Dr. Matthew Gianforte

Statins are among the most popular medications for cholesterol control. Statin drugs lower your risk of stroke and heart disease, but they have potential side effects. Learn more about statins below, from how they work to control high cholesterol to statin drug side effects and risk factors.

What is a Statin Drug?

A statin drug is a medication that lowers bad cholesterol (low-density lipoprotein, or LDL) and improves your good cholesterol (high-density lipoprotein, or HDL) (1). There are 7 FDA-approved statins available today, which are:

  •         Lipitor (atorvastatin)
  •         Pravachol (pravastatin)
  •         Zocor (simvastatin)
  •         Livalo/Nikita (pitavastatin)
  •         Altroprev/Mevacor (lovastatin)
  •         Crestor (rosuvastatin)
  •         Lescor (fluvastatin) 

How Statin Drugs Work

Regardless of the brand name, statin drugs work the same way. They target the liver enzyme that produces cholesterol, HMG CoA Reductase. If this enzyme has too much cholesterol, plaque builds up and hardens the arteries.

The outcome puts you at risk of heart attacks, blood clots, and stroke. In theory, statin drugs reduce harmful cholesterol and plaque to decrease the chances of heart diseases.

That said, you need a critical eye to interpret research about statins. For example, a 2017 study showed that statin drugs could reduce heart disease deaths by 28% in men (2). However, this measures the relative risk of heart disease, not absolute risk. What’s the difference?

Absolute risk refers to patients who have high cholesterol or previous heart-related conditions. Relative risk means patients with lower cholesterol and no aforementioned heart conditions. The absolute risk data is the most important in terms of outcomes, but relative risk data often sounds more impressive. This may be the case with this 2017 study and several others.

Effectiveness of Statin Drugs

Let’s look at another study published in The Lancet in 2017 (3). For every 39mg/dL of statins administered, patient mortality decreased by 10%. A closer look at that same study tells a different story: mortality rates for absolute-risk patients reduced from 2.3% to 2.1%, or 0.2%— less impressive than the 10% result.

 

Statin Drug Side Effects

The most common statin side effect is muscle pain, but there are many common, serious, and rare side effects.

 

Common Side Effects:

  •         Headaches, drowsiness, dizziness
  •         Skin issues: flushing, rashes, acne
  •         Digestive issues: bloating, gas, nausea, vomiting, constipation, stomach cramps, diarrhea
  •         Muscle aches, weakness, or tenderness
  •         Sleep issues
  •         Low platelet count
  •         High blood pressure

 

Serious Side Effects:

  •         Muscle inflammation and weakness from myositis
  •         Increased CPK (creatine phosphokinase) leads to muscle pain and inflammation
  •         Muscle damage from rhabdomyolysis

 

Rare Side Effects:

  •         Hair loss
  •         Pins-and-needles sensation on the skin
  •         Liver and pancreas inflammation
  •         Sexual difficulties like low sex drive or erectile dysfunction
  •         Memory loss
  •         Neuropathy

 

Statins may also increase your risk of diabetes. A study published in Diabetes Metabolism in 2019 showed that statins might double your risk of diabetes, especially for patients taking them for two years or longer (4)

 

Statins may put you at risk of staph skin infections too. A study published in the British Journal of Pharmacology showed that statins increased the risk of skin infections by 40% (5). This was both a complication related to diabetes and to taking statin drugs.

 

Statin Drug Side Effect Risk Factors

Certain risk factors increase the chances of getting the above statin drug side effects. These include patients who: 

 

  •         Are female
  •         Over 65 years old
  •         Have liver or kidney diseases
  •         Have a small physique
  •         Take excess alcohol
  •         Take more than one cholesterol medication
  •         Have vitamin D deficiency

 

Vitamin D deficiency is a less-known but important risk factor. A study published in Disease Markers in 2019 found that patients with low vitamin D levels had a higher risk of muscle pain induced by statins (6).

 

Statin Drugs and Mitochondria

Mitochondria essentially power your bodily functions by generating energy in your tissues. Statin drugs can negatively affect how you process cellular energy, as demonstrated in the studies below:

 

  •         In 2017, the Journal of Clinical Medicine published a review of statin drugs and statin-associated muscle symptoms (SAMS) (7). Researchers found the discontinued use of statin drugs because of SAMS.
  •         In 2016, Postepy Biochemii published a review indicating that statin drugs may lead to mitochondrial impairment (8). Researchers discovered that statin drugs reduced mitochondrial activation, oxidation, and membrane function.

 

Conclusion

While statin drugs can effectively control high cholesterol, there’s still plenty of work to do. The best approach is holistic: control high cholesterol naturally through diet and exercise, then minimize the risk of statin drug side effects if you must take them. To learn more about statins, visit your nearest Kansas City physician today.

 

Sources:

 

  1. Cholesterol medications. American Heart Association. Link Here

 

  1. Antonio J. Vallejo-Vaz, Michele Robertson, Alberico L. Catapano, Gerald F. Watts, John J. Kastelein, Chris J. Packard, Ian Ford, Kausik K. Ray. LDL-Cholesterol Lowering for the Primary Prevention of Cardiovascular Disease Among Men with Primary Elevations of LDL-Cholesterol Levels of 190 mg/dL or Above: Analyses from the WOSCOPS 5-year Randomised Trial and 20-year Observational Follow-Up. Circulation, 2017. Link Here

 

  1. Cholesterol Treatment Trialists’ (CTT) Collaboration, Baigent C, Blackwell L, Emberson J, Holland LE, Reith C, Bhala N, Peto R, Barnes EH, Keech A, Simes J, Collins R. Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170,000 participants in 26 randomized trials. Lancet. 2010 Nov 13;376(9753):1670-81. doi: 10.1016/S0140-6736(10)61350-5. Epub 2010 Nov 8. PMID: 21067804

 

  1. Zigmont VA. Statin users have an elevated risk of dysglycemia and new-onset diabetes. 2019. Diabetes Metabolism. Link Here

 

  1. Humphrey HTK. A sequence symmetry analysis of the interrelationships between statins, diabetes, and skin infections. BJCP. 2019. Link Here

 

  1. Pennisi M, Di Bartolo G, Malaguarnera G, Bella R, Lanza G, Malaguarnera M. Vitamin D Serum Levels in Patients with Statin-Induced Musculoskeletal Pain. Dis Markers. 2019 Mar 25;2019:3549402. Doi: 10.1155/2019/3549402. PMID: 31019583

 

  1. Ramachandran R, Wierzbicki AS. Statins, Muscle Disease, and Mitochondria. J Clin Med. 2017 Jul 25;6(8):75. doi: 10.3390/jcm6080075. PMID: 28757597

 

  1. Broniarek I, Jarmuszkiewicz W. Statyny a mitochondria [Statins and mitochondria]. Postepy Biochem. 2016;62(2):77-84. Polish. PMID: 28132458

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