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Most Statin Users Won't Have Major Side Effects

However, large review found 9 percent higher risk of developing type 2 diabetes

WebMD News from HealthDay

By Serena Gordon

HealthDay Reporter

TUESDAY, July 9 (HealthDay News) -- Statins -- the widely used cholesterol-lowering drugs -- have few serious side effects, although they do slightly raise the risk of type 2 diabetes, according to a large new evidence review.

In the analysis of 135 previous studies, which included nearly 250,000 people combined, researchers found that the drugs simvastatin (Zocor) and pravastatin (Pravachol) had the fewest side effects in this class of medications. They also found that lower doses produced fewer side effects in general.

"As with any drugs, statins have both benefits and harms," said study lead author Huseyin Naci, a doctoral candidate at the London School of Economics and Political Science.

"We show that harmful side effects of statins are not common, and they are greatly outweighed by their benefits," said Naci, also a research fellow in the department of population medicine at Harvard Medical School in Boston.

Results of the study, which received no drug company funding, were released online July 9 in the journal Circulation: Cardiovascular Quality and Outcomes.

Statins are medications used to lower the amount of LDL cholesterol or "bad" cholesterol -- in your blood. LDL levels can be lowered through dietary changes and exercise, but many people find it difficult to maintain these lifestyle changes.

Moreover, statins may be useful for stabilizing plaque in the blood vessels (plaque can break off and cause a heart attack or a stroke) and reducing inflammation, according to Dr. Suzanne Steinbaum, a preventive cardiologist and director of Women and Heart Health at Lenox Hill Hospital in New York City. She was not involved with the new study.

In the analysis, the researchers reviewed data from randomized clinical trials, some of which compared statins to each other, while some compared statins to an inactive placebo pill. The average follow-up time for the studies included in the analysis was 1.3 years.

The review included data from the seven statins currently on the market. Atorvastatin (Lipitor), simvastatin and pravastatin were the most commonly used statins among participants.

Simvastatin and pravastatin had the best safety profile, according to this review.

Overall, the researchers found a 9 percent increased risk of type 2 diabetes in people taking statins. Naci said it's possible that statins may impair the secretion of insulin, although this study didn't examine potential mechanisms for why statins might increase diabetes risk.

"The slight increase in diabetes risk is greatly outweighed by the cardiovascular benefits of statins," he said.

Statins were not linked to any increase in the risk of cancer, according to the review. "There is conclusive evidence that statins do not raise cancer risk," Naci said.

The use of statins, particularly atorvastatin, was linked to an increase in liver enzyme irregularities. Naci said these blood test changes don't cause any symptoms, and are reversible when the drug is stopped. "If monitored closely, there is no cause for concern, and no specific precautions are warranted based on our study," he said. "Switching to a statin associated with fewer elevations may be appropriate."

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Congratulations! Your total cholesterol level is in the Desirable range, and your level of "bad" LDL cholesterol is near optimal.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is borderline high. If your LDL goes higher, your total cholesterol level could become Borderline High. Consider reducing the amount of foods you eat with saturated fats and increasing physical activity. If you get more exercise, your level of "good" HDL cholesterol may increase, which could also help to keep your levels of LDL and total cholesterol in check.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL. The HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is in the Desirable range, but your level of "bad" LDL cholesterol is Very High. This may mean that your level of high-density lipoprotein (HDL), or "good" cholesterol, is too low. It is best to have a high level of "good" HDL and a low level of "bad" LDL because the HDL helps keep your LDL level in check. Ask your doctor for your HDL level. If your HDL is low, increasing your physical activity can increase it, which may help reduce your LDL level.

Your total cholesterol level is Borderline High, but fortunately 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 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, 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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