Should You Take Statins? Study Says Heart Benefits Outweigh Diabetes Risk

The new findings clarify the Type 2 diabetes risks associated with statins, but the debate over who should be taking the cholesterol-lowering drugs is likely to persist

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In February, the U.S. Food and Drug Administration (FDA) added a new warning to cholesterol-lowering statin drugs, noting the increased risk of Type 2 diabetes in users. But now a new study suggests that the cardiovascular benefits of taking the drugs may outweigh any potential diabetes risk.

The new study, published in the journal Lancet, analyzed existing data from the well-known and controversial 2008 JUPITER trial (for Justification for the Use of Statins in Primary Prevention), which tested a single statin, Crestor (rosuvastatin), for the prevention of heart disease in healthy people with no history of heart problems.

It’s well-established that taking statins reduces cardiovascular risks in people who already have heart disease. But the JUPITER trial found that healthy people with no heart disease or high cholesterol — but with high levels of C-reactive protein (CRP), a marker for inflammation — also had significantly lower risks of nonfatal heart attacks and stroke when taking Crestor, compared with people not taking the drug. Those findings prompted the FDA to expand the eligible patient population for Crestor by millions.

(MORE: Who Should Take Statins? Inside the Debate)

The JUPITER trial, which included more than 17,000 participants, also suggested, however, that taking statins could raise diabetes risk in users — a finding that has been borne out by subsequent research. So Dr. Paul Ridker, the principal investigator of the original trial, and his colleagues at Brigham and Women’s Hospital in Boston took another look at the data.

They found that the increased diabetes risk applied almost exclusively to those people who already had risk factors for the disease, such as obesity or higher fasting blood-sugar levels. Over five years of follow-up, people who took Crestor but had no diabetes risk factors, did not see an increase in risk of the disease.

Among people with at least one major risk factor for diabetes, those taking Crestor were 28% more likely to develop diabetes than those taking placebo. But they were also 39% less likely to develop heart disease and 17% less likely to die, suggesting that even in high-risk people, the benefits of statins outweigh their diabetes risks. Among participants at low risk for diabetes, statin use reduced heart risk by 52% with no increased risk of diabetes.

Overall, among people at high risk of diabetes, the study estimated that 134 heart attacks, strokes or deaths were prevented, while 54 new cases of diabetes were diagnosed. In the low-risk group, 86 heart attacks, strokes or deaths were prevented, with no new cases of diabetes.

(MORE: Do Statins Work Equally for Men and Women?)

“We believe that most physicians and patients would regard heart attack, stroke and death to be more severe outcomes than the onset of diabetes, and so we hope that these results ease concern about the risks associated with statin therapy when these drugs are appropriately prescribed — in conjunction with improved diet, exercise and smoking cessation — to reduce patients’ risk of cardiovascular disease,” said Ridker in a statement.

Both the JUPITER trial and the new study were funded by AstraZeneca, maker of Crestor, and Ridker holds a patent for the test used to measure CRP in the trial.

The new study is unlikely to fully resolve the ongoing debate over administering statins to a healthy population. Many doctors think statins are already overprescribed as it is. As USA Today reported:

Prescribing statins to people who don’t have heart disease “is still a big issue, despite what this paper says,” according to physician Eric Topol, director of the Scripps Translational Science Institute in San Diego. “Per 100 people you have two heart attacks less and one increase in diabetes. They’re trying to say it benefits more than it harms. But the benefit is so small.”

Topol says the patients he sees aren’t aware of the risks associated with taking statins. “The patient doesn’t know this might make their protection for heart attack marginally better but it also could backfire by inducing diabetes,” he says.

Still, if the current findings are confirmed in future studies, Gerald Watts of the University of Western Australia argues in an editorial accompanying Ridker’s study, the FDA may want to limit its diabetes warning on statins only to people with major risk factors for the disease. The main take-home message for both doctors and patients, he noted further, is that any patient at high risk for diabetes taking statins should be fully informed of the risks and carefully monitored.

But while heart disease is a major concern for people diabetes, that doesn’t mean all diabetes patients should be on statins. Physicians agree that the best prevention for Type 2 diabetes is exercise and a healthy diet.

MORE: FDA Warns Statin Users of Memory Loss and Diabetes Risks

5 comments
sdhuggs
sdhuggs

My husband took Crestor for six weeks about one year ago.  He noticed increasing muscle pain until it got so bad he was unable to work or move for 4 days.  He stopped taking the Crestor and within two weeks had lost 25 pounds and most of his hearing, was numb and had burning in his hands, lower arms, lower legs, and feet.  His only relief was taking 7-12 hot tub baths a day, often in the middle of the night.  He was diagnosed with poly neuropathy and tested negative for any of the diseases for which poly neuropathy is a symptom.  Several doctors later, one said he had found research indicating some Crestor patients may experience poly neuropathy as a result of taking the medication.

Currently Steve feels he's at about 85% of normal after several different pain medications, laser therapy, and now acupuncture.  He continues to take pain pills and though he tries to maintain the active life style he had before, he is limited physically, and continues to experience pain and burning in his arms, legs, hands, and feet.

We've contacted several attorneys to file suit and go on public record about Steve's experience, but because he's not dead, didn't have a heart attack or contract diabetes, all of which are what the current suits are suing for, no one would take the case.

I hope this post helps the people who read it.

juki654
juki654

I would like to know how the findings reported in July, that arteriosclerosis is probably caused by stem cells already in our arteries, rather than cholesterol deposits, factors into these findings.  I understand the inflammation-lowering value of statins, but is the cholesterol reduction of any good?  And can't we get the inflammation-lowering with a baby aspirin a  day?  Here's the research:  http://www.theheart.org/articl...

Also, my understanding is that there is no good research showing that stains help older women , with no history of CAD, at all.  I was on them for six weeks a number of years ago, and during that short time got very sore gums and shingles.  A doctor told me that statins had stripped my body of Co-Q10, causing these issues.

I am just so suspicious of all the research showing how wonderful statins are.

http://teachloveofreading.blog...

William Butler
William Butler

My mother was on Lipitor (the best selling of the statins and a billion dollar drug) until a few months ago. As soon as she went off of it she had feeling back in her feet for the first time in a decade (when she started taking Lipitor), she no longer had neuropathy causing her severe pain in her legs, her blood sugar dropped by 20-30 points, and most suprising when we went to her Neurologist she was across the board better mentally (she was diagnosed with alzheimer's). Stay away from the Statins!!!! They are a billion dollar boondoggle that will ruin your health.

Ponta Vedra
Ponta Vedra

Funny. I have been on Lipitor for six or seven years, and have mild Type 2 diabetes. I heard about the study linking the drug to worsened diabetes effects and decided to cut it out for three months. The result? Nothing except that my cholesterol levels spiked rather notably. My doctor recommended that I try lower doses of the drug (5mg a day instead of 10), so I did--and after another 3 months, just saw my A1C and fasting sugar levels decrease, and my cholesterol levels go back down to normal. Lesson: different people react differently, and you cannot make wild claims based on an isolated experience. Your story sounds like the apocryphal tales about people who suffer from a broad range of maladies which magically  disappear when they have amalgam fillings removed. In short, something which, if true, only affects a tiny subset of people who likely have a highly specific reaction to certain drugs, which is why these drugs are administered on a per person basis and the effects monitored. So forgive me if I take your warnings of ruined health with a grain of salt.

Marlene Grant
Marlene Grant

Years ago a NIH very large study had to discontinue it because the statin group had more health issues than the blind study group. 

Chelation is a non-invasive way to get rid of plaque in the vessels. There has been studies going on for years now and the results have not been released. 

Dr. Carter of Mandeville, LA  is one of the doctors involved.

From what I have seen a lot of people have not had to go thru open heart because of EDTA chelation IV. It has been outlawed in LA except for Dr. Carter. I am not sure why but I would like to know.