Statins are widely used drugs to prevent heart disease and stroke.
For fear of side effects – which may exist – up to one in two patients interrupts or modifies their treatment (reduction of doses, irregular doses), which potentially exposes these patients to an increased risk of serious heart problems.
The question of risk was still much debated until now.
However, a meta-analysis published Wednesday in the European Heart Journal, in which we took into account 176 studies on the subject and analyzed the case of four million patients, puts an end to received ideas on the subject. This type of publication brings a priori more robust answers than an isolated study.
The authors of this research point out that statin intolerance is overestimated and overdiagnosed. Patients are more likely to have heart and blood vessel problems, including death, caused by high cholesterol, than to suffer side effects from taking statins.
Until now, various reports and studies indicated that intolerance to statins could vary from 5 to 50%. According to the data compiled by this meta-analysis, it would in fact be 9.1%. The prevalence would be even lower, according to certain international standards.
These results% of patients on statins can be treated effectively, with very good tolerance and without any risk”,”text”:”means that approximately 93% of patients on statins can be treated effectively, with very good tolerance and without any risk “}}”>mean that approximately 93% of patients on statins can be treated effectively, with very good tolerance and without any risksays the study’s lead author, Professor Maciej Banach, of the Medical University of Lodz and the University of Zielona Góra, Poland.
We need to assess patient symptoms very carefullyhe noted.
First, we need to see if these symptoms are actually caused by statins. Second, we need to assess whether patients’ perceptions of statin harm might actually be responsible for more than half of all symptoms rather than the drug itself.
In a study published in 2017 in The Lancet, researchers from Imperial College London said they already believe that several studies on the side effects of statins seem to have convinced people to experience them themselves. This psychological phenomenon is called
Another contribution of the meta-analysis published on Wednesday: the elderly, of the female sex, of black race or of Asian origin, obese or suffering from diabetes, underactive thyroid glands as well as chronic hepatic or renal insufficiency are more likely to be statin intolerant.
Medicines to control irregular heartbeats (arrhythmia), calcium channel blockers (often prescribed for chest pain and high blood pressure) and alcohol consumption also increase the risk of intolerance.
This is very useful information, notes Professor Banach, because in the event of a high risk of intolerance, it may be necessary to decide to reduce the doses or to consider prescribing other drugs than statins.
The researchers recognize certain limitations to their meta-analysis, in particular differences between the patients who participated in the various studies and the lack of information on the quantity of alcohol consumed by some of them.
However, the large number of studies and patients included in this meta-analysis limits the margin of error.
For Professor Banach, the most important message to take away from this study is that
patients should continue taking statins at the prescribed dose and discuss any side effects with their doctor, rather than stopping the medication.