Busting myths about statins

Statins are among the most commonly prescribed medications in the UK, used to lower cholesterol and reduce the risk of heart attacks and strokes. Despite their widespread use and strong evidence supporting their benefits, many people are hesitant to take them. Myths and misinformation, especially online, have contributed to fear about side effects and long-term harm.

This article addresses the most common concerns patients have about statins and explains what the evidence actually shows.

What are statins and how do they work?

Statins work by blocking an enzyme in the liver involved in producing cholesterol. By lowering levels of low-density lipoprotein (LDL), or ‘bad’ cholesterol, statins reduce the risk of fatty build-up in the arteries. They also stabilise any cholesterol that has already been deposited in arteries around the body. In these ways statins decrease the likelihood of cardiovascular events and symptoms such as:

• Heart attacks and angina

• Strokes

• Peripheral arterial disease

They are usually prescribed to people with a history of heart disease or at high risk of developing it, based on factors like cholesterol level, age, blood pressure, smoking status and family history.

What are the most common myths about statins?

Many patients hesitate to start statins due to widely circulated myths. These include:

• Extremely uncommon: “Statins cause severe muscle pain or damage in everyone.”

Muscle aches are a reported side effect, but most people either don’t experience this or find symptoms are mild. Studies have shown that patients get more muscle aches when given placebo (sugar pill) compared to statins. In very rare cases, severe muscle damage (rhabdomyolysis) can occur, but this is extremely uncommon and often related to high doses or interactions with other medications.

• Rare: “Statins damage the liver.”

Routine blood tests are carried out after starting statins, but significant liver injury is rare. For the majority, liver function remains normal.

• No solid evidence to prove that: “Statins cause memory loss or dementia.”

This concern has been widely studied. There is no good evidence that statins increase the risk of dementia. In fact, they may lower the risk of vascular dementia by reducing stroke risk.

• “Once you start statins, you can’t stop.”

Statins are long-term medications because cardiovascular disease is a chronic condition. However, if side effects occur or lifestyle changes make them unnecessary, they can be stopped under medical supervision. Alternative medications may be considered in this situation.

• Not a substitute: “Statins are a substitute for a healthy lifestyle.”

Statins are most effective when combined with a healthy diet, regular exercise, weight control and not smoking. They do not replace the need for lifestyle changes.

How can patients decide whether statins are right for them?

Taking statins is decision based on balancing the benefits against any potential risks. Tools such as the QRISK calculator help estimate an individual’s risk of cardiovascular disease and the degree to which this can be decreased by lowering cholesterol with a statin.

Patients with concerns should speak with their GP or cardiologist, who can:

• Review the evidence for benefit in their specific case

• Address concerns about side effects

• Suggest alternative doses or formulations of statins if needed or even non-statin agents

• Monitor and adjust treatment based on response

What is the evidence supporting statin use?

Dozens of high-quality studies involving many millions of patients across the world have shown that statins significantly lower the risk of heart attacks and strokes and death from these events. For those at increased cardiovascular risk, the benefits are more likely to far outweigh the risks. Most people tolerate them well, especially when started with the right support and information.

If you are having heart issues, you can arrange an appointment with Dr Ghosh today on his Top Doctors profile.