The benefits of statins are outweighed by the side-effects, argue two health experts
An apple is better for heart health than a statin, say experts Photo: ALAMY
By Sarah Knapton, Science Editor
12:01AM GMT 23 Jan 2016
Statins do more harm than good and people would be better of eating an apple-a-day to prevent heart attacks and strokes, health experts have argued.
In a debate in the BMC Medicine Journal, consultant cardiologist Dr Aseem Malhotra and Professor Simon Capewell of Liverpool University argue that the cholesterol-busting drugs bring debilitating side effects while having little impact on health for most people.
They claim that industry sponsored studies do not back up real-world data which shows up to half patients give up taking statins within a year and 62 per cent of those say it was because of muscle pain and fatigue.
“The focus in primary prevention should the form be on foods and food groups that have a proven benefit in reducing hard endpoints and mortality.”
Dr Aseem Malhotra, Frimley Park Hospital
They suggest that more should be done to encourage people to eat more healthily and exercise to improve the condition of their heart rather than simply prescribing pills.
Although they help people who already have heart disease, they claim there is little evidence to show they are useful for the general public.
Dr Malhotra, of Frimley Park Hospital, Surrey, said: “The published literature states an unequivocal mortality benefit for patients with established heart disease. However the same does not apply to primary prevention, especially in individuals of low risk.
“For those at low risk, eating an apple a day has an equivalent risk reduction for myocardial infarction as taking a statin.
“More than 80 per cent of cardiovascular disease is attributable to environmental factors, notably unhealthy diet and also smoking, alcohol and physical inactivity.
“The focus in primary prevention should the form be on foods and food groups that have a proven benefit in reducing hard endpoints and mortality.”
An apple has the same benefits as a statin Photo: DANIEL JONES
Britain is already the “statins capital” of Europe - with the second highest prescribing levels in the Western world, amid spiralling obesity and aggressive prescribing of the medication by GPs, whose pay is linked to take-up of the pills.
The drugs are the most commonly prescribed medication in Britain, costing the NHS £450 million a year.
Under revised NHS guidance the majority of men aged over 60, and women over 65, are offered the drugs, even if they only have a one in 10 chance of developing cardiovascular disease within 10 years.
Forty per cent of adults will be advised to take statins under new NHS guidance which aims to cut 50,000 deaths a year from strokes and heart attacks.
Health experts believe that around 20,000 and 50,000 deaths could be prevented each year if everyone recommended statins took the medication.
But Professor Capwell argues that Nice guidelines condemn middle-aged adults to lifelong medications of questionable value and
“Pfizers own patient information leaflet of atorvastatin states that the common side effects of the drug include pain in the throat, nauseam indigestion, join and muscle pain and increases in blood sugar levels,” he said.
“Fortunately the majority of these symptoms may be reversible on cessation of the drug. However the small increased (0.5 – 1.1 per cent) risk of type 2 diabetes now directly attributed to statins should not be dismissed lightly.”
Statins cost the NHS around £450 million each year Photo: ALAMY
Richard Hobbs professor of Primary Care Health Services at Nuffield Department of Primary Care Health Services in Oxford said doctors should let patients know of the relative risks and not force people on to statins.
“Whether they take one or not is a patient choice issue and we should not offer or attempt to cajole patients one way or another,” he said.
“For some patients their fear of vascular disease will dominate and they many want a statin regardless of the calculated risk. For others, the risk of symptoms may negate the perceived gain.”
However consultant Dimitri Mikhailidis, of University College London Medical School, said trials showed that statins played an essential role in preventing deaths from strokes and heart attacks.
“Despite the continuing discussion of the effect of statins on all-cause mortality in these groups of patients, their role in primary prevention individuals, especially in high-risk ones are unquestionable,” he said.
Statins do more harm than good and people would be better of eating an apple-a-day to prevent heart attacks and strokes, health experts have argued.
In a debate in the BMC Medicine Journal, consultant cardiologist Dr Aseem Malhotra and Professor Simon Capewell of Liverpool University argue that the cholesterol-busting drugs bring debilitating side effects while having little impact on health for most people.
They claim that industry sponsored studies do not back up real-world data which shows up to half patients give up taking statins within a year and 62 per cent of those say it was because of muscle pain and fatigue.
“The focus in primary prevention should the form be on foods and food groups that have a proven benefit in reducing hard endpoints and mortality.”
Dr Aseem Malhotra, Frimley Park Hospital
They suggest that more should be done to encourage people to eat more healthily and exercise to improve the condition of their heart rather than simply prescribing pills.
Although they help people who already have heart disease, they claim there is little evidence to show they are useful for the general public.
Dr Malhotra, of Frimley Park Hospital, Surrey, said: “The published literature states an unequivocal mortality benefit for patients with established heart disease. However the same does not apply to primary prevention, especially in individuals of low risk.
“For those at low risk, eating an apple a day has an equivalent risk reduction for myocardial infarction as taking a statin.
“More than 80 per cent of cardiovascular disease is attributable to environmental factors, notably unhealthy diet and also smoking, alcohol and physical inactivity.
“The focus in primary prevention should the form be on foods and food groups that have a proven benefit in reducing hard endpoints and mortality.”
An apple has the same benefits as a statin Photo: DANIEL JONES
Britain is already the “statins capital” of Europe - with the second highest prescribing levels in the Western world, amid spiralling obesity and aggressive prescribing of the medication by GPs, whose pay is linked to take-up of the pills.
The drugs are the most commonly prescribed medication in Britain, costing the NHS £450 million a year.
Under revised NHS guidance the majority of men aged over 60, and women over 65, are offered the drugs, even if they only have a one in 10 chance of developing cardiovascular disease within 10 years.
Forty per cent of adults will be advised to take statins under new NHS guidance which aims to cut 50,000 deaths a year from strokes and heart attacks.
Health experts believe that around 20,000 and 50,000 deaths could be prevented each year if everyone recommended statins took the medication.
But Professor Capwell argues that Nice guidelines condemn middle-aged adults to lifelong medications of questionable value and
“Pfizers own patient information leaflet of atorvastatin states that the common side effects of the drug include pain in the throat, nauseam indigestion, join and muscle pain and increases in blood sugar levels,” he said.
“Fortunately the majority of these symptoms may be reversible on cessation of the drug. However the small increased (0.5 – 1.1 per cent) risk of type 2 diabetes now directly attributed to statins should not be dismissed lightly.”
Statins cost the NHS around £450 million each year Photo: ALAMY
Richard Hobbs professor of Primary Care Health Services at Nuffield Department of Primary Care Health Services in Oxford said doctors should let patients know of the relative risks and not force people on to statins.
“Whether they take one or not is a patient choice issue and we should not offer or attempt to cajole patients one way or another,” he said.
“For some patients their fear of vascular disease will dominate and they many want a statin regardless of the calculated risk. For others, the risk of symptoms may negate the perceived gain.”
However consultant Dimitri Mikhailidis, of University College London Medical School, said trials showed that statins played an essential role in preventing deaths from strokes and heart attacks.
“Despite the continuing discussion of the effect of statins on all-cause mortality in these groups of patients, their role in primary prevention individuals, especially in high-risk ones are unquestionable,” he said.
