adverse effects of bad cholesterol on the heart and blood vessels are well
deposits within the walls of
arteries, and slowly narrows them, thereby reducing blood supply to the heart
and other organs.
‘Statin are popularly used to reduce the incidence of heart disease, however recent study indicates that use of statin for 6 to 7 years can lead to a slight increase in the risk of developing diabetes.’
Statins are the preferred cholesterol-lowering
. They are effective
and are associated with lesser side effects as compared to other
cholesterol-lowering drugs. Drugs belonging to this group
include simvastatin, lovastatin
. By reducing production and thereby lowering the
levels of bad cholesterol
, these drugs reduce the chances of cardiovascular diseases.
person's risk for heart disease can be estimated using risk
, and the patient can be accordingly treated with statins.
However, there are reports that the American College
of Cardiology and American Heart Association (ACC/AHA) risk calculator may
over-estimate the risk of heart disease. This may result in more number of
people taking statins, while not all may actually require them.
Side effects of statin therapy include muscle
damage, liver injury and subsequent kidney damage, and
neurological side effects like confusion and forgetfulness
. Liver injury is currently rated as rare by the FDA
and therefore the patient may not require regular monitoring for this side
effect. Testing for liver enzymes is advised
just before starting the statin medication and may be repeated only if
required. Muscle pain is seen mainly with lovastatin. Memory loss
is reversible on
stopping the medication.
A more recent side effect that has been noted is an
increased risk of statin-related diabetes. Statins may be associated with the
development of diabetes, as shown in studies in patients taking
statins for 6 to 7 years
. Though the exact mechanism is not known, the
suggested mechanisms for the appearance of diabetes in these patients are:
- Statins cause the pancreatic cells
to take up more cholesterol, which affects insulin production and secretion.
Lack of insulin increases blood glucose levels thereby causing diabetes.
may cause insulin resistance. Insulin resistance means that insulin is present
in the body, but the cells are unable to utilize it to take in glucose. This
causes blood glucose levels to rise, and diabetes.
This side effect does not mean that people should
completely avoid taking statins. Statins have made invaluable contribution in
preventing heart disease over the years.
A proper assessment of the patient before
prescribing these drugs may help to select the patients who would benefit most
with the medication, while suffering from minimal side effects. Patients at a
high risk of heart disease are most likely to experience the benefits of these
medications, irrespective of the risk of diabetes. Those at a low risk could
possibly avoid statins and opt for lifestyle changes like a healthy diet and
may have to be used with caution in patients at a high risk for suffering from
diabetes, like those with prediabetes. Blood sugar
may have to be regularly
monitored in these patients.
2. Brett AS, Schwenk TL. Cholesterol Guidelines and
Statin Therapy: Debate Continues. http://www.jwatch.org/na39857/2015/12/30/cholesterol-guidelines-and-statin-therapy-debate-continues