Statins get an undeserved bad rap. Most of the listed side effects are questionable (you see no statistical difference in placebo controlled trials for things like liver damage, muscle aches and pains, Etc).
So, the real things that are well verified.
-About 1 out of 10 people with prediabetes will progress to full blown diabetes sooner if placed on a statin. However, so long as diabetes is managed, people who continue to take the statin will live longer and be healthier on everage than those who stop it. Note, this is people with prediabetes, if you have that, you should be cleaning up your diet and exercising as otherwise it will progress to diabetes.
-1 in 100,000 people will have a trues muscular fibrosis response, this is rare, but can happen. There are ways to reduce the risk.
Statins are not associated with dementia and lowering cholesterol actually reduces the risk of dementia. However, for some people they do cause memory issues. These issues resolved with stopping the statin, and a statin vacation (1-6 weeks al of not taking it) will provide a clear answer. One statin will cause this issue for someone, while a different one does not. So, just because one causes an issue doesn't mean a different one will.
Statins have a very strong nocebo effect. This is basically the evil twin of the placebo effect. There are ways to manage this, primary being giving to person taking the statin some control over dosing.
Statins are about risk reduction, no one has a crystal ball, but you are more likely to live longer and be healthier if you take one, then if you don't. This is supported be multiple large, long term, data sets in humans (one of the benefits of old meds that have been around for over 35 years, along with being cheap). It really sucks if you turn out to have a bad side effect, but not being able to predict the future, all a health care provider can do is recommended the lowest risk option.
Now, on balance, statins are pretty safe with a very small risk of significant adverse effects. Probably safer than taking ibuprofen (which can cause kidney failure, heart attacks, life threatening bleeding, and all your skin to fall off and you basically die from the equivalent of 3rd degree burns which is called SJS). Additionally, unlike ibuprofen, statins have a pretty significant benefit profile.
There was a time when there was concern that lowering cholesterol too much could cause issues, as science has proven this to be false and in large human datasets shown that further reduction in cholesterol reduces risk further, the case for more aggressive treatment has become stronger. The benefits of lower cholesterol shows up over years of lowering. Just like you can't start walking at 60 and expect the health benefits of a life long athlete.
The rather ill informed idea of revenue generation always gets brought up, so lets address that.
The way to make money is to tell people not to take them. If I Rx a statin to someone for 10 years, and assume they only need an annual visit for a refill, our office brings in about $3500 and you can assume drug companies make about $800 over that 10 years. Assuming current guidelines are used to guide starting treatment, I need to treat 10 people to prevent one heart attack in that 10 years. So, $35,000 + 8,000, for $43,000 in 10 years.
Compare that to the best case without prescribing any statins, the person develops angina, I see them in the office, get them a stress test and echo, then send them for a heart cath and they get a stent, my employer would net about $18,000 more when all is said and done as opposed to treating 10 people with statins. But, in the worst case, we are talking hundreds of thousands in addition revenue for the medical industry that is lost by preventing a single heart attack.
Some of the older intervention cardiologists remember 20+ years ago having partners that didn't believe in prescribing statins, those guys had a steady rotation of the same people getting stents every few years. Great business model, flat out shit way to treat people though.
I do find it amusing how people actually drive up medical expenses by avoiding good preventative care in the name of not enriching big pharma.
www.escardio.org
pmc.ncbi.nlm.nih.gov
