Cholesterol problems are a frequent finding on blood tests. The Center for Disease Control and Prevention’s cholesterol facts estimates that 71 million American adults have high cholesterol. That is just under 34% of the American population! The most commonly prescribed treatment to elevated cholesterol, is a statin medication. Statin medications work by preventing the enzyme, HMG-CoA reductase, which produces about 70 percent of total cholesterol in the body. This enzyme is found in the liver. The reason researchers want to lower cholesterol levels is to try and prevent heart related complications.
According to Wikipedia, in 2010, the following cholesterol lowering statin medications were on the market: Lipator (atorvastatin), Lescol (fluvastatin), Mevacor and Altocor (lovastatin), Livalo (pitavastatin), Pravachol (pravastatin), Crestor (rousvastatin), and Zocor (simvastatin). Due to the prevalence of Americans with high cholesterol, it is not surprising that a cholesterol related medication would win the award for the best selling pharmaceutical. In 2008, Pfizer announced that Lipator exceed $12.4 billion in sales.
There is no doubt that statin medications can lower elevated cholesterol levels. The controversial aspects of these medications come from the potential side effects, and the minimal benefits that a patient could experience. Statistics taken from Dr. David Newman’s research found that in patients that received statin medications for 5 years with known heart disease, 96% of the patients saw no benefit relating to heart disease. Other notable statistics are in the image below.
Dr. Newman’s research also included an evaluation of individuals that did not have a diagnosis of heart disease. For 5 years, these patients also were given cholesterol lowering statin medications, yet 98% of them demonstrated no benefit in relation to heart disease prevention. Once again, other statistics are included from his work:
The research is clear that statin medications will lower cholesterol levels in an individual. The bigger debate comes from if lower cholesterol will really help an individual to prevent heart disease. The statistical data does not appear to indicate that these cholesterol lowering medications are achieving the goal that we as doctors and patients want.
When it comes to medications, there is always the potential for side effects. Statin medications are not exempt from these possible adverse reactions. In 2012, the FDA released a consumer update, warning both doctors and patients of the side effects that cholesterol lowering medications pose. This consumer update, expanded the warning label for statin medications, illustrating the risk of liver damage, congnative decline, muscle injury, and increased risk of diabetes.
These statin medications do not appear to offer a tremendous benefit to preventing heart disease, even though they are able to lower cholesterol. With the potential for damaging side effects, are these prescriptions really worth the cost?