Mixed Feelings About Side Effects From Cholesterol Pills

Drugs to lower cholesterol run neck and neck with antidepressants for popularity in the U.S.

There’s ample evidence cholesterol-lowering pills called statins can reduce the risk of a repeat heart attack. The pills are frequently prescribed for people who’ve never had a heart attack or stroke, but are at high risk for trouble.

That’s how Lipitor became the No. 1 drug in the world. And now that Lipitor and other drugs like it are generic in the U.S., they’re pretty cheap to boot.

Obesity, too much bad cholesterol and a family history of heart disease are some of the risk factors doctors consider before recommending drugs to lower cholesterol.

But there’s fresh debate about the widespread use of statins to prevent heart attacks in people who’ve never had one. “For most healthy people, data show that statins do not prevent heart disease, nor extend life or improve quality of life,” cardiologist Rita Redberg, a skeptic, wrote recently in The Wall Street Journal. “And they come with considerable side effects.”

In February, the Food and Drug Administration beefed up the warnings on statins to highlight the potential for memory loss and diabetes. Other potential side effects include fatigue, muscle weakness and aches.

We wondered how Americans see the issue, so we asked in the latest NPR-Truven Health Analytics Health Poll. Truven used to be the health care business of Thomson Reuters.

First off, we found that about 6 percent of respondents had had heart attacks already. Those people and others who’d been told by a doctor they were at risk for one say they’re taking action. In this group, three-quarters of people are taking a prescription drug to lower the risk of a heart attack. Two-thirds are taking aspirin.

Of those taking a prescription drug to lower their risks, 70 percent, or 276 people, are taking a statin. And in that group, 81 percent said they’re aware of side effects with the drugs.

Still with me? OK, so we also asked people who hadn’t been diagnosed with heart trouble what they would be willing to do if they were told in the next six months they were at risk for a heart attack.

Almost everybody — 95 percent — says they’d make a lifestyle change, such as losing weight. And 85 percent say they’d take a prescription drug to lower drug. As you can see, that’s probably going to be a statin.

So how does this group of people (2,508 in all) feel about side effects? They’re split down the middle. People who make more money and have more education are less tolerant of potential side effects.

Among those who think at least some side effects are acceptable, only 24 percent would be OK with a diabetes risk. Memory loss was about the same. A little over half would accept muscle weakness, and more than 70 percent would be OK with fatigue.

People with high cholesterol don’t feel it, so taking a daily pill to lower cholesterol doesn’t relieve symptoms. That may affect the way some people consider the balance of benefit and risks.

While all drugs carry risks of side effects, there’s no certainty about a given person experiencing a side effect when it comes to statins.

“Most medications can be tolerated by most people without a side effect,” Ray Fabius, chief medical officer at Truven, tells Shots. Still, he says, he was heartened by findings for people already taking statins. “There was intelligent balancing of the value of taking the medicine with the potential side effects,” he says.

The nationwide telephone poll of more than 3,000 households was conducted in May. The overall margin of error is 1.8 percentage points. You can find the questions and full results here.

Copyright 2023 NPR. To see more, visit https://www.npr.org.