Researchers Find Abundant Evidence of Statin Side
Effects, Risk Higher for Senior Citizens
Statins' benefits have not been found to exceed
their risks in those over 70 or 75 years old, even those with heart
disease
Jan. 27, 2009 A new review report has found 900
studies reporting on the adverse effects of taking statins from the
most common, muscle problems, to cognitive difficulties. The authors
also report the risk of adverse effects goes up with age and the
stronger the statin, the more likely the side effects.
"The risk of adverse effects goes up as age goes
up," says co-author Beatrice Golomb, MD, PhD, associate professor of
medicine at the University of California, San Diego School of Medicine
and director of UC San Diego's Statin Study.
Consumer Reports' chief medical adviser blogs
about recent study showing a cholesterol lowering drug - Crestor - cut
the risk of heart attack and stroke, even in people with normal
cholesterol.
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"This also helps explain why statins' benefits have
not been found to exceed their risks in those over 70 or 75 years old,
even those with heart disease."
The review paper, currently published in the
on-line edition of American Journal of Cardiovascular Drugs, provides
the most complete picture to date of reported side effects of HMG-CoA
reductase inhibitors (statins), a class of drugs widely used to treat
high cholesterol.
The paper shows the state of evidence for each side
effect and also helps explain why certain individuals have an increased
risk for such adverse effects.
"Muscle problems are the best known of statin
drugs' adverse side effects," said Golomb. "But cognitive problems and
peripheral neuropathy, or pain or numbness in the extremities like
fingers and toes, are also widely reported." A spectrum of other
problems, ranging from blood glucose elevations to tendon problems, can
also occur as side effects from statins.
The paper cites clear evidence that higher statin
doses or more powerful statins those with a stronger ability to lower
cholesterol as well as certain genetic conditions, are linked to
greater risk of developing side effects.
"Physician awareness of such side effects is
reportedly low," Golomb said. "Being vigilant for adverse effects in
their patients is necessary in order for doctors to provide informed
treatment decisions and improved patient care."
The paper also summarizes powerful evidence that
statin-induced injury to the function of the body's energy-producing
cells, called mitochondria, underlies many of the adverse effects that
occur to patients taking statin drugs.
High blood pressure and diabetes are linked to
higher rates of mitochondrial problems, so these conditions are also
clearly linked to a higher risk of statin complications, according to
Golomb and co-author Marcella A. Evans, of UC San Diego and UC Irvine
Schools of Medicine.
Mitochondria produce most of the oxygen free
radicals in the body, harmful compounds that "antioxidants" seek to
protect against. When mitochondrial function is impaired, the body
produces less energy and more "free radicals" are produced. Coenzyme Q10
("Q10") is a compound central to the process of making energy within
mitochondria and quenching free radicals.
However, statins lower Q10
levels because they work by blocking the pathway involved in cholesterol
production the same pathway by which Q10 is produced. Statins also
reduce the blood cholesterol that transports Q10 and other fat-soluble
antioxidants.
"The loss of Q10 leads to loss of cell energy and
increased free radicals which, in turn, can further damage mitochondrial
DNA," said Golomb, who explained that loss of Q10 may lead to a greater
likelihood of symptoms arising from statins in patients with existing
mitochondrial damage since these people especially rely on ample Q10
to help bypass this damage.
Because statins may cause more mitochondrial
problems over time and as these energy powerhouses tend to weaken with
agenew adverse effects can also develop the longer a patient takes
statin drugs.
The connection between statins' antioxidant
properties and mitochondrial risk helps explain a complicated finding
that statins can protect against the very same problems, in some people,
to which they may predispose others problems such as muscle and kidney
function or heart arrhythmia.
This paper was funded in part by a Robert Wood
Johnson Generalist Physician Faculty Scholar award to Dr Golomb.
Keep up with the latest news for senior citizens, baby
boomers
Jan. 27, 2009 A new review report has found 900
studies reporting on the adverse effects of taking statins from the
most common, muscle problems, to cognitive difficulties. The authors
also report the risk of adverse effects goes up with age and the
stronger the statin, the more likely the side effects.