Taken by millions of people across the United States, statin medications can reduce the risk of heart attack and stroke by lowering cholesterol levels. But an untold number of people who could also benefit from these drugs avoid them due to concerns about potentially serious side effects.
[1]
[2]
But statins don’t cause nearly any of the more than 60 possible side effects listed on the drug packaging, according to a new research review.
[3]
“I think this underscores what most cardiologists and physicians in general have known for a long time — that statins are incredibly safe,” says Omar K. Siddiqi, MD, an assistant professor of cardiovascular medicine and director of the Cardiovascular Medicine Fellowship Program at Boston Medical Center in Massachusetts.
“The Achilles heel for a long time has been this idea that statins are associated with a lot of side effects,” Dr. Siddiqi says. “I’ve even heard people say things like they’re the most dangerous medications you can take, and that’s been kind of popularized in the general media. So it’s become a bit of folklore that statins are associated with muscle breakdown and muscle pain — and that’s what people tend to know about,” he says.
Only a Handful of Statin Side Effects Are Supported by Evidence, Analysis Finds
Researchers looked at data from more than 150,000 participants among 23 large randomized clinical trials that either analyzed the effects of statins compared with a placebo, or the effects of stronger-acting statins compared with milder ones.
They found a similar frequency of side effect reports between participants taking statins and those taking placebos. That means people really are experiencing these symptoms — but it’s not the statins that are causing them.
For instance, cognitive or memory issues were reported in about 0.2 percent of participants taking either statins or placebo — meaning the increased incidence was equal for both people on statins and those on placebos, says lead study author Christina Reith, PhD, an associate professor at the University of Oxford’s Oxford Population Health in England.
“In this latest work, we found no significant excess risk with statins for almost all the conditions listed in package leaflets as potential side effects,” says Dr. Reith.
The study found no excess risk from statin use for any of the following:
- Depression
- Sleep disturbance
- Erectile dysfunction
- Weight gain
- Nausea
- Fatigue
- Headache
There was a small increase (around 1 percent) in the risk of muscle pain for people taking statins, “which largely occurred in the first year of treatment,” Reith says.
[4]
The review also found a 0.1 percent increased risk of having liver blood test abnormalities, but not an increase in reports of actual liver disease — which suggests that these cases didn’t lead to more serious liver issues.
Siddiqi notes that while liver-related and other risks are rarely seen in practice, it’s still possible for them to occur. “I think the side effects that you can detect on a lab test are almost unheard of, but they do happen and there are real people who have them — so we’re not undermining that.”
Statins side effects that the analysis did find to be supported by evidence include urinary changes and tissue swelling.
Research Has Some Limitations
The current research comes with some limitations, including the possibility of longer-term side effects linked to statins that surpass the duration of the clinical trials studied, which were up to seven years.
“Adverse events experienced were also based on reports, rather than full biochemical-laboratory data, which may underestimate the liver blood test abnormalities, although the lack of serious liver outcomes suggests this is unlikely to change the main conclusions,” Reith adds.
Tips for Using Statins
There are multiple different types of statins to select from if one doesn’t work well for a particular patient, with higher-intensity statins cutting cholesterol levels more than lower-intensity versions.
[4]
“If somebody develops symptoms from one statin, that does not mean that that’s a drug class effect, so they may actually tolerate other statins better,” Siddiqi says.
- Take statins exactly as prescribed by your healthcare provider.
- Don’t suddenly stop taking statins on your own.
- Talk to a healthcare provider about any symptoms or concerns.
Above all, the researchers hope the findings highlight that the known benefits of statins outweigh any risks.
“Statins are potentially lifesaving treatments for people who are at risk from heart attack and stroke, which remains a leading cause of death and disability worldwide,” Reith says. “Statin drug packaging and other sources of health information for statins should be reviewed to enable doctors and patients to make informed decisions.”
