For years, the medical community has been touting statins as the silver bullet to save lives, but a report last month in the Journal of the American Medical Association (JAMA) only served to cloud the picture further.
The JAMA report looked at competing studies, between the one released in 2013 by the American College of Cardiology (ACC) and the American Heart Association (AHA) versus the most recent recommendation by the US Preventive Services Task Force (USPSTF).
Currently over 20% of Americans between the ages of 40 and 75 use statins to prevent an initial heart attack or stroke. Both groups, JAMA said, would like to increase that figure, but they differ by how much. The earlier study, by the ACC and AHA, would more than double it, but the USPSTF study, while also favoring an increase, leans toward a more conservative approach.
Why the difference? It has to do with risk assessment. The USPSTF study decided that the use of statins wouldn’t benefit the average person under 60 unless he or she also has another risk factor for heart disease, such as diabetes, family history, or poor lifestyle choices such as smoking.
The ACC/AHA study conclusions were much more broad, recommending that an additional 9.3 million people begin using statins to prevent an initial stroke or heart attack. Further clouding the issue is the fact that several of the JAMA studies’ authors reported receiving grants and fees from the ACC and the AHA and certain pharmaceutical companies that manufacture statins and other related drugs. The USPSTF researchers did not disclose any grants, but the large majority of their clinical trials were sponsored by the pharmaceutical industry.
According to a CNN report, the JAMA study does not estimate what the effects of either recommendation would be—such as how many heart attacks or strokes would be prevented or what the harms and costs would be. But it acknowledged that some health experts have criticized both recommendations for inflating the benefits, which they say could push doctors to over-prescribe the drugs, leading to minimal rewards, a large price tag, and potential side effects.
And that latter is not an insignificant point. Because side effects from statin use can include such issues as fatigue, muscle pain, the onset of diabetes, liver damage, and cognitive impairment, and the life-extending benefits from statins for a given person are often unclear.
This is why it’s important to have a long talk about this issue with your concierge primary physicians at MD 2.0 in Jupiter, FL. We can help you sort through the pros and cons of starting on or continuing such medication. One of the advantages of the direct primary care model is the amount of time it allows you to spend all the time you need with us to get clear answers about your concerns.