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Study Links Statin Use to Tendon Injury

Tendinitis, Tendon Rupture Reported but Considered Rare
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WebMD Health News
Reviewed by Louise Chang, MD

Feb. 28, 2008 -- New research suggests a link between the use of cholesterol-lowering statin drugs and tendon injury, but the study falls short of proving an association, a cholesterol expert tells WebMD.

Millions of people worldwide use medications like Lipitor, Zocor, Crestor, and other statins to lower their cholesterol, and they are among the most widely studied drugs ever.

Tendon ruptures and other tendon injuries have not been reported as a side effect of statin use in previous studies, but there have been anecdotal reports of a link over the years, appearing mostly in French medical journals.

Statin Use and Tendon Injury

These reports led researchers from France's Rouen University Hospital, Rouen Cedex, to conduct a look-back study using a database of patients who reported adverse side effects associated with statin use between 1990 and 2005.

Of the 4,597 side effects reported, 96, or about 2%, involved tendinitis or tendon ruptures.

The Achilles tendon was the most common site of injury, with pain, swelling, warmth, and stiffness being the most common complaints.

According to the researchers, tendon problems began in 59% of patients within a year of starting statin treatment, and the problems went away in many patients after they stopped taking the drugs.

"(Tendon complications) recurred in the seven patients (100% of cases) in whom statin therapy was reinstituted, which strongly supports a relationship with the use of these drugs," researcher Isabelle Marie, MD, PhD, and colleagues write in the March issue of the journal Arthritis and Rheumatism.

Cholesterol Expert Unconvinced

But heart surgeon Michael Richman, MD, is unconvinced. He tells WebMD that there is no way to know from the study design if the tendon problems reported by the patients had anything to do with their statin use.

He points out that none of the pre- and post-marketing statin studies, involving around 45,000 patients, ever identified tendon injury as a complication of statin use.

Richman is president of the Center for Cholesterol Management in Los Angeles.

"Statins are among the most studied and the safest drugs we have," he says. "They save lives every day, and they have changed the face of cardiovascular medicine. As far as I'm concerned, doctors should be looking for reasons to put more people on them rather than looking for reasons not to."

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Your total cholesterol level is Borderline High, but fortunately your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have other non-measured increases in LDL-like particles that can increase heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is Borderline High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. Your level of "bad" LDL cholesterol is High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is Borderline High. But your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol is High, but your level of "bad" LDL cholesterol is optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol is High, but your level of "bad" LDL cholesterol is near optimal. This could mean you have a high level of high-density lipoprotein, or "good" HDL cholesterol, which protects against heart disease. Or you could have elevated secondary lipids, such as non-HDL particles that increase the risk of heart disease. Your LDL level also could be optimal if you are taking a statin medication. Please check with your doctor to get your complete lipid profile and see if you may need additional treatment. In the meantime, find more information on WebMD's Cholesterol Health Center.

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is Borderline High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels!

Your total cholesterol level is High. Your level of "bad" LDL cholesterol is High, too. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe medication, such as statins. Following medication, dietary, and exercise instructions should result in improvements.

Your total cholesterol level is High, and your level of "bad" LDL cholesterol is Very High. Working to bring down your total cholesterol decreases your LDL cholesterol level. You can do this by exercising more and eating less food with saturated fats. Check food labels! If you are struggling to bring down your total cholesterol and LDL cholesterol levels, your doctor may prescribe statins or other cholesterol-lowering medications.

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