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AHA: Statin benefits outweigh risks
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An American Heart Association scientific statement on statin treatment concluded that most adverse effects from the drugs are not serious enough to warrant discontinuing them.
“This scientific statement was based on a careful review of not only randomized trials, but all available data,” Larry B. Goldstein, MD, FAAN, FANA, FAHA, chair of the neurology department and co-director of the Kentucky Neuroscience Institute at the University of Kentucky and a member of the Cardiology Today Editorial Board, said in an interview. “The central message is that the benefits of statins in reducing cardiovascular events such as heart attacks and strokes well outweigh risks in patients who have conditions or characteristics that increase their risk.”
Statins can have a variety of adverse effects with the most serious being muscle or liver injury, according to Goldstein, although the review of research suggests that the risk for statin-induced rhabdomyolysis is less than 0.1% and the risk for hepatoxicity is approximately 0.001%.
Researchers also found that statin therapy may be associated with an approximately 0.2% risk for developing type 2 diabetes, primarily in patients who already have risk factors for it, such as a sedentary lifestyle or obesity.
In addition, the use of statins has the potential to modestly increase risk for hemorrhagic stroke in patients who have already had one, but statins also reduce risk for atherothrombotic stroke, total stroke and other CV events, the authors wrote.
Myopathy, the most common adverse effect of statin therapy, is defined as unexplained muscle pain or weakness accompanied by a creatinine kinase concentration more than 10 times the upper limit of normal. According to the statement, it is rare and the excess risk for it from statins relative to placebo is less than 0.1%.
The researchers noted that muscle symptoms are usually not caused by pharmacological effects of the statin.
According to Goldstein, there is no convincing evidence that statins lead to cancer, cataracts, cognitive dysfunction, neuropathy, erectile dysfunction or tendonitis.
Regarding drug interactions, researchers found that some statins may increase the anticoagulant activity of warfarin, which could necessitate that patients reduce use of the drug. With this exception, statins are the victims of drug interactions and not the perpetrators, according to the researchers.
“Patients and providers should have a thorough discussion of the benefits and risks of beginning statin therapy, as should be done with any medication or treatment approach,” Goldstein said. “Continued study of the risks and benefits of statins in patients with a history of brain hemorrhage would be helpful.” – by Melissa J. Webb
For more information:
Larry B. Goldstein, MD, FAAN, FANA, FAHA, can be reached at larry.goldstein@uky.edu.
Disclosures: The authors report no relevant financial disclosures.
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