Statins – are they worth it?

Crestor and Other Statins: Are They Really Worth the Risk?

By Dr. Joseph Mercola
with Rachael Droege

With at least 12 million Americans taking cholesterol-lowering drugs, mostly statins, and experts’ recommendations that another 23 million should be taking them, it’s no wonder that the drug companies are scrambling to get their piece of the pie by releasing new and “improved” statin drugs.

AstraZeneca just released their new statin called Crestor (generic name rosuvastatin). According to the company, Crestor is less expensive and more effective than similar drugs like Pfizer’s Lipitor, which is currently the statin market leader, taking in about $8 billion of the $13 billion total statin sales in 2002.

And while it appears that the drug may be slightly better than other statins at raising good (HDL) cholesterol levels, there are loads of safety concerns surrounding the drug. For instance, the highest, 80-milligram dose of Crestor could not be approved because of serious side effects including muscle and kidney damage. Some say the drug may produce side effects even at lower doses, and caution that patients should be closely monitored when on the drug.

Of course, all statins pose risks, so the question of which statin is most dangerous is somewhat tongue-in-cheek. Dangers of statin drugs include, but are not limited to, a potential increase in liver enzymes so patients must be monitored for normal liver function, muscle aches, weakness, immune system suppression, an increase in cancer risk, and a serious degenerative muscle tissue condition called rhabdomyolysis.

Naturally, one would assume that with the extensive list of side effects associated with statins, they must be doing some pretty good things. Well, what statins do do is lower cholesterol levels, that is true. But if lowering your cholesterol is your goal, why not try a healthy diet with little to no grains and sugars? This will work in the majority of cases. On a side note, eliminating sugar and grains will inevitably cause beneficial side effects, such as normalizing your weight, increasing your energy and lowering your blood pressure and triglycerides.

But suppose that lowering your “bad” (LDL) cholesterol was not actually the key to lowering your risk of heart attacks and heart disease? Would you still want to risk all of those statin side effects? Well, this is just what several research studies have found, raising the basic question of whether statin drugs even work to lower the risk of heart disease.

One study, published in the August 2003 American Journal of Cardiology found that lowering bad cholesterol with statin drugs may not reduce the rate at which plaque builds up in the arteries surrounding the heart. This finding flies in the face of the widespread belief that lowering LDL cholesterol levels is the best way to reduce arterial plaque. In the study, participants taking varying doses of a statin did generally lower their cholesterol. However, all the groups had an average increase in arterial plaque of 9.2 percent.

Another study published in the December 2002 Journal of the American Medical Association looked at the effect of statin drugs versus usual care (improving diet, exercise, etc.). While the statin group did lower their bad cholesterol levels significantly more than the usual care group, both groups had the SAME rates of death and heart disease.

In light of these reports, and the known dangers of statin drugs, you would expect some major news in the area of statins, but the studies received hardly any mainstream media coverage. As with many health care issues, you’ll have to sort out the truth for yourself.

If you truly want to prevent heart disease, check out my article Protect Yourself From Heart Disease With Simple Lifestyle Changes. For a quick tip, one of the easiest and most effective ways to reduce your risk of heart disease is by increasing the omega-3 in your diet. Omega-3 fatty acids, which are found in oily fish and fish oils, offer great protection. Studies have shown that omega-3 works by preventing the buildup of fatty deposits in the arteries. One of the best ways to make sure you have enough omega-3 in your diet is by regularly consuming fish oil. It’s important to use a high-quality oil to ensure that the product is fresh and purified of mercury and other toxins. Carlson’s fish oil is the best brand I’ve come across; you can look for it in your local health food store or in our online store.

Safety Concerns Surround the Latest Statin, Crestor

A new cholesterol-lowering statin drug, Crestor, will soon be hitting the market, joining its highly successful competitors Lipitor and Zocor. In 2002, statin drugs brought in $13 billion in sales. At least 12 million U.S. adults take cholesterol-lowering drugs.

Crestor, known generically as rosuvastatin, is manufactured by AstraZeneca. The drug may be slightly better than other statins at raising good cholesterol levels and may also be more powerful than the other statin drugs.

However, the highest, 80-milligram dose of Crestor could not be approved because of serious side effects including muscle and kidney damage. Some say the drug may produce side effects even at lower doses, and caution that patients should be closely monitored when on the drug.

All statin drugs can cause an increase in liver enzymes so patients must be monitored for normal liver function. Statins can also cause muscle aches, weakness and, rarely, a dangerous degenerative muscle tissue condition called rhabdomyolysis.

Washington Post August 12, 2003; Page HE01

Common Cholesterol Drug Lowers Cholesterol but Not Death Rate

Numerous studies have shown that statins, drugs to lower cholesterol, can reduce rates of heart disease and prevent heart disease by lowering cholesterol levels, however a new study involving the statin pravastatin, known as Pravachol, proved otherwise.

In the study, which compared the effects of pravastatin versus the usual care recommended by physicians on cholesterol levels of over 10,000 people, found that the drug did not reduce the risk of death or heart disease in those with moderately high cholesterol and high blood pressure. Though statins have been the subject of many clinical trials, groups of people, such as women and certain racial groups, and individuals such as those with well-controlled hypertension and diabetes, were not adequately represented. The new study used a wide range of people — made up of almost half women, 38 percent black, 35 percent with a history of diabetes, and 55 percent aged 65 years or older — to assess the drug’s effects.

Results showed that pravastatin did indeed lower cholesterol, with a decrease of 17 percent in total cholesterol levels among those taking statin, compared with eight percent in the usual care group after four years of the study. Levels of LDL, bad cholesterol, had also dropped — 28 percent among those taking pravastatin and 11 percent in the usual care group.

However, while lowered LDL cholesterol has been shown to reduce the risk of stroke and heart attack, study participants who took pravastatin and those who received usual care showed the same rates of death and heart disease.

JAMA December 18, 2002;288:1998-3007,3042-3044

Cholesterol Drugs May Increase Cancer Risk

Drugs Stimulate Growth of New Blood Vessels By Mimicking Growth Factor

New research indicates that besides lowering levels of harmful cholesterol, the drugs may also promote the growth of new blood vessels, which may not necessarily be such a great thing. Although this effect may help to prevent heart attacks and other forms of heart disease, it may have the potential to promote cancer as well.

  • Tests in human cell samples and in rabbits, show that the cholesterol-lowering drug simvastatin (Zocor) seems to activate a pathway through which cells communicate and act very similar to a naturally-occurring growth factor, according to Dr. Kenneth Walsh, of Tufts University School of Medicine in Boston, Massachusetts.
  • Researchers suspect that the drug interacts with a molecule called protein kinase Akt/PKB, which helps regulate blood vessel development properly.
  • Simvastatin produced similar effects on the growth of new blood vessels, a process called angiogenesis, as does vascular endothelial growth factor (VEGF), a substance essential for healthy blood vessels, according to Dr. Walsh. “The same pathway is being activated by statins as VEGF,” he said.

But if statins do promote angiogenesis, the effects may not always be helpful, Dr. Michael Simons, of Beth Israel Deaconess Medical Center in Boston points out in an editorial that accompanies the study.

For example, statins might increase the growth of blood vessels in cancerous tumors, Simons notes. However, even though statins are some of the most widely used prescription drugs, these and other potential harmful effects have not been reported, which calls into question their vessel-promoting abilities, Dr. Simons adds.

Nature Medicine September, 2000;6:965-966, 1004-1010.

Dr. Mercola’s Comment:

Well, with half the population anticipated to take these drugs in the future, it is time that we seriously re-evaluated what we are doing with them. Just like our weight, there is an optimum with cholesterol as well. Some people believe that the lower your cholesterol, the healthier you are. Nothing could be further from the truth. If your cholesterol is too low you will have an increased risk of mood disorders, depression, stroke, violence.

This best predictor of heart disease with respect to cholesterol is the HDL/total cholesterol ratio.

Now, to add insult to injury, it appears that these drugs also contribute to increased cancer risks. Some patients (about one in 500) with impaired LDL receptors (familial hypercholesterolemia) do require these drugs and they should be on Coenzyme Q10, as this important nutrient is blocked by many cholesterol-lowering drugs. However, one in 500 people is sure a bit different than the one in 2 which is being predicted to take these drugs.

This is not the first time that the cancer-causing potential of cholesterol-lowering medications have been discussed. A review published in the prestigious Journal of the American Medical Association in 1996 (JAMA 1996 Jan 3;275:55-60) provides some excellent information on this. The authors of the study state (emphasis mine):

All members of the two most popular classes of lipid-lowering drugs (the fibrates and the statins) cause cancer in rodents, in some cases at levels of animal exposure close to those prescribed to humans. … Longer-term clinical trials and careful postmarketing surveillance during the next several decades are needed to determine whether cholesterol-lowering drugs cause cancer in humans. In the meantime, the results of experiments in animals and humans suggest that lipid-lowering drug treatment, especially with the fibrates and statins, should be avoided except in patients at high short-term risk of coronary heart disease.

Additionally, if statins act on the same pathway as VEGF, as the study’s authors state, it further explains the cancer connection. A just-published study shows that VEGF plays an important role in the spread of colorectal cancer and found that survival time was diminished in patients whose cancerous tumors tested positive for VEGF (Br J Cancer 2000 Oct;83:887-891).

Another just-published study shows that VEGF plays a role in diabetic retinopathy (Horm Res 2000;53:53-67). Therefore, if statins act along the same pathway, this is another potential adverse effect of the drugs. Considering the fact that a high percentage of diabetics have heart disease and are likely on these drugs, this is significant.

Related Articles:

Low Cholesterol Linked to Depression

Lowering Cholesterol Could Cause Violent Behavior

Low Cholesterol Linked to Stroke Risk

Low Cholesterol and Albumin Bad Signs in Elderly

Statins May Impair Brain Function

Half of Population Will be Taking Statins

Low Cholesterol May Affect Mood

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