Statins: beyond cholesterol
When his doctor first suggested he start taking one of the cholesterol-lowering drugs called statins, Steven Peterson hesitated. "If it meant taking a pill every day for the rest of my life, I wanted to make sure it was safe," said the Petaluma, Calif., business consultant. He remembers exactly what his doctor told him. "If it was up to him, he said, they'd put this stuff in the water supply."
Indeed, doctors have been prescribing statins to millions of Americans because of the drugs' remarkable success at cutting a type of cholesterol that has been linked to heart disease. Now, a host of studies suggest that statins may have other significant benefits, from strengthening bones to lowering the risk of Alzheimer's disease.
Though almost everyone, from doctors to patients, agrees that statins are saving many lives, some experts caution that the drugs' benefits are being overblown and that serious side effects are being largely overlooked.
Statins, for example, don't lower cholesterol in every patient who tries them. As for side effects, about 5% of patients experience muscle aches and pains. In rare cases, a more severe condition occurs, one called rhabdomyolysis, in which muscle cells die and are sloughed off. Rhabdomyolysis can lead to kidney failure and death.
One of the newer statins, Baycol, was pulled from the market after reports of 52 deaths linked to the drug. And a consumer watchdog group has called for tough warnings on the labels of statins because of these potential risks.
But circumstances surrounding Baycol, a particularly potent version of statins, were an exception, many researchers say. "Statins have been in use for 15 years, we have millions of people taking them, and we've seen remarkably few problems associated with these drugs," said Dr. P.K. Shah, director of the cardiology department at Cedars-Sinai Medical Center in Los Angeles. "Are we likely to see risks show up when people take them for 20 or 25 years? There's no way to know.''
One thing doctors do know: Statins save lives. Studies show they reduce the risk of death from heart attacks and other causes by 30% to 40% in people with elevated cholesterol levels. "The fact is, the risks of not taking statins are far greater than the potential side effects," said Dr. Gregg C. Fonarow, professor of cardiology at UCLA. In randomized studies of more than 100,000 patients taking statins, there have been no deaths attributed to the medication. (The deaths associated with Baycol occurred outside clinical trials in patients taking drugs but not closely monitored, as they would be in a research study.)
