diabetes Reading:


by Jason Fung (Author), Nina Teicholz (Foreword)

Dr. Neal Barnard's Program for Reversing Diabetes: The Scientifically Proven System for Reversing Diabetes Without Drugs
by Neal Barnard (Author)

The End of Diabetes: The Eat to Live Plan to Prevent and Reverse Diabetes
by Joel Fuhrman M.D. (Author)


by Alan L. Rubin (Author)

Bright Spots & Landmines: The Diabetes Guide I Wish Someone Had Handed Me
by Adam Brown (Author), Kelly L. Close (Foreword)

The Complete Diabetes Cookbook: The Healthy Way to Eat the Foods You Love
by America's Test Kitchen (Editor), Dariush Mozaffarian M.D. (Editor)

Dr. Neal Barnard's Cookbook for Reversing Diabetes: 150 Recipes Scientifically Proven to Reverse Diabetes Without Drugs
by Neal Barnard (Author), Dreena Burton (Author)

Dr. Bernstein's Diabetes Solution: The Complete Guide to Achieving Normal Blood Sugars
by Richard K. Bernstein (Author)

Mayo Clinic The Essential Diabetes Book
by Mayo Clinic (Author)

Managing Type 2 Diabetes For Dummies
by American Diabetes Association (Author)

Best Science Podcasts 2019

We have hand picked the best science podcasts for 2019. Sit back and enjoy new science podcasts updated daily from your favorite science news services and scientists.
Now Playing: TED Radio Hour

The Next Frontier
Colonizing Mars or more distant planets seems like science fiction. But becoming a spacefaring species may be in our near future. This hour, TED speakers on living beyond Earth--and whether we should. Guests include NASA Chief Scientist James Green, science writer Stephen Petranek, MIT Media Lab researcher Lisa Nip, and astronomer Lucianne Walkowicz.
Now Playing: Science for the People

#508 Freedom's Laboratory
This week we're looking back at where some of our modern ideas about science being objective, independent, and apolitical come from. We journey back to the Cold War with historian and writer Audra Wolfe, talking about her newest book "Freedom's Laboratory: The Cold War Struggle for the Soul of Science".