The Statin Debate Rages On
A recent report in Science Daily on a study soon to be published in the Journal of the American College of Cardiology may stir anew the debate over cholesterol-lowering statin drugs.
The study suggests that the formula commonly used to estimate levels of low-density lipoprotein (LDL) cholesterol is inaccurate (you did know it’s only an estimate, right?). This is thought to be of greatest concern to patients at high-risk for heart disease as it may understate their risk for a heart attack or other cardiovascular event.
This is of obvious concern to such patients. My concern, however, is that its message will find its way down the ladder to moderate and low-risk patients and result in even more over-prescribing of cholesterol-lowering statin drugs.
Currently approved statin drugs in the U.S. include Zocor, Lipitor, Crestor, Pravachol, Selektine, Mevacor and Lescol.
Much has been written about the over-promotion of statins for even those with normal cholesterol levels, including by me (see Our Healthcare Sucks). Of particular note is the estimate – derived from the drug manufacturers’ own disclosures – that only 1 in 100 people taking these drugs for prevention will actually benefit, as discussed further below.
But too little attention is paid, as is true in general of American healthcare, to the other side of the equation.
Risks of Harm With Statins
Were these drugs as safe as many doctors would have you believe, this could boil down to a simple financial decision – but there’s more at stake here than your money.
There’s an ongoing dispute within the medical community about the long-term safety of statin drugs (the “statin wars”), although the bulk of mainstream medicine continues to promote them heavily despite these misgivings by their peers.
Indeed, the name of the game in medicine has become to drive LDL cholesterol levels as low as possible. This, of course, increases demand for these products – explaining the pharmaceutical industry’s research and marketing investments to promote such “treat-to-target” cholesterol levels.
A report in Scientific American – “Doubts Emerge on the Value of Very Low Cholesterol Levels” – included this pithy critique of our doctors’ obsession with lowering cholesterol levels:
“The (ACCORD) trial demonstrated the folly of assuming that risk factors must have a causal role in disease, says Robert Vogel, a cardiologist at the University of Colorado, Denver. ‘Short people have a higher risk of heart disease,’ he says. ‘But wearing high heels does not lower your risk’.”
Not only might lower cholesterol not be the holy grail it’s become among cardiologists, but statin drugs have been repeatedly found in clinical studies and case reports to be associated with a range of harmful conditions.
The best known of these is muscle pain and weakness – a substantial concern considering your body’s biggest muscle is your heart.
Many patients discontinue statin drugs because of such side effects, which also include insulin resistance, weight gain, type 2 diabetes, hemorrhagic (bleeding) stroke, insomnia, memory and mood disorders, immune dysfunction and more.
Heart Protection or…?
One probable effect that hasn’t been widely reported yet but that seems eminently plausible is heart failure, especially given the drug’s muscle-weakening effects. This, of course, would suggest that a drug prescribed to protect your heart may actually be harming it.
Statin drugs are very effective at lowering cholesterol, but they also lower the CoQ10 enzyme that’s essential for muscle function. As noted, your heart is your body’s largest muscle.
It’s also your only muscle that never rests. Its energy requirements are constant. It’s crucial for heart strength and longevity that it has a steady source of energy to keep it pumping with a steady and unvarying rhythm.
Statin drugs interfere with this process – and may actually lead to heart failure in those with coronary artery disease – through the following progression to disease (click here for more on this association):