But for several years now there has been a simmering debate in medicine over statins."The prevailing dogma has been this statins are almost harmless and that they're a wonderful drug," says Tom Perry, MD, a pharmacologist and internist in Vancouver Canada. Caray is part of a team of doctors at the University of British Columbia that looks at the evidence for and against drugs.
A recent issue of their free bi-monthly, Therapeutics Letter, urged doctors to be more mindful of side effects when writing prescriptions for statins. Their review found statins decrease energy and fitness, increase fatigue and sleep problems. They also found that statins may increase the risk of muscle aches and pains, kidney and liver problems, bleeding in the brain, and type II diabetes.
"If people understood how relatively modest the benefits of statins are, they might be much more conservative about taking them, especially if they're experiencing an adverse effect, and we don't think the salesmanship has included an adequate emphasis on the importance of not harming people,"
This is the hottest issue in the statins debate.
Most of the data on the benefits of statins use come from larger studies that looked at adults of varying ages. The results don’t conclusively establish the benefits of using statins for seniors with healthy hearts, Dr. Kamel said.
(This is a test to assess the risk of a heart attack. You can calculate your own Framingham Risk score here..)
An outspoken critic of statins is Armon Neal, a consulting pharmacist who has received the annual achievement award from the American Society of Consultant Pharmacists. Neel, together with Bill Hogan, are authors of the intriguing book, Are Your Prescriptions Killing You?" The book has a chapter titled, "Statin Roulette."
If you are over 60, Neel warns, "stay away from statins at all costs." Not one to pull punches, Neel says:
I stop these drugs on all the older patients I see because they are invariably at the root of nearly all their problem.I reported on the case against statins made in this book in a July 2012 post.
- Total cholesterol - 150 (below 200 is the desirable target)
- L(ousy)DL - 81 (target under 100)
- H(ealthy) - 60 (target between 40 and 60)
- Triglycerides - 47 (target under 150) I was off the chart since the lowest number listed for scoring was 50)
And "less is more!"
The decision: So long statins.