Statins – Good or Bad for the Heart

Two million Englishmen are on statins today. And a recent study suggests millions more should be prescribed the medication. But medication is no substitute for a healthy lifestyle, opine several experts.

Statins were first introduced nearly 2 decades ago as medication for people with heart disease. Gaining in popularity, they are today taken by more than two million people in Britain alone, at an annual cost to the NHS of around £730 million. Earlier this year, a National Institute for Health and Clinical Excellence (NICE) study said that another 3.3 million people with at least a one-in-five chance of developing heart disease in the next 10 years – are ready to start on statins. This was supported by another study published last week which stated that most middle-aged men and older women in Britain should be on statins.

These medications save nearly 6,000 to 7,000 lives every year against a heart disease fatality rate of 280,000 people annually. Dr. Anthony Wierzbicki, Chairman of the Medical and Scientific Committee of the Charity Health UK believes statins are among the greatest advances in cardiovascular medicine of this century because of their ability to reduce a cardiovascular event by nearly one third to a half.

The 2001 Heart Protection Study conducted by The British Medical Council and British Heart Foundation conducted was the first to deduce that statins reduce the chances of heart attacks and strokes not only in people with a history of heart disease, but even for those with other vascular diseases or diabetes, even if they had low or normal cholesterol levels. Dr. Wierzbicki commented, "As more evidence of benefit comes in, we drop the target levels, which results in higher doses of statins being prescribed and more people put on them. We are probably getting close to the final threshold now. In certain high-risk individuals, it may be worth dropping levels further, but for the vast majority, it will not be worthwhile.”

Tom Sanders, Professor of Nutrition and Dietetics at King's College London, while being pro-statin for people at higher risk or above 60 years of age, also wonders if things have already gone too far. The problem he feels is that statins are today being prescribed to much younger people who are at much lower risk and therefore stand the chance of an extended exposure. His opinion is that this could lead the drug to become potentiated and cause certain unexpected problems.

Very rarely, statins can lead to rhabdomyolysis – a muscle breakdown that can occasionally be fatal. But this side effect occurs in not more than one in 25,000 patients. Certain other patients suffer from liver problems or muscle aches and pains, which affect around two to three per cent.

Studies suggest that problems do not increase with extended use, but personal experiences of patients paint a different picture. Concerns have also been expressed that high statin use is pushed more by pharmaceutical giants that are trying to substitute lifestyle changes with medicine prescription.

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