The US Preventive Services Task Force (USPSTF) has just come out with recommendations that doctors consider a statin for anyone between 40 and 75. Whether or not the physician prescribes such a drug should depend, says the USPSTF, on whether patients have any cardiovascular risk factors that would put them at a 10 percent or higher chance of a heart attack over the next 10 years.
Three years ago, the American College of Cardiology and the American Heart Association produced guidelines suggesting that everyone with a 7.5 percent risk of a heart event should be taking a statin. This would result in even more individuals taking these drugs. Indeed, almost 40 million Americans already take them, up from about 22 million people in 2002.
There is not enough data for the Task Force to determine whether older adults beyond the age of 75 benefit from statins. Some experts are concerned that people at advanced ages are more vulnerable to possible side effects such as muscle pain, weakness, cataracts and diabetes. Others insist that statins do not cause such adverse reactions.
Stories from Readers:
For some people, especially older adults, statin side effects can be debilitating. Many cardiologists insist that reports of adverse reactions are inflated and statins don’t really cause complications. We can only share what visitors to this web site have been saying for many years:
SHK in Arkansas:
“My husband went from a strong man of 65 (who chopped his own wood) and could lift extremely heavy objects to someone who couldn’t lift his arms. He couldn’t sleep because of the pain in his shoulders.
“The doctor took him off his statin drug and the last two months he has continued to lose muscle tone. He still can’t get out of his recliner by himself. He now has pain in almost every joint.
“I put him on CoQ10 last week and we are watching and waiting. He is miserable. He had been on his statin for over 20 years so we fear this is permanent. Sleep is impossible which makes the fatigue even harder to deal with.”
John in Iowa has a tale of woe:
“Ten years ago my internist recommended a statin to prevent heart problems. I developed insomnia. I also experienced burning and stinging pain in my feet. I had severe calf and thigh muscle pain and loss of strength and significant pain in the mid back. It was especially sore on the left side. I also developed a stiff neck and numerous headaches. I was diagnosed with peripheral neuropathy in both hands and lost the ability to type. I became a clumsy person since I could not feel anything that my hands were touching. I thought the end was in sight.
“Two weeks ago I fell in my garage and broke the top of the femur bone in the hip. It required surgery and I am really restricted in my movement and am enduring significant pain. The primary reason for the fall was the loss of strength and feeling in my hands and legs and I was unable to stop the tragic fall. I have a long road ahead to hopefully return to something normal. Statin drugs are dangerous for some people and I am a classic example.”
Ken in Maine:
“I was initially put on Zocor, 40mg then switched to simvastatin, 80mg. My problems are primarily with my left leg. It will cramp, spasm or collapse. My thighs feel like I ran a marathon. I had a biopsy done on the calf muscle and I have atrophy. I have developed ‘dropped foot.’
“I read that someone else also had trouble picking up a leg to get dressed. Stairs are a challenge. Lead with right, drag left. I could go on but you get the idea.”
Delores in Sun City, Arizona:
“I have been taking simvastatin for several years. I have muscle cramps in my legs and feet. The worst is my left leg. I cannot lift it without using my hands to put on pants. It almost feels like a I had a stroke.”
Jean in Scotland was devastated:
“I have necrotizing myositis, diagnosed by a muscle biopsy, triggered by atorvastatin. After 15 months and the failure of treatment with corticosteroids and rituximab, I have started infusions of immunoglobulin and methotrexate taken in tablet form.
“I am now so weak I cannot get up from most ordinary chairs or use a normal toilet. I cannot walk far and can only get up my stairs very slowly and with great effort. I cannot lift anything above my shoulders or from below my hip level. I cannot go for a walk or do my own shopping, and I can hardly get into and out from the car.
“Life has been wrecked by this. I am 59, and until this happened I enjoyed hill walking and keeping my half acre garden.”
Do Statins Really Cause Muscle Pain?
Physicians admit that statins can sometimes cause severe muscle pain and weakness. Things like rhabdomyolysis or necrotizing myopathy are considered extremely rare. What remains controversial is whether patients can experience muscle pain and weakness without elevations in a blood marker called CK (creatine kinase). Many doctors insist that such reports (like the ones described above) are psychosomatic reactions (all in the head). That’s because the randomized clinical trials (RCTs) of statins did not reveal any increase in myalgia (muscle pain), muscle cramps or muscle weakness.
An article in JAMA titled “What to Believe and Do About Statin-Associated Adverse Effects” (November 15, 2016) by Paul D. Thompson, MD, asks the question:
“How could the statin RCTs miss detecting mild statin-related muscle adverse effects such as myalgia? By not asking. A review of 44 statin RCTs reveals that only 1 directly asked about muscle-related adverse effects.”
If investigators do not ask about muscle pain, there is a good likelihood that they will not discover it and will not report it in the result section of their publications. That means that other health professionals will read statin studies that never mention muscle pain, weakness, cataracts or diabetes as side effects.
The Bottom Line from The People’s Pharmacy:
Heart disease is still a major killer in the US. Although statins can lower the risk, especially for people who have already had a cardiovascular event, they are not magic bullets and can’t undo the harm from smoking, a sedentary lifestyle or a poor diet. Learn about relative risk vs. absolute risk in the HOPE-3 trial that has cardiologists so very excited. Do the results merit such enthusiasm? Here is a link to a story about HOPE-3 and brain function from this week.
What’s your take on the new recommendations?
Do you think everyone over 40 should be taking a statin?
Do you think statin side effects are imagined?
Share your thoughts below in the comment section.
Want to learn more about other strategies to control cholesterol and lower risk factors for heart disease, check out our Guide to Cholesterol Control and Heart Health.
