Specialists judge about statins Cholesterol-lowering drugs are much too often recommended

Doctors complain: No standardized recommendations on statins

On the one hand, the preventive intake of cholesterol-lowering drugs (statins) can reduce the risk of subsequent cardiovascular diseases. On the other hand, the medicines can cause a number of dangerous side effects such as cataracts, liver damage or diabetes. What is the point where the benefit is greater than the risk posed by the side effects? Experts complain that there are currently no uniform guidelines and the statins are too often prescribed.

Milo Puhan is Professor of Epidemiology and Public Health at the University of Zurich. He and his team investigated in a study when taking cholesterol-lowering drugs makes sense. The team of experts noted that currently too many statins are recommended and prescribed. Many patients would have more disadvantages than benefits. The study results have recently been published in the journal "Annals of Internal Medicine".

Researchers at the University of Zurich have come to the conclusion in a recent risk-benefit analysis that around half of all recommendations for taking cholesterol-lowering drugs are unnecessary. (Image: roger ashford / fotolia.com)

Too many healthy people take cholesterol-lowering drugs

According to the specialists, healthy people also take cholesterol-lowering drugs, although there are no signs of heart disease. This type of preventive use has been discussed controversially among medical specialists for years. "Ultimately, it is only in a few people a heart attack or a stroke avoided," said Professor Puhan in a press release on the study results. By contrast, there is a risk of severe side effects in all individuals.

Lack of guidance and controversial recommendations

The Swiss experts explain how it usually comes to a recommendation for ingestion: The treating physician calculated from various risk factors such as cholesterol, the body mass index (BMI) and the smoker status, the risk that the person concerned suffer a heart attack or stroke in the next ten years. At this point there are many controversial recommendations from different institutions. According to the University of Zurich, the thresholds at which intake is recommended fluctuate between 7.5 and 20 percent.

Are current recommendations misleading??

"According to such recommendations, over a third of all 40- to 75-year-olds would have to take preventive cholesterol-lowering drugs," conclude the researchers. Worldwide, that would be several hundred million people. The broad discrepancy between the individual recommendations is, according to the research group, due to the fact that the thresholds were set without systematic investigations. Even the sometimes severe side effects such as muscle pain, cataracts, liver damage and diabetes were little or not considered in current recommendations.

First comprehensive study on benefits and risks

To find a good balance between the benefits and the harmful side effects, the research team led by Professor Puhan has now for the first time carried out a comprehensive statistical modeling of the use of statins. The team calculated new thresholds for men and women in different age groups between 40 and 75 years, taking into account side effects.

Every second takes for free Cholesterinsenker?

"It has been shown that statins are clearly recommended too often today," concludes Puhan. According to the expert group's calculations, the number of people taking cholesterol-lowering drugs can be halved. According to the study, the benefit for seniors was greatly overestimated. The calculations came to the conclusion that in the age group of 70 to 75 year olds, statins are only worthwhile after a threshold of 21 percent. In the age group 40-45, the experts calculated a threshold of 14 percent for men and 17 percent for women.

Some preparations showed a much better balance

The researchers also took a close look at four common statin preparations. It turned out that not all drugs show the same balance between benefits and risks. According to the Swiss experts, the cholesterol-lowering drugs atorvastatin and rosuvastati showed a significantly better balance between benefit and harm than the two other drugs simvastatin and pravastatin. Specialists recommend carefully considering the prevention of statin use with the family doctor.

For more information on ways to naturally lower cholesterol, see the article "Lowering cholesterol - the best tips and home remedies." (Vb)