Doctor consultation at hospital. (illustrative).
(photo credit: INGIMAGE)
The Society for the Study, Prevention and Treatment of Atherosclerosis has issued a new position paper urging people at medium to very high risk of cardiovascular diseases not to stop taking statins or ezetimibe (Ezetrol).
The document, issued by the Israel Medical Association’s Institute for Quality in Medicine, comes as a result of various recent publications about possible side effects, including joint and muscle pains that could result from taking the drugs to lower low-density lipoprotein (LDL) cholesterol.
“Patients with moderate to very high risk of cardiovascular disease should keep on taking statins rather than discontinuing it,” the authors concluded, “because heart disease is a major cause of morbidity and mortality with heart attacks and stroke,” according to the position paper.
All patients should consult with their cardiologist, internal medicine specialist or family physician before considering any discontinuation of medications.
Dr. Dov Gavish, a member of the society, explained: “Statins offer tremendous benefit in preventing disease and death from cardiovascular diseases. They have changed the map of morbidity and mortality from cardiovascular disease. In addition, new drugs that are not statins and are given by injection have recently been introduced and can be substitutes or supplements to treat high levels of cholesterol.”
There are indeed patients who claim muscle pain due to statin drugs, he continued, and in cases where there are significant side effects, the physician may change the type or dosage of the drug. Most patients who take these drugs are older people who also suffer from joint and bone problems before taking these drugs and tend to attribute the pain to the drug.
In studies that compare a group of patients who take the drug to a group in which patients received the drug but did not know what they were getting, there was a relatively small difference between the groups in complaints of joint or muscle pain.
Prof. Reuven Zimlichman, chairman of the Institute for Medical Quality added: “What is troubling is the tendency of Israeli patients, as well as those in other countries around the world, to stop drug treatment within six months to a year after starting it. About 60% of patients stop taking statins or reduce the dosage about a year after starting treatment, causing themselves health damage.”
In the new position paper, “The diagnostic and treatment approach to dyslipidemia,” there is evidence from many studies of the importance of reducing LDL cholesterol values to reduce the risk of morbidity and mortality. The paper said that there are new drugs that allow lowering cholesterol levels through different mechanisms than statins, such as the human monoclonal antibody called alirocumab (commercially known as Praluent).