Statins May Not Be Necessary for People with Lower Heart Disease Risk

• Researchers in the United Kingdom say statins may not be needed for people with low to moderate risk of heart disease.
• They say the side effects of the cholesterol-lowering medications may outweigh the benefits from the drugs for some people.
• Experts say diet and exercise are among the alternatives to taking statins to keep cholesterol in check.
• Taking the “better safe than sorry” approach with cholesterol drugs may no longer be the best way to slow heart disease.

Statins — including cholesterol-lowering medications such as Lipitor, Mevacor, Crestor, and Zocor — may not be as helpful as once believed for people in low to moderate risk categories, according to a new studyTrusted Source from the United Kingdom.

Researchers at the National University of Ireland Galway concluded that statins as primary prevention against heart disease “may be an example of low value care and, in some cases, represent a waste of healthcare resources.”

Statins are drugs that lower the level of cholesterol in the blood by blocking the enzyme in the liver responsible for producing cholesterol.

According to the researchers, statins are among the most frequently used drugs in the world, accounting for global sales that will approach $1 trillion by 2020.

The study doesn’t challenge the use of statins by those who already have a diagnosis of heart disease, only for healthy older adults.

Who should take statins?

The guidelines around who should take statins have changed over the years.

In Ireland, the 1987 guidelines put about 8 percent of people 50 or over eligible for the drugs. By 2016, that number increased to 61 percent, the researchers reported.

The new study suggested people classified as low or moderate risk for cardiovascular disease wouldn’t reach acceptable cholesterol risk levels to justify taking statins.

The study authors said the use of statins in these people “warrants more careful consideration,” and that the concepts of overuse and low value care “should become integral to policy making and resource allocation decisions.”

Some experts point out that in the United States, medical guidelines say the benefit of using statins in people with a low or medium risk really isn’t always justified.

“The current American College of Cardiology guidelines for statin use emphasize collaborative decision-making between providers and patients,” Tomas Ayala, MD, FAAC, a cardiologist at Mercy Medical Center in Baltimore, Maryland, told Healthline.

“In general, statins are not recommended for low-risk patients. For patients at high risk… statins are recommended for primary prevention of cardiac events. For those of immediate risk, statins are recommended only if the patient also has a high-risk illness, such as diabetes, peripheral vascular disease, or cerebrovascular disease.”

“So, as you see, the current recommendations are really in line with what’s being described,” Ayala said.