Benefits of statins far exceed side effects: expert

In the backdrop of controversies over the use of cholesterol-lowering drugs Statins, a leading Indian cardiologist has expressed the view that the benefits of these drugs far exceed the side effects in the very high-risk population.
Professor Upendra Kaul, executive director at the Fortis Escorts Heart Institute, has said in a paper that cardio vascular disease (CVD) is the leading cause of death annually, including in India. The lipid-lowering drug therapy is one of the most effective measures to deal with the disease.
Kaul said that Statin group of drugs are the most studied and prescribed medicine for the prevention and treatment of CVD. However, in recent past there have been controversies associated with these drugs confusing the patients as well as the treating physicians.

Most common side effects are myopathies (muscle weakness), liver enzyme elevation and rarely rhabdomyolysis (breakdown of muscle tissue that releases a damaging protein into the blood that can damage the kidneys), the paper titled 'Statins, Cholesterols and Controversies' notes.
The United States Food and Drug Administration (FDA) has also stated that statin use may lead to cognitive decline, essentially impaired memory, forgetfulness, but Kaul says that a cause and effect relationship can only be demonstrated by carefully conducted prospective studies as these disorders are not uncommon in patient groups requiring statins.
Kaul also tried to clear the air on Cholesterol in the paper explaining the central place it holds in a healthy body while holding sugars and polyunsaturated fats to be the real culprits. "Cholesterol performs or assists in thousands of bodily functions such as building cell membranes, nerve sheaths and brain," he said.

The paper notes that dietary cholesterol may actually prevent inflammation in the blood vessels, which is the main cause of heart attacks. Mediterranean diet, characterised by high consumption of olive oil, legumes, unrefined cereals, fruits and vegetables, fish and non-fish meat products, has shown to be reducing the mortality from CVD diseases by up to 70 per cent, it says.
The paper concludes that statin drugs have an important role in preventing cardio vascular deaths in patients with established heart disease due to atherosclerosis (narrowing of arteries).
"Statins are not without side effects which should always be remembered. Some of these are muscle pains, cognitive disorders and acquisition of diabetes. The benefits however far exceed these problems in the very high risk populations," he said.