My hypothesis on the merits of statin therapy is as follows:-
Do statins reduce serum cholesterol?
Is cholesterol instrumental in the clogging up of arteries?
Do blocked arteries (atherosclerosis) lead to heart attacks/strokes?
Having answered in the affirmative to all 3 questions, which people benefit from taking them?
Those with abnormally high serum cholesterol (genetic causes)
Those with significant family history of cardiovascular disease.
Those with a past medical history of cardiovascular disease.
It is surely logical, therefore, for people within these groups to take statins, since they are extremely efficient in reducing serum cholesterol levels. People with genetic hypercholesterolaemia for instance (like myself) will not be able to to reduce their cholesterol level to within normal limits by diet alone, and nothing has proved to be more effective in lowering cholesterol levels in these patients than statins (as told to me by my lipid consultant). Unfortunately many people refuse to try statins because of the very bad press they receive, and if they do decide to evaluate them & subsequently develop aches & pains, etc., they immediately attribute these symptoms to statins, when there could well be a different cause. I wonder, also, whether there might be some psychological overlay amongst the statin sceptics due to adverse publicity. Many people fear muscle damage (rhabdomyolysis) which can be due to statin therapy, but this is extremely rare and is easily detected by regular screening of the CK level in a simple blood test. All drugs run the risk of side effects, but unless you actually try a drug yourself, you will not know whether you can tolerate it or not. 40 years ago the general public had never heard of cholesterol, never mind lipoproteins, and, whilst it is good to be aware, I do feel a lot of anxiety has been created by the media. This publicity has also exacerbated the pressure to continually attain lower & lower cholesterol levels. In the 1970s & 1980s the upper limit of normal serum cholesterol was 7.2 mmol/l. Nowadays, everyone is urged to reduce it to well below 5 mmol/l, which can be very stressful. Ultimately, when considering whether to take statins (if these drugs are indicated & advised) a risk assessment needs to be employed to ensure that the dangers of not taking them are outweighed by the benefits of doing so.