A landmark review found that cholesterol-lowering drugs are responsible for less than 10 percent of aches and pains in patients taking them. The symptoms are probably just the natural signs of aging, according to the Oxford University study. The researchers say the results will help patients and doctors “make informed decisions” when considering whether to stop taking their pills. Lead researcher Professor Colin Baigent, an epidemiologist at Oxford, said that if a patient taking statins suffers muscle pain, “it’s more likely to be due to other causes”. “Statin therapy should be continued until other possible causes are investigated,” he added. Statins are the most widely prescribed drugs in the world, taken by around 8 million adults in Britain and 32 million in the US to prevent heart attacks and strokes. However, up to one in three patients stop taking them, partly because of concerns about side effects such as muscle and joint problems. The latest study, published in The Lancet, looked at the rates of side effects in 155,000 patients who received statins or placebos in 23 randomized trials. Statins don’t usually cause muscle pain and weakness, major review finds (file image) Overall, 27.1 percent of patients who received the drugs reported muscle pain or weakness, compared with 26.6 percent of those who received a placebo. After the first year of treatment, there was no difference between those who received statins and those who received placebo tablets. The researchers found that stronger doses carry a slightly higher risk of muscle problems, but most cases are mild.
WHAT ARE STATINS?
Statins are a group of drugs that can help lower levels of “bad cholesterol” in the blood. Too much of this type of cholesterol – called low-density lipoprotein (LDL) cholesterol – can lead to thickening of the arteries and heart disease. Statins work by preventing the liver from producing as much LDL. Previous studies have shown that the drug will prevent one heart attack or stroke for every 50 people who take it over five years. The drug comes as a tablet taken once a day. Most people must take them for life, as stopping will cause their cholesterol to return to high levels within weeks. Some people experience side effects from the drug, such as diarrhea, headache, or nausea. People are usually told to make lifestyle changes in an attempt to lower their cholesterol – such as improving diet and exercise habits, limiting alcohol consumption and quitting smoking – before being prescribed statins. Dr Christina Reith, joint lead author of the study and a researcher at the University of Oxford, said: “Our research shows that while people on statin therapy may experience muscle symptoms, it is important to note that people who do not taking statins often experience such symptoms. “For people on statins who experience muscle symptoms, most of the time the statins will not be the cause. “We hope these results will help physicians and patients make informed decisions about whether to start or continue statin therapy, given its known important benefits in reducing cardiovascular disease risk.” The NHS website lists muscle pain and weakness as two of the most common side effects, along with headaches, sickness, digestive problems, insomnia and low blood platelet counts. But the Oxford team says the tiny risk of muscle pain needs to be highlighted and balanced against the benefits of statins. Professor Baigent said: “Medicine regulators around the world are interested in keeping patients safe. “And until now they thought that doing that was best served with these warnings about the potential for muscle soreness. “What we’ve shown is actually that’s not the best way to serve patients, because patients get that information and the moment they develop muscle pain, they suspect the statin, and that leads many of them to stop the statin, which in reality puts them in a bad way. “And so we need to try to change the balance of that and work with regulators to do a better job of communicating the risks.” Overall, there was a 7 percent increased risk of muscle pain or weakness from statins during the first year, on average, compared with a placebo. But that disappeared after 12 months. Strong doses were associated with a slightly higher risk of 11% in the first year, falling to 5% after that. Professor Sir Nilesh Samani, medical director at the British Heart Foundation, which co-funded the study, said: “This accumulation of data from many clinical trials provides a clear picture that while statins are associated with a small increase in the risk of muscle pain or weakness, they do not cause the majority of muscle pain symptoms commonly associated with them. “It strengthens the evidence that statins are safe, which should provide reassurance to the many people taking or considering taking these lifesaving drugs that have been shown to protect against heart attacks and strokes.” This study was presented at the 2022 European Society of Cardiology Congress in Barcelona. Statins are a group of drugs that stop the liver from making ‘bad’ cholesterol, known as low-density lipoprotein (LDL) cholesterol. Over time, its accumulation can lead to hardening and narrowing of the arteries and heart disease – one of the world’s leading causes of death. Statins are currently prescribed to people if they have been diagnosed with the disease or have a family history of it. The tablets, which cost just 20p a pill and are proven lifesavers, are taken once a day. Patients who stop taking them can see their cholesterol rise again within weeks.
