STATIN DRUGS

One of the most frequent questions I am asked as a Cardiologist and physician is – do I really need to take Statin drugs?  On one side doctors are suggesting they be incorporated in a polypill which everyone should take, to other more ‘naturally based’ experts saying they do not work and people should not take them (click here)

This article is my assessment from the current medical literature, and the advice I give to my patients.  Because the article is quite long, I will put my conclusion first as well as at the end, but I would recommend that you read the reasons for my conclusions as well.

My Conclusion – sifting through all of the data below, my recommendations are relatively simple:

1. If you have proven cardiovascular disease (heart attack, angina, stroke, angioplasty, high levels of calcium in cardiac CT scan) then you should take a statin drug preferably at a low dose. This would reduce your risk of a heart attack, stroke or death by about 20%.

2. If you get any side-effects – muscle pain, abnormal liver function tests, or you feel that your mental function has deteriorated, stop the drug for a couple of months, and then restart. Possibly consider restarting with a water-soluble statin such as pravastatin. If the symptoms recur then don't take the statins anymore.If you feel fine, then continue the statin. There is little evidence showing that any other cholesterol-lowering agent provides any benefit.

3. If you don't have cardiovascular disease (primary prevention) unless you have a very high cholesterol, diabetes or an extremely strong family history then I would not recommend that you take a statin drug. My advice would be to have a CT scan for calcium**  which will show early coronary artery disease, if this is strongly positive then maybe you should consider taking a statin drug. If it is negative or normal for age, then I would not take a statin.

4. For elderly people the benefits of statins do continue, but if there is any suggestion of impaired mental function, then stop taking the statin.

5. If you are taking a statin, you must be taking the supplement coenzyme Q 10, at least 100 mg daily.