Tony Dao, M.D., F.A.C.C., is board certified in cardiovascular disease and has special interests in clinical cardiovascular disease, congestive heart failure and nuclear cardiology. Dr. Dao practices with Johns Hopkins Community Physicians in Bethesda.
If you’ve swapped bad habits (like nightly takeout and binge-watching) for good ones (like a jogging and cooking a healthy meal), you’re on the right track for keeping or getting your cholesterol levels within a normal range. But sometimes making lifestyle adjustments isn’t enough to reduce your cholesterol. That’s when your doctor may recommend statin drugs.
Statin drugs are prescription medications that lower cholesterol and prevent cardiovascular disease, which is the leading cause of death in the United States. Often the first line of therapy after lifestyle changes, statins can reduce the risk of stroke, heart attack and even death from heart disease by 25 percent or more. If you’ve already experienced a cardiovascular event, statins are a mainstay of long-term preventive therapy to reduce the chance it will happen again.
Although statins benefit those most at-risk people for heart disease, many people have concerns about taking this class of drug due to misconceptions about potential side-effects.
There are many studies—involving thousands of patients over the decades—that have shown the benefit of statin therapy in patients with coronary artery disease, strokes, peripheral vascular disease and diabetes. To reap those benefits, people first have to get past the myths.
Myth #1: Taking Statin Drugs Leads to Diabetes Out of the Blue
Truth: In clinical trials, statins appear to accelerate a diagnosis of adult-onset diabetes because they cause a slight elevation in blood sugar. However, many people impacted by this side effect already have higher than normal blood sugar, or prediabetes, due to risk factors such as obesity. For those who are borderline diabetic, the mild increase in blood sugar can lead to a diabetes diagnosis about five weeks earlier than it would be otherwise.
Research indicates that statin drugs do not induce diabetes in someone who isn’t already nearing a diabetes diagnosis. Overall, the benefit of statins in reducing cardiovascular events in an at-risk patient far outweighs the potential for a mild increase in blood sugar.
Myth #2: Statins Frequently Cause Memory Loss
Truth: In 2012, the FDA changed statin drug labels to include information that some people had experienced memory loss and confusion while taking the medications. People became seriously concerned that lower cholesterol levels could affect the brain’s function. But the brain makes its own cholesterol and doesn’t depend on the cholesterol in the blood.
A review of studies done by Dr. Seth Martin at Johns Hopkins did not show any evidence of accelerated dementia or memory loss. Overall, statins theoretically have the potential to decrease the incidence of dementia due to stroke prevention.
Myth #3: You Could Get Cataracts from Taking Statin Drugs
Truth: Some studies have indicated that there may be a relationship between statin drugs and an increased risk for developing cataracts. However, these investigations have been either conducted in animals or in less-than-rigorous studies.
The best evidence we have comes from high-quality clinical trials in humans, which showed that statin drugs do not increase risk of cataract formation. Some studies performed eye exams in people over time and showed no difference in eye health between those taking and not taking statins.
The Bottom Line
Physicians and health care providers are encouraged to practice what is called evidence-based medicine. This means that we try to make decisions to the betterment of our patients based on the available evidence obtained through high quality clinical studies.
There is an overwhelming amount of data based on many studies over the years to support that statins will significantly decrease cardiovascular events and death. The use of statins along with diet, exercise, and risk factor modification are the foundations in our treatment of heart disease. If there is any concern about the use of statins and any potential side-effects, it is important that patients talk with their health care provider.