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Thursday, March 1, 2012

Statin Benefits vs Safety

Earlier this week this week the FDA issues new changes to the safety labels of statin medications.

There are a few things I want to clarify.
  • Statins overall are safe. 
  • Statins work. 
They are extremely effective in lowering cholesterol levels. There is very strong evidence that they help in reducing the risk of recurrent cardiac events in patients who have suffered a heart attack, in patients with established coronary artery disease, and in patients with vascular disease. They have also been shown to help prevent the development of symptomatic heart disease. They have even been shown to induce cholesterol plaque regression in the walls of the arteries. 

Despite the new labeling I will explain below, the take home message needs to be stressed: The risk vs. benefit ratio supports the use statin therapy in combination with lifestyle modification to prevent cardiovascular events, as the benefits of statins continue to outweigh any associated risks. Please remember this as you continue reading.

The new changes to the labeling of statins include the following:
  1. It is no longer recommended to to periodically monitor liver enzymes. The risk of liver enzyme abnormality is extremely rare and unpredictable and routine screening does not seem to help.
  2. Some patients seem to develop memory loss or forgetfulness. These symptoms are not permanent and are reversible after discontinuation of treatment
  3. There does appear to be a potential increase in blood glucose levels. This may increase the chance that a patient be classified as diabetic while on this medication. But remember, the cardiovascular benefits of statins outweigh the small increased risk associated with increases in blood glucose levels. 
Remember, that the overall benefit of statins + lifestyle have towards preventing cardiovascular events far outweigh the rare increased risk of the above side effects.

Please do not stop your statin medication without discussing with your physician first.

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