Statins warning: Stopping treatment prematurely is ‘not a wise choice’ – risks

Lorraine – Dr Hilary talks about latest findings on statins and diabetes

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According to researchers, stopping treatment of statins early could reduce protection against heart disease for patients. The study suggests that patients who started taking statins in their 50s and stopped in their 80s saw a reduction in their level of protection.

Researchers reached their conclusion after using data of 118,000 patients from statin trials as part of the Cholesterol Treatment Trialists Collaboration (CTT) alongside data of 500,000 people from the UK Biobank.

From this they were able to work out the potential impact of stopping statin treatment early and estimate the benefits of statins in regard to heart attack and strokes.

Lead author of the study Dr Runguo Wu said: “The study indicates that people in their 40s with a high likelihood of developing cardiovascular disease, and people of all ages with existing heart disease, should be considered for immediate initiation of cholesterol-lowering treatment.

Dr Wu added: “Stopping treatment, unless advised by a doctor, does not appear to be a wise choice.”

How effective are statins?

While other measures such as improved lifestyle choices can have a positive impact on reducing heart disease risk, research suggests statins can help reduce the risk of a heart attack or stroke by around 25 percent.

Furthermore, research suggests heart disease is the most common cause of ill health and death globally, sitting ahead of cancer in its impact on global health.

Speaking about the study results, Dr Wu commented: “Our study suggests that people who start taking statins in their 50s but stop at 80 years of age instead of continuing lifelong will lose 73 percent of the QALY benefit if they are at relatively low cardiovascular risk and 36 percent if they are at high cardiovascular risk – since those at elevated risk start to benefit earlier.”

What does QALY stand for?

QALY stands for quality adjusted life years; it is the measurement by which the benefits of statins are measured by. One QALY is equal to one year of perfect health.

As well as identifying the benefits of statins to the wider population, the Queen Mary University of London study was also able to identify which gender benefitted least from stopping statin treatment early.

Overall, since men were found to have worse cardiovascular health than women, they were found to exhibit the least benefit from stopping early. Dr Wu said: “Women’s cardiovascular risk is generally lower than men’s. This means that for women, most of the lifelong benefit from statins occurs later in life and stopping therapy prematurely is likely more detrimental than for men.”

Alongside measuring the negative impacts of ending statin treatment early, the study also assessed the impact of beginning it late. They found that those who under the age of 45, who had a 20 percent risk of a heart attack, faced a greater risk if they delayed treatment than those who had a five percent risk.

Dr Wu said of this data: “Again, this is because people at higher cardiovascular risk start to accrue benefit early on and have more to lose by delaying statin therapy than those at low risk.”

What is high cholesterol?

High cholesterol is more than just a case of cholesterol levels being too high. It is a case of levels of the wrong type of cholesterol exceeding healthy levels.

The reason for this is because there are two types of cholesterol, HDL and LDL. HDL stands for high-density lipoprotein, this type of cholesterol is needed by the body to maintain overall health and to keep the heart healthy.

Meanwhile, LDL stands for low-density lipoprotein. It is this type of cholesterol which is the dangerous type as it forms as a plaque in the arteries, raising blood pressure and increasing the risk of a heart attack.

As a result, the aim is to have high levels of HDL, also known as good cholesterol, and low levels of LDL, also referred to as bad cholesterol and the equilibrium statins are designed to achieve.

Are there any side effects to statins?

In common with other medications, statins can cause side effects such as:
• Headache
• Dizziness
• Feeling sick
• Feeling unusually tired or physically weak
• Digestive problems
• Muscle pain
• Sleep problems
• Low blood platelet count.

This is not an exhaustive list; the full list will appear on the leaflet with each packet of medication.

While statins can cause side effects, they are an effective way to manage high cholesterol and maintain overall heart health.

Furthermore, as the study demonstrates, it is important to commit to one’s treatment so that the risk of a heart attack or stroke can be mitigated.

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