Researchers Say Not Everyone Needs Statins to Prevent Heart Disease

Researchers say more widespread use of statins may be unwarranted.

ByABC News
January 18, 2011, 11:21 AM

Jan. 19. 2011— -- Millions of people take statin drugs to lower their cholesterol levels. And there's been an even bigger push to use them to prevent heart disease since the cholesterol-busting statin drug Crestor was approved by the U.S. Food and Drug Administration as a way to stave off cardiovascular disease in those who don't yet have it.

But new research may throw into question exactly who is at enough risk for heart problems to justify taking the medications – and who might be better off skipping them.

On the one hand, the drugs have been shown to lower levels of dangerous LDL, or "bad," cholesterol. And they are fairly inexpensive. On the other hand, they do carry rare but serious side effects, including the breakdown of muscle tissue, memory loss and a nervous system malfunction called neuropathy.

Delores Wyse wonders if she should be one of the people who skips them. She completely baffled her doctors in October when she had a heart attack, despite that fact that she never had any risk factors for heart disease. She currently takes several drugs to help protect her heart, and one of them is simvastatin.

"I never had high cholesterol, never had high blood pressure or diabetes," said Wyse, who lives in Maui, Hawaii. "I'm also not overweight. I exercise and always eat healthy. My doctors still consider me extremely low risk for heart disease."

A group of British researchers found that people who are at low risk for heart disease -- in this case, those who have never had heart disease and aren't likely to develop it -- may not benefit very much from taking statins. In a report published in The Cochrane Database of Systematic Reviews, a group of British researchers reviewed 14 studies with more than 34,000 low-risk participants who took statins for at least a year and found that there is a very low likelihood of death from any cause.

"Cochrane Review guidance is helpful in highlighting that the current evidence does not support use of statins below a 1 percent annual all-cause mortality risk or an annual CVD [cardiovascular disease] event rate of below 2 percent," the report said. Experts say this level of risk is extremely low.

The researchers also found that statins lowered cholesterol levels, reduced the number of procedures required to improve or restore blood flow through the heart and reduced the number of strokes. Despite these benefits, the authors say the use of statins doesn't really improve people's quality of life, and that a number of the trials they analyzed were significantly flawed. As a result, they say "caution should be taken in prescribing statins for primary prevention among people with low cardiovascular risk."

In an accompanying editorial, another British researcher said those flaws include the selection of favorable outcomes to make drugs appear move effective and pre-existing relationships between study authors and pharmaceutical companies.

But a number of other doctors told ABC News they disagree with several of the review's conclusions. They say that most doctors do not prescribe statins for people whom they consider very low risk, and also say it's difficult to define "low risk."