Statin side-effects 'felt by those who fear them'

3rd May 2017 – Patients who experience side-effects when they take statins may do so because they already have a negative view about the medication, says a study.

Statins are prescribed in the UK to reduce levels of low density lipoprotein (LDL) cholesterol in the blood – the so called 'bad' cholesterol.

Cardiovascular disease prevention

High levels of LDL cholesterol are linked to hardening and narrowing of the arteries, known as atherosclerosis. This condition increases the likelihood of a heart attack, heart disease and stroke.

Statins have been hailed as a cheap and effective way of reducing rates of cardiovascular disease. However, they have proved controversial because with reports linking them to other conditions such as diabetes.

Statins are widely prescribed to reduce the risk of cardiovascular disease.

However, their widespread use has proved controversial because of their link to a number of side-effects, such as an increased risk of diabetes.

Do statins cause muscle problems?

One contested issue is whether statins cause muscle pain and weakness. Some observational studies have suggested that up to 20% of patients experience symptoms, while trials in which patients were randomly assigned to either receive statins or a placebo found little or no increase in symptoms.

The results of a trial, published in the medical journal The Lancet, show that patients who were unaware they were taking statins reported no increase in muscle pain or weakness. However, when patients were told they were taking a statin, they were more likely to report symptoms.

The 'nocebo effect'

The researchers, led by Imperial College London, say their findings are consistent with the so-called 'nocebo effect' where the expectation of side-effects makes patients more likely to report them.

The study looked at 26 side-effects from a trial involving 10,180 patients aged 40 to 79 from the UK, Ireland and Scandinavia. All the patients had high blood pressure and at least 3 other risk factors for cardiovascular disease.

All the participants were randomly assigned to either take the 10mg of the statin atorvastatin or a placebo. Neither the patients nor the doctors involved were told which drug was which.

After 3 years, the rate of muscle-related symptoms was found to be similar in both groups. In all, 2.03% of the group taking statins reported muscle problems compared with 2% of those taking statins.

The study also found little difference between the statin and placebo groups for erectile dysfunction. (1.86% vs 2.14% per year). The study also found fewer cases of sleep disturbance among those taking statins. However, more people in the statin group reported the need to urinate in the night than those in the placebo group.

After 3 years, the statin was found to be effective at reducing cardiovascular disease and all those involved in the study were offered the choice of taking a statin or not.