Statins: the great risk debate
Feed the word "statins" to Google and the three suggestions that roll up are "statins side effects", "statins and diabetes" and "statins and memory loss". The search engine's negative take on the drug designed to tame your cholesterol levels is mirrored by controversy about statins in the medical community.
Commenting on whether statins pose a risk, Jonny Bowden, a nutritionist and co-author of The Great Cholesterol Myth, comments: "That's precisely the problem - we don't really know."
Statins in general are safe for many people, according to Bowden, who critiques the drugs in his book. "But they are also riddled with side effects, such as muscle pain, memory loss, loss of libido and loss of energy," he says, adding that, in some studies, some statin-treated groups experience a troubling spike in diabetes.
There are many conflicting studies, however. In a study published in the journal Circulation: Cardiovascular Quality and Outcomes in July last year, researchers reviewed data from 135 previous drug studies published between 1985 and early 2013.
The tests involving nearly 250,000 patients evaluated the safety of the seven statins on the market.
They concluded "as a class, adverse events associated with statin therapy are not common". They also noted a nine per cent increased risk of diabetes among statin users.
But according to a previous landmark study, 250 patients need to be treated with a statin for one case of diabetes to be diagnosed.
"I am concerned that patients may misunderstand this small increase in risk, and stop adhering to their medications," says Huseyin Naci, the study's lead author and research fellow at Harvard Medical School's Department of Population Medicine.
The proven ability of statins to significantly cut the rate of death and hospitalisation in patients who have heart disease outweighs the "small increase in diabetes risk", he says.
New guidelines from the American Heart Association and American College of Cardiology suggest that many more people should use statins to stave off cardiovascular disease.
"While side effects can sometimes be troublesome it is important to also appreciate the very real benefits statins do provide," says Britain's National Health Service website.
Statins do some good, says Bowden. They modestly benefit middle-aged men with existing cardiovascular sickness, because they thin the blood and are anti-inflammatory. But he says they are being "wildly over-prescribed" for populations - such as women, the elderly, and men with no existing heart disease - in which they've shown little to no benefit.
Bowden adds that about 75 per cent of patients taking statins "may experience no benefit whatsoever". Further, long-term implications of taking statins is not known, he says.
One early statin, Baycol, was pulled from the market because of increased mortality, says Dr Barry Sears, founder of the Inflammation Research Foundation in Massachusetts. Another statin, Warfarin, must be constantly monitored by blood test because of its potential to cause internal bleeding, he says.
Lifestyle, genetics, food and environment all play a role in how a patient reacts to statins, says Australian nutritionist Cyndi O'Meara. "Studies have shown that, for every 60 patients treated with statins for an average of 4.3 years, only one will be protected from a single heart attack," she says.
Worse, taking statins indefinitely might fuel the complacent, delusional belief that a lifestyle defined by poor eating habits and no exercise is sustainable, she says.
The alternative to statins, says Bowden, is to stay healthy through exercise, stress reduction, and an anti-inflammatory diet low on sugar and starch but full of invigorating ingredients.
He also recommends anti-inflammatory omega-3 and magnesium, which relaxes the blood vessels. Also good are vitamin D, vitamin C, resveratrol - an antioxidant found in red wine - and curcumin, which is found in the spice turmeric.