Dr. Jacqueline Gerhart: Patient Quits Taking Statins
Madison, Wisconsin - UW Health Family Medicine physician Jacqueline Gerhart writes a column that appears Tuesdays on madison.com and in the Wisconsin State Journal. Columns are re-published here with permission.
Dear Dr. Gerhart: I heard on a recent health show that cholesterol medications called "statins" are bad for you. So I stopped taking mine but am reluctant to tell my doctor. Is there something else you can recommend?
Dear Reader: You are right, there has been quite a bit of controversy recently over cholesterol medications, especially statins. Statins are the most commonly used medications to lower cholesterol.
They work by lowering the amount of cholesterol produced by your liver and decreasing the absorption of cholesterol by your gut.
The 1985 Nobel Prize in medicine was given to Michael Brown and Joseph Goldstein for researching and producing these drugs. They were first approved by the FDA and used in patients in 1987.
Since then, multiple studies have concluded that statins lower the risk of heart disease, heart attacks and stroke. This is likely why so many physicians prescribe them, and why so many people use them.
The National Center for Health Statistics states that one in four Americans over the age of 45 takes statins. And we spend more than $14.3 billion per year on these drugs.
It is clear that in most patients with pre-existing heart disease, a statin's benefits outweigh its risks. Namely, if you have had a prior heart attack or stroke, using statins lowers your risk of having another one.
But what about people who have high cholesterol but no other risk factors for heart attack or stroke? In one analysis comparing more than 34,000 patients, it was concluded that "otherwise-healthy patients" had only a slightly decreased risk of heart attack on statins versus on placebo.
All the study participants had high cholesterol but were otherwise healthy and had no known heart disease. Over time, the study noted in the patients who took a placebo, three out of 100 had heart attacks, whereas in the statin group, two out of 100 did. So there was a slightly decreased risk with statin use.
And statins do come with risk. They can cause muscle pains and weakness, and could even increase the risk of diabetes. That's why some physicians advise otherwise healthy patients with mild to moderately increased cholesterol to first try other treatments.
These other treatments always include diet and exercise modification, but can also include natural supplements or other prescription medications. Your individual plan to lower your cholesterol will be chosen based on your specific lab results and risk factors.
Now, to quickly address your comment about not wanting to tell your physician about stopping your statin use: As you can imagine, it's a really bad idea not to tell your physician when you start or stop a medication. First off, your physician is your ally, not your enemy. We want what is best for your health.
So, if you aren't going to take something, be honest so we can find an alternative to suit your needs. And, as in the case of statins, we may be able to give you further information so you can make an informed decision.
This column provides general health information and is not specific advice intended for any particular individual(s). It is not a professional medical opinion or a diagnosis. Always consult your personal health care provider about your concerns. No ongoing relationship of any sort (including but not limited to any form of professional relationship) is implied or offered by Dr. Gerhart to people submitting questions.
Date Published: 02/19/2013