Statins are good for you

Friday, 09 December 2011 From Issue Vol. XIX No. 49 By  Dr. Iain Corness

When I was in General Practice in Australia, the cholesterol-lowering drug Simvastatin became available.  After telling patients to cut down on animal fats to lower their cholesterol, there was now a drug that could help.

I was never one to be the first to prescribe new ‘wonder’ drugs, but with the cardiologists sending patients back on this drug regimen, I too began to prescribe it.  Simvastatin became one of the drugs I enjoyed prescribing most - it actually did work!  Not that other prescribed medications did not work, but Simvastatin produced an amazing lowering of the body’s burden of cholesterol very quickly.  And every time.

However, the long term results of any drug use are sometimes difficult to demonstrate at first.  After many years, does your blood pressure go through the roof?  Or do your dangly bits fall off?  In some instances it could be a case of ‘wait and see’.  However, as far as is possible, the results of longer term usage are looked at through many ways, including animal testing.  The poor old laboratory mouse is flat out keeping numbers up to scratch!

There is just so much information to collect - there are epidemiological results found from over hundreds of thousands of cases and critically reviewing the results at the end.  This is one of the ways that differentiates between the pharmaceutical industry and the “alternative” industry.

Now, a startling fact has emerged from one of the longer term examinations of statin usage.  It appears that statins safely reduce the risk of cardiovascular illness even years after treatment is stopped, according to a probe into the popular cholesterol-lowering group of drugs published in November.

A look at the background is justified here.  Statins work by blocking a liver enzyme that makes fatty molecules, which line arterial walls and increase the danger of heart disease and strokes.  With worldwide annual sales of more than 20 billion dollars, the drugs have been dubbed “the aspirin of the 21st century” because of their benefit and wide use.  However, lingering questions persisted about their long-term safety for the heart, liver and cancer risk.

In this latest examination, researchers at the Heart Protection Study Collaborative Group in Oxford in the UK looked at 20,536 patients at risk of cardiovascular disease who were randomly allocated 40 mg daily of simvastatins or a dummy look-alike (known as placebo’s) over more than five years.

During this period, those who took the statins saw a reduction in “bad” cholesterol (LDL) and a 23 percent reduction in episodes of vascular ill-health, compared to the placebo group.  The exhaustive study did not end there.  The monitoring of the volunteers continued for a further six years after the trial ended.  The investigators found that the benefits persisted throughout this monitoring period even among those volunteers who had stopped taking the statins.  Now that is somewhat amazing.  In addition, there was no emergence of any new health hazard among those who had taken, or were continuing to take, the drugs.

“The persistence of benefit we observed among participants originally allocated simvastatin during the subsequent six year post-trial period is remarkable,” said one of the investigators, Richard Bulbulia.

As far as cancer incidence was concerned, a number of cancers (nearly 3500) developed amongst the 20,536 volunteers during this follow-up period (roughly one in six), but there was no difference in cancer incidence between the statin and placebo groups.

Richard Bulbulia continued, saying, “In addition, the reliable evidence of safety, with no excess risk of cancer or other major illnesses during over 11 years follow-up, is very reassuring for doctors who prescribe statins and the increasingly large numbers of patients who take them long-term to reduce their risk of vascular disease.  A previous investigation in November 2010 found that long-term use of statins was less risky than thought for people with non-alcoholic fatty liver disease (NAFLD), a common liver ailment.

So what does all this mean as far as cardiovascular disease is concerned?  It has been shown, beyond doubt, that LDL cholesterol is a major factor in coronary artery disease.  It has now been shown that statins do reduce LDL, do reduce your risk, and appear safe and have lasting benefits.

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