Viewpoint: The hidden (and painful) cost of statins
About a million Britons take statins to reduce their cholesterol - now American medics are suggesting at least 80 per cent of men over 50 and women over 60 should be prescribed them.
One expert who is far from convinced is Dr Andrew Bamji, a consultant in rheumatology and rehabilitation at Queen Mary's Hospital, Sidcup. He was on statins until things went horribly wrong...
As a rheumatologist, my job is to help people with joint problems and arthritic complaints. So it was with some irony that I diagnosed myself with tenosynovitis - a severe tendon inflammation I often treat in my patients.
But the greater irony was that this chronically painful problem had been triggered by the statins I'd been prescribed to lower my cholesterol. The very pill that was supposed to be improving my health was actually making it worse.
Statins are the 'wonder drugs' enthusiastically prescribed for people whose cholesterol is considered to be significantly raised. Yes, it's generally accepted that if you've had a heart attack, statins are an important tool in preventing another. But the problem is that these drugs are being handed out willy-nilly, with very little apparent benefit.
A patient undergoes a test to check cholesterol levels at a London hospital
Yet many patients face debilitating side-effects in return for the marginal protection statins can offer against heart attacks. And it's time that the medical profession recognised this.
Put simply, though people are put on statins for a reason, is that reason in any way reasonable?
I discovered the link between statins and rheumatic side-effects quite by chance. My attack of tendon inflammation occurred at the front of my shin - a highly unusual place for tenosynovitis - so I decided to do some research into what could have triggered this.
I was amazed to discover the only other related case was linked to a patient on statins.
Following a high cholesterol-reading of 9.2 a couple of months before, I'd been put on the drug. Intrigued by the connection, I decided to stop taking my statin to see what happened. Within a couple of weeks, the pain had gone.
I went back to my GP and, over successive months, tried various statins, including rosuvastatin which is one that is often prescribed.
Each form of the drug caused terrible problems, including night cramp, muscle pain, severe muscle disorders known as myopathy and general fatigue. In fact, I became so tired I couldn't lift anything when I was gardening or even walk the half-mile from my home to the centre of town.
Yet whenever I halted the medication, my symptoms disappeared within a few weeks.
Joan Hardman told the Daily Mail in 2007 she experienced severe side-effects from taking statins. She suffered depression and chest pains after being prescribed the drug to lower her cholesterol
I began to realise many of my patients with musculoskeletal conditions such as polymyalgia - pain, stiffness, and tenderness in the muscles - were on statins. When I advised them to stop taking their medication, their problems went away.
Was this reckless? Not at all. Statins only marginally increase protection for the heart - but that protection comes at a great price. If a patient has heart disease and high cholesterol, the chance of their dying from a heart attack over four to six years is about 8 per cent. If they're given a statin every day, this decreases to about 6 or 7 per cent.
If the payback is a life of musculoskeletal misery, is it worth it? And what about the idea that most elderly people should be on statins? By their very survival, they have proved they are the fittest. Should they be given pills to prevent a condition they don't have, nor are likely to get?
The recent JUPITER study found that daily treatment with rosuvastatin slashed the rate of heart problems and deaths by 44 per cent.
Crucially, the study involved those whose cholesterol was healthy and so would not qualify for statin treatment in the UK and many other countries. But all those who took part had high levels of a protein which is linked to heart disease.
Now this study is being pushed as evidence that our own drug watchdog, NICE, should bring down its risk threshold for statins. This would mean millions more could be put on the things.
In fact, JUPITER suggests that rather than raising the numbers of statins, we should be looking at the role of the protein.
Furthermore, where is the evidence to show that if your cholesterol is seven and you lower it by two, you dramatically reduce your risk of heart attack? There is none.
Branded cholesterol drugs cost the NHS between £10 and £25 per patient per month. As a rheumatologist, I know that money could be better spent treating the millions who are actually ill, including the many patients with rheumatoid arthritis. They are being refused treatment with effective medication such as anti-TNFs because it is too expensive.
Of course, if you take statins without any problems then there's no reason to abandon the treatment. But the idea of their widespread prescription, given the cost, minimal (and questionable) benefit and potential side-effects, is just nonsense. As a patient who has thrown his statins away, I'm happy to take my chances.
• Interview: ANGELA EPSTEIN
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