Statins: Is the cost just too high?
Tip of the Month: November 2011

There is an increasing body of scientific research questioning the validity of the mainstream medical belief that high cholesterol is bad for our health. A recent scientific study 1 published in the Journal of Evaluation in Clinical Practice found not only was high cholesterol not a good predictor for coronary heart disease (CHD) but that women with higher cholesterol levels were less likely to die of ANY type of disease. For men, the report continues, the relationship between cholesterol and disease is not quite as simple but instead followed a U-shape trend, concluding that both excessively low and excessively high cholesterol levels might be associated with an increased risk of CHD.

The author Petursson concludes, “If our findings are generalizable, clinical and public health recommendations regarding the 'dangers' of cholesterol should be revised. This is especially true for women, for whom moderately elevated cholesterol (by current standards) may prove to be not only harmless but even beneficial.”

This clinical study when added to the increasing pile of published research papers disagreeing with the link between elevated cholesterol levels and disease, make the latest figures from the NHS database on the prescription of the cholesterol lowering drugs Statins, quite astounding.

In 2009 the most commonly prescribed drug by the NHS was Simvastatin, a hypolipidemic drug used by doctors to control elevated cholesterol levels. This one statin drug alone was prescribed 37.3 million times to the extraordinary cost to the NHS of £66.8 million. Add this together with the prescriptions for the other main Statin drugs; Atorvastatin, Cerivastatin, Fluvastatin, Lovastatin, Pravastatin and the figures are believed to increase to over £450 million.

It is not only the financial cost that should make one stop and take stock but also the worrying number of potential side effects this group of drugs can cause. Published research on statin usage has been linked with a decrease in neurological function 2, liver failure 3, 8, lupus 4, diabetes 5, birth defects 6, kidney disease 7, 8, esophageal cancer 8, cataracts 8, decreased heart function 8, stroke 9, breast cancer 10, testicular cancer 11, rheumatoid arthritis 12, and heart failure 13.

With 1 in 3 UK adults aged over 40 currently taking statins, most of whom are the ‘worried well’ isn’t it time we finally admitted that the costs of taking stains far out way any benefits?

• Petursson H, et al: Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid? Ten years prospective data from the Norwegian HUNT 2 study. J Eval Clin Pract. 2011 Sep 25

• Tiffany Mailman, Manoj Hariharan, Barbara Karten, J: Statin drugs may interfere with neurological function in the brain by inhibiting cholesterol biosynthesis and synaptic transmission. Neurochem. 2011 Sep 7

• Einar Björnsson, Elin I Jacobsen, Evangelos Kalaitzakis: Liver failure and damage are rare but severe unintended consequences of statin drug use. J Hepatol. 2011 Aug 31

• Hilda J I de Jong, Jan Willem Cohen Tervaert, Siti R F Saldi, Rob J Vandebriel, Patrick C Souverein, Ronald H B Meyboom, Henk van Loveren, Olaf H Klungel: Statin drug use is associated with a Lupus-Like syndrome. Semin Arthritis Rheum. 2011 Aug 23.

• Uchechukwu K Sampson, Macrae F Linton, Sergio Fazio: Statin drugs increase the risk of diabetes. Curr Opin Cardiol. 2011

• Simon Horvat, Jim McWhir, Damjana Rozman: Drugs targeting cholesterol synthesis are embryo lethal in mice and likely contribute to birth defects in humans. Drug Metab Rev. 2011 Feb

• Joel C Marrs, Joseph J Saseen: Although statin drugs decrease LDL cholesterol in end-stage kidney disease, their use does not lower morbidity or mortality. Pharmacotherapy. 2010 Aug

• Julia Hippisley-Cox, Carol Coupland: Unintended consequences of statin drug use are increased risk of esophageal cancer, kidney failure, cataract, liver dysfunction and myopathies. BMJ. 2010

• L B Goldstein, P Amarenco, M Szarek, A Callahan, M Hennerici, H Sillesen, J A Zivin, K M A Welch: The statin drug atorvastatin increases the risk of hemorrhagic stroke. Neurology. 2008 Jun 10

• Denise M Boudreau, Onchee Yu, Diana L Miglioretti, Diana S M Buist, Susan R Heckbert, Janet R Daling: Statin use is associated with an increased risk of breast cancer among statin users of 5 years or more. Cancer Epidemiol Biomarkers Prev. 2007 Mar

• Sunny A Linnebur, William H Hiatt: Statin-induced testicular pain has been reported. Ann Pharmacother. 2007 Jan

• H J I de Jong, O H Klungel, L van Dijk, R J Vandebriel, H G M Leufkens, Jw van der Laan, J W Cohen Tervaert, H van Loveren: Statin drug use is associated with a significantly increased risk of rheumatoid arthritis. Ann Rheum Dis. 2011 Oct 6

• Peter H Langsjoen, Alena M Langsjoen: The depletion of coq10 by statin drugs may be contributing to increasing rates of congestive heart failure. Biofactors. 2003