Statins are the most
That was the case when the
Q. Should we be scared about these warnings?
A. These are not new findings, well known to people in the field. But as data accumulates, the FDA is highlighting the information in the package insert.
Q. But higher blood sugar levels?
A. It has been known for many years that there is a small but documented increase in
Q. What about these complaints about forgetfulness?
A. The cognitive effects are less well substantiated. We have anecdotal reports, but when it was looked at scientifically, studies failed to show an increase — in fact, statins may have a slight protective effect forAlzheimer's. But the FDA felt that there were enough of these anecdotes that doctors should be aware … even though the data is not as robust as the diabetes data.
Q. There has also been some concern about muscular aches?
A. This is also well known and included in the package insert. About 1 out of 200 patients experience inflammation of the muscles and up to 8 percent get some aching … But we can turn it around and say the vast majority of people have no side effects from statins and tolerate them quite well for many years.
Q. So, there's no need for a drug holiday — even if you've been on statins for years?
A. Clinical studies show no evidence that people who've been on them for a long time should take a hiatus. There's no long-term or accumulative effect. We'd only recommend a drug holiday in response to side effects.
Q. I know a lot of people who say they'd prefer to control their cholesterol with diet and exercise. Is there anything wrong with that?
A. Statins are prescribed for two components: How high is the cholesterol and what is the risk level of some kind of heart event? It is very effective for those who are at high or moderate risk. But do I think you should give it to everyone at age 50? No. Controlling cholesterol by lifestyle changes — diet, exercise, weight loss — is still the best.
Q. So, in light of this news, will you be changing your prescribing habits?
A. No. It just verifies what we knew before. Some of us are a little worried that these reports will scare patients away from something that can be highly beneficial to them. If you have any concerns, talk to your doctor so you can make an informed decision.