2024-01-05 07:00:16
According to a recent Swiss study, almost a third of people over 65 take a statin, a medication prescribed to lower blood cholesterol levels. In recent years, the occurrence of musculoskeletal disorders in some of the patients treated has created controversy over the benefit of these medications. What is the latest data on these drugs? Has their prescription been reduced? Let’s take stock of statins.
Statins, widely prescribed medications for cardiovascular health
Currently in France, five drugs constitute the drug class of statins :
Atorvastatin; Pravastatin; Rosuvastatin; Simvastatin; Fluvastatin.
Statins are indicated in treatment of high cholesterol to lower blood cholesterol levels and prevention of recurrence of myocardial infarction.
Like any medication, taking statins exposes patients to various side effects. While most are benign (digestive problems, headaches, fatigue, dizziness, etc.), other side effects can be serious:
An increase in liver enzymes, reflecting liver damage; Of the musculoskeletal problemswith muscle damage or even destruction of muscle tissue.
Furthermore, statins may contribute to increased blood sugar levels, necessitating increased blood sugar monitoring in diabetic subjects.
Read also – Should we stop statins following 75?
A controversy followed by a consensus
The question of the prevalence of serious musculoskeletal effects linked to statins sparked controversy a few years ago, leading to the question of the relevance of these drugs in subjects aged over 75 years. Following this controversy, many patients stopped their treatment without medical advice, leading to an increase in cardiovascular accidents in the following months and years. Gradually, researchers reached a relative consensus. While statins were prescribed to a very large number of patients, they encouraged us to differentiate between two situations. On the one hand, for patients at low or moderate cardiovascular risk, the relevance of statins can be discussed with regard to the risks linked to side effects. On the other hand, for patients at high cardiovascular risk, statins remain decisive in reducing the occurrence of major cardiovascular events.
Since this controversy, studies have multiplied both on the effectiveness and the risks of statins. In April 2023, during the annual international cardiology congress (CADECI), a meta-analysis bringing together data from 176 clinical studies involving more than 4 million patients revealed that approximately 9% of patients treated with a statin were statin intolerant. The analysis made it possible to identify risk factors for this intolerance, including:
Read also – Proton pump inhibitors, should their use be restricted?
Two recent studies confirming the benefit of statins
Furthermore, in the fall of 2023, two studies confirmed the clinical benefit of statins. The first study, carried out on a cohort of 14,828 patients over 65 years old, demonstrated that statin treatment might reduce the all-cause mortality rate by 9%. On the other hand, the benefit on the risk of major cardiovascular events was not significant.
The second study was conducted on 710,313 US military veterans, 86,327 of whom were considered to be in poor health. Followed over an average period of 8 years, veterans who started statin treatment during the study presented a reduced risk of mortality and major cardiovascular events, regardless of their fragility. These two very recent studies demonstrate the value of statins in the prevention of cardiovascular events. Between their therapeutic benefit and the risks of major musculoskeletal disorders, statins must be prescribed following a precise assessment of the context of each patient. And treatment must be reassessed regularly, particularly following age 75.
Read also – Statins, the truth and the falsehood regarding their side effects
Estelle B., Doctor of Pharmacy
Sources
– Cholesterol: Should we stop taking preventive statins following age 75? www.inserm.fr. Accessed December 20, 2023.
– Statins, Mortality, and Major Adverse Cardiovascular Events Among US Veterans With Chronic Kidney Disease. jamanetwork.com. Consulté le 20 décembre 2023.
– New statin use, mortality, and first cardiovascular events in older US Veterans by frailty status. agsjournals.onlinelibrary.wiley.com. Consulté le 20 décembre 2023.
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