Few recommendations evoke strong opinions like the subject of statin therapy. It is unfortunate that there is so much misinformation about statins guiding ill informed choices. I hope this brief overview adds more light than heat to the discussion.
The evidence of statin benefit in high risk populations (reduction in death and disability from heart attack and stroke) is overwhelming. That evidence guides our recommendations for statin use in appropriate cases, which we identify using leading edge techniques to identify atherosclerosis.
Our bottom line: If you have atherosclerosis, and you can tolerate them, you should be taking a statin to prevent arterial disease progression and prevent events. Lipid lowering is not the primary endpoint of our approach with statins. Pushing higher doses increases side effects without an increase in benefit.
Though statins can provoke side effects, most commonly muscle aching, a vast majority of us can take them safely with benefit and little or no adverse results. Untreated sleep apnea and low vitamin D can increase the likelihood of muscle aches; correction of these problems reduces these side effects and has other benefits.
The reduction in arterial disease related dementia is far greater than the incidence of cognitive harm from statins. CoQ10 or ubiquinol may reduce these side effects.
Concerns about increasing diabetes risk and insulin resistance are offset by the reduction in risk of heart attack and stroke that is very high in those with insulin resistance, even with a normal blood glucose.
Without personally trying any drug, predicting whether you will tolerate that drug, including a statin, is impossible. The experience of a friend or family member will not predict your experience with statins or any other drug. Predictions of statin intolerance tend to be self fulfilling. Google “nocebo effect.”
Many published articles emphasizing statin toxicity promote the sale of less proven, more costly supplement and other alternatives. Beware of the agenda behind any message.
Intolerance to one statin doesn’t necessarily predict intolerance to all statins. Some side effects disappear with lower doses without reduction in benefit.
If we strongly believe something will harm us, no amount of facts will change that belief. So, if that is the case, let’s just skip the argument and move on. Open minded willingness to consider risks AND benefits of any choice leads to the best outcomes.