Caution urged on high-potency anti-cholesterol drugs

Taking strong statins to lower your cholesterol? Maybe it’s time to take a closer look at the risks and benefits.  New Canadian research shows that patients who started with high-strength statins were 34 per cent more likely to be hospitalized for acute kidney injury than those who started on low-strength versions of the drugs in the first 120 days of treatment.
The research was conducted by the Canadian Network for Observational Drug Effect Studies (CNODES) and published in the latest edition of the British Medical Journal. Researchers examined the health records of two million patients in Canada, the US and Britain.Higher-dose statins, including Lipitor and Crestor, have become the world’s most widely prescribed drugs with some researchers arguing anyone over 50 should be taking them.

Lead investigator Colin Dormuth, assistant professor of anesthesiology, pharmacology and therapeutics at the University of British Columbia, says the results of the study throw doubt the common practice of using higher doses of drugs to cut cholesterol levels lower and lower.

Statins are considered life-saving drugs for for heart and stroke patients with high cholesterol. As well, they are often prescribed for people with no history of heart disease.  However, studies have found that in younger patients, in women and in those without heart disease, the benefits are minimal. Meanwhile, the consequences of rapid loss of kidney function can be profound and long-lasting.

About one-third of patients in the study were on higher doses of the cholesterol-cutting drugs, which were defined as rosuvastatin (Crestor), atorvastatin (Lipitor) and simvastatin (Zocor), taken, respectively, at 10, 20 and 40 milligrams or higher.

A commentary that appeared along with the study suggests that statins have proven value in the general population when it comes to preventing cardiovascular disease, especially with patients who have had heart attacks, but doctors should prescribe weaker cholesterol-lowering drugs whenever possible to minimize kidney damage.

A new skin test allows pharmacists to measure the level of skin cholesterol
A new skin test allows pharmacists to measure the level of skin cholesterol © CBC

A new skin test allows pharmacists to measure the level of skin cholesterol. (CBC)

According to IMS Brogan, a prescription-drug tracking firm, an estimated 30.3 million prescriptions for the drugs were filled in Canada two years ago,

Health Canada updated the labelling for statins in January, warning users that they may be at a small increased risk of developing diabetes, particularly in people with pre-existing risk factors such as high blood-sugar levels and obesity. Other unintended effects linked to statins include degenerative muscle disease called myopathy, liver dysfunction and cataracts.

Terry Haig spoke by phone with Colin Dormuth in Vancouver.

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