Heart Association Still Wants You to Take Statins,
But Acknowledges Side Effects
Says persons having myopathy with a statin should
discuss other alternatives with their physician
March 24, 2010 – The American Heart Association,
while sticking to its guns in recommending the use of statin drugs to
prevent coronary heart disease, acknowledged this week that myopathy -
muscle pain or weakness - a side effect sometimes experienced by those
taking these drugs, “can be a reason to discontinue or reduce the dose.”
The AHA issued a news release Monday after a March
19 article in Time Magazine about the use of statins in women and
a recent statement from the U.S. Food and Drug Administration (FDA)
about the use of simvastatin in men and women.
Those reports addressed both the benefits and side
effects of statin therapy for elevated cholesterol values administered
in an effort to reduce the risk of heart disease and stroke. Over the
last several decades, deaths due to coronary heart disease and stroke
have declined substantially, in part due to the use of important new
medical treatments, among which includes statin therapy, according to
the AHA.
“However,” the ANA release said, “an area of
appropriate concern is muscle pain or weakness, known as myopathy, a
side effect that can be experienced by people taking statins. While
uncommon and reversible, myopathy can be a reason to discontinue or
reduce the dose of medication, and should be discussed with your
healthcare provider.”
The American Heart Association also reminded
patients that controlling cholesterol is critical for preventing
coronary heart disease and reducing heart attack and stroke risk.
American Heart Association guidelines for reducing
the risk of cardiovascular disease and stroke have long recommended a
healthy lifestyle and, when indicated, medications for lowering
cholesterol, usually including a statin (ACCF/AHA
2009 Performance Measures for Primary Prevention of Cardiovascular
Disease in Adults; AHA/ACC Guidelines for Secondary Prevention for
Patients With Coronary and Other Atherosclerotic Vascular Disease: 2006
Update).
These recommendations are based on the joint
guidelines of the National Heart Lung and Blood Institute’s Cholesterol
Education Program, in which the association participates.
The 2007 Update of the American Heart Association’s Evidence-Based
Guidelines for Prevention of Cardiovascular Disease in Women,
written with the participation and co-sponsorship of multiple health
organizations (see below news report), continues to support
cholesterol-lowering as an important part of reducing risk of both heart
disease and stroke.
|
Muscle Disorders
Also called: Myopathy
Your muscles help you move and help your
body work. Different types of muscles have different jobs. There
are many problems that can affect muscles. Muscle disorders can
cause weakness, pain or even paralysis.
There may be no known cause for a muscle
disorder. Some known causes include
● Injury or overuse, such as
sprains or strains,
cramps or
tendinitis
● Genetics, such as
muscular dystrophy
● Some
cancers
● Inflammation, such as
myositis
● Diseases of
nerves that affect muscles
● Infections
● Certain medicines
>>
More at MedlinePlus |
The scientific publication referred to in the
Time article demonstrated that the specific categories of women
studied benefited from taking a statin for primary prevention, with a
reduction in risk for hospitalizations for unstable chest pain and for
important blood vessel operations (surgical or catheterization-based).
“Because of the well-documented benefit of
cholesterol-lowering with statins, the association advises that patients
respect the benefit of statin therapy and only consider discontinuation
after a discussion with the appropriate healthcare provider,” the
statement said.
“For the person who experiences myopathy with a
statin, other alternatives should be discussed with their physician.
Patients who are taking statins and not experiencing any side effects
should continue to take their medication unless advised for other
reasons to stop by their healthcare provider.
“Only the very rare side effect of rhabdomyolysis
(muscle injury), signaled by dark urine, should lead a patient to stop
their statin immediately but then talk promptly with their healthcare
provider.
“As with all therapies, the decision to use statins
for primary or secondary prevention must include careful consideration
of the risks and benefits, side-effects and cost. Side effects can vary
by dose, by individual, and by the presence of other medical conditions
or other medications. Awareness of possible side effects and open
communication between patient and provider will allow optimal treatment
benefit for each patient."
FDA Alert Addresses Higher Doses
The FDA alert addresses an increased likelihood of
side effects at higher doses (80mg) of the statin Zocor, also known as
the generic simvastatin, as well as at lower doses when taken with
specific other medications.
The FDA recommends that patients be given the
minimum effective dosage of that statin to reduce the likelihood of
myopathy and rhabdomyolysis, and that healthcare providers be aware of
drug-drug interactions when prescribing.
It’s important to note that the benefit of lowering
cholesterol is most evident in people who have already had a
cardiovascular event, such as a heart attack or stroke, says the AHA.
“The data for statins as preventive treatment for
women who have not had a first event, as described in Time, is still
building, but results so far tell us that certain women can benefit from
more aggressive therapy to avoid a first heart attack or stroke. Your
healthcare provider can tell you if you would benefit,” the statement
concludes.
For more information on preventing heart disease
and stroke, visit:
www.heart.org/mylifecheck
Editor’s Notes
Other organizations participating in developing the
guidelines for preventing cardiovascular disease in women included the
American College of Cardiology Foundation, the American Academy of
Family Practitioners, the American College of Obstetricians and
Gynecologists, American Medical Women’s Association, the American
College of Nurse Practitioners, the American College of Physicians, the
Association of Black Cardiologists, the Society of Thoracic Surgeons,
the Centers for Disease Control and Prevention, the Office of Research
on Women’s Health, the World Heart Federation, and the National Heart,
Lung, and Blood Institute.
The association receives funding primarily from
individuals; foundations and corporations (including pharmaceutical,
device manufacturers and other companies) also make donations and fund
specific association programs and events. The association has strict
policies to prevent these relationships from influencing the science
content. Revenues from pharmaceutical and device corporations are
available at www.americanheart.org/corporatefunding.
