If you are taking a statin drug, you need to know this

Statin drugs, which are prescribed in order to lower the risk of heart attacks and strokes, are among the most (over?) prescribed drugs on the planet.

Why? Because the argument has long been that since they are known to be cardio-protective in some people, why not give them to everyone since they they are harmless drugs, so the risks are tiny but the gains may be huge.

But here’s the thing: Although statins have certainly proven to be very beneficial in people who’ve had a previous heart attack, and also beneficial in people at very high risk of heart attack sometime in the future, they have not been proven to be nearly as beneficial at people at lower risk of imminent heart problems, who are, unfortunately, the vast majority of people prescribed statins under the most recently-updated guidelines, which have lowered the bar – significantly – about who should get a statin and who doesn’t need one.

So if that’s you – no previous heart attack, no evidence of heart disease and only at mild or moderate risk for one – you really need to pay attention to a recent review about statins in the BMJ.

The researchers in that review estimate that you need to treat 400 people with statins for 5 years to prevent one heart attack in that entire group.

Or put another way, if 400 average risk users take a statin drug for 5 years, one lucky user will not have a heart attack because of taking the statin drug, but 399 users will not get any cardiovascular benefit from the medication.

On the other hand, the researchers also claim that for every 10,000 patients treated with statins for 5 years, there would be at least five cases of a muscle inflammation known as a myopathy (some studies claim that that’s way too low an estimate), there will be 50-100 new cases of diabetes, (and diabetes can of course quite perversely actually increase the risk of heart attack and stroke), and there will be 5-10 strokes of the type known as hemorrhagic strokes (caused by bleeding in the brain, and which are quite difficult to treat).

So when it comes to using statins for what’s called primary prevention – no previous heart attack – you really have to ask yourself what Dirty Harry would ask, “You feeling lucky, punk?”