Mixed reaction from cardiologists to review of anti-cholesterol drug

Irish specialists have given a mixed reaction to a major review of statins that says the benefits of the cholesterol-busting drugs have been underestimated and their harmfulness exaggerated.

Misleading reports of high levels of side-effects from statins bear a "serious cost to public health", according to the review published in the Lancet.

The Irish Heart Foundation and individual cardiologists welcomed the scientific backing for statins in the review.

However, Dr Sherif Sultan, a Galway-based consultant who is president-elect of the International Society for Vascular Surgery and a long-time critic of statins, dismissed its findings.

The review contained no new data, he claimed, and was mainly written by scientists who had carried out the original trials reviewed.

The review found that lowering cholesterol by 2 millimoles per litre with a statin, such as a daily tablet of atorvastatin for five years in 10,000 patients, would prevent major cardiovascular events in 1,500 people and cause problematic side effects in about 200.

Reduce death rates

“The message we take home from this review is that these drugs are safe, they work well and they reduce death rates and illness among patients,” said Dr

Angie Brown

, medical director of the IHF.

The negative commentary around statins in recent years had prompted some patients to contact the IHF with their concerns and some had even stopped their medication without getting medical advice, she said. “This study is quite clear. Statins save lives.”

Even where patients reported side-effects, it was often possible to move them on to another drug or treatment, she said.

‘Bad press’

Dr

Jonathan Lyne

, a cardiologist at

Blackrock Clinic

, said statins had received “a bad press”, and their side-effects were often “overplayed”. For many patients, altering cholesterol levels might be the only way of modifying their risk of a heart attack, he pointed out.

Dr Sultan said he “couldn’t trust” the review, pointing to the lengthy declaration of interests section at the end of the review. This lists research grants and other payments made by large drug companies to many of the authors of the review.

The team behind the review has previously refused to share their raw data with other researchers for further analysis, he asserted.

He claimed there was no evidence that statins extended the life of patients or reduced the risk of heart attack or stroke in primary prevention. People who took the drugs were more likely to be sedentary and obese, often because they did not see the need to eat healthily.