Statins are not particularly effective at reducing the risk of dying from heart disease, a study claims.
Scientists analysed 35 studies into the effects of the drugs which lower ‘bad’ LDL cholesterol and found the pills have no consistent benefit.
The research, published in the British Medical Journal, found three quarters of all trials reported no reduction in mortality among those who took the drugs.
And half of all studies suggested that cholesterol-busting pills did not prevent heart attacks or strokes.
The research flies in the face of decades of medical advice. Authors claimed doctors have overlooked evidence that suggests statins, which are routinely prescribed to people at risk of heart disease, are not effective.
Scientists analysed 35 previous studies into the effects of drugs which lower ‘bad’ LDL cholesterol, finding that the pills have no consistent benefit
Lead author Dr Robert DuBroff, from the University of New Mexico School of Medicine, said that ‘it seems intuitive and logical’ to target LDL cholesterol because it is considered essential for the development of cardiovascular disease.
But, they added: ‘Considering that dozens of trials of LDL-cholesterol reduction have failed to demonstrate a consistent benefit, we should question the validity of this theory.’
Around 8million people in Britain and 35million in the US take statins. They are thought to prevent heart attacks and strokes by lowering levels of LDL cholesterol in the blood.
Statins are routinely prescribed to people thought to be at risk of heart disease, including those with diabetes, high blood pressure and over-75s.
WHY ARE STATINS CONTROVERSIAL?
Up to six million adults in Britain currently take statins to lower their cholesterol levels and thereby reduce the risk of heart attacks and strokes.
But many doctors and patients are worried about their long-term harms and they have been linked to diabetes, muscular pain and memory loss.
Scores are uneasy with what they describe as the ‘overmedicalisation’ of the middle-aged, which sees statins doled out ‘just in case’ patients have heart problems in later life.
Supporters on the other hand, including the health watchdog Nice, say the pills should be prescribed more widely to prevent thousands of early deaths.
They are proven to help people who have suffered heart problems in the past.
But experts say the thresholds may be too high, meaning benefits are outweighed by side effects for many people.
Commonly reported side effects include headache, muscle pain and nausea, and statins can also increase the risk of developing type 2 diabetes, hepatitis, pancreatitis and vision problems or memory loss.
However, in the new study, scientists argue that widespread prescription of statins is not particularly effective at reducing death.
If anything, they argue, the focus on cholesterol levels fails to identify many of those at high risk of heart disease while including those at low risk, who don’t need treatment.
The researchers systematically reviewed all published clinical trials comparing treatment with one of three types of cholesterol lowering drugs – statins, ezetimibe and PCSK9.
Their analysis showed that over three quarters of all the trials reported no positive impact on risk of death and nearly half reported no positive impact on risk of future cardiovascular disease.
The researchers claimed that doctors have overlooked evidence which suggests statins are not effective.
Dr DuBroff said: ‘In most fields of science the existence of contradictory evidence usually leads to a paradigm shift or modification of the theory in question, but in this case the contradictory evidence has been largely ignored, simply because it doesn’t fit the prevailing paradigm.’
However, the findings were criticized by several other experts who stressed that there is lots of evidence showing the health benefits of lowering cholesterol.
Cardiologist Professor Robert Storey, from the University of Sheffield, said: ‘There is a huge amount of evidence showing that LDL or “bad” cholesterol is responsible, to a large extent, for the build-up of fat in the blood vessels supplying the heart, brain and other parts of the body.
‘People who have developed furring of these blood vessels) benefit greatly from treatment to lower cholesterol, such as statins, and this has contributed to a big fall in risk for patients who have had the most common types of heart attack and stroke.
‘Where the evidence becomes less clear is for the use of cholesterol-lowering treatment in people who do not have any evidence of furring of the arteries.
‘This is because people who do not have ongoing furring of the arteries will not benefit in a meaningful way from cholesterol treatments over the few years that it takes to do a clinical trial, although this does not mean that they won’t benefit over a longer period of time if they are at higher risk of cardiovascular disease.’
Alun Hughes, professor of cardiovascular physiology and pharmacology at UCL, said the authors had conducted ‘flawed analysis of published data’.
He added: ‘In contrast to the authors’ conclusion, I think there is convincing evidence that statins reduce total mortality and cardiovascular events.’
Professor Sir Nilesh Samani, medical director at the British Heart Foundation, yesterday defended the use of statins.
He said: ‘There’s no question that statins save lives. As one of the most widely prescribed drugs in the UK, they have been subject to a huge amount of in-depth scientific research, which time and time again, has shown that they’re a safe and effective way to prevent deadly heart attacks and strokes.
‘Flawed analysis of this vast evidence leads to unnecessary concern and confusion for patients, which can ultimately cost lives.
‘If you have been prescribed statins you should continue to take them regularly, as prescribed. If you have any concerns you should discuss your medication with your GP.’