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Health & Medicine for Senior Citizens

Cardiovascular Benefits of Taking Statins Outweigh Diabetes Risk

No risk for those without diabetes risk factors, one risk factors jumps risk 28%

Aug. 10, 2012 - The benefits of taking statins to reduce the risk of cardiovascular disease outweigh the increased risk of developing diabetes experienced by some patients who take these cholesterol-lowering drugs, according to an Article published Online First in The Lancet. Those with major risk factors for diabetes should be cautioned.

A team of scientists led by Professor Paul Ridker, based at Brigham and Women's Hospital, Boston, USA, analyzed data gathered during JUPITER, the first controlled study to report that taking statins results in an increased risk of developing diabetes. This finding, subsequently confirmed by several other studies, led to the US Food and Drug Administration (FDA) enforcing a compulsory warning on statin labels, advising users of the increased risk of diabetes.

 

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Professor Ridker and colleagues analyzed the JUPITER results to determine whether or not the risk of developing diabetes was outweighed by the benefits to cardiovascular health conferred on patients who took statins over the five year trial period. They found marked differences in the likelihood of developing diabetes, depending on whether or not the patient was already at risk of developing diabetes when the trial began.

FDA on Statins & Diabetes

Increases in blood sugar levels (hyperglycemia) have been reported with statin use. The FDA is also aware of studies showing that patients being treated with statins may have a small increased risk of increased blood sugar levels and of being diagnosed with type 2 diabetes mellitus. The labels will now warn healthcare professionals and patients of this potential risk.

FDA Notes:

Diabetes occurs because of defects in the body’s ability to produce or use insulin—a hormone needed to convert food into energy. If the pancreas doesn't make enough insulin or if cells do not respond appropriately to insulin, blood sugar levels in the blood get too high, which can lead to serious health problems.

A small increased risk of raised blood sugar levels and the development of Type 2 diabetes have been reported with the use of statins.

“Clearly we think that the heart benefit of statins outweighs this small increased risk,” says Egan. But what this means for patients taking statins and the health care professionals prescribing them is that blood-sugar levels may need to be assessed after instituting statin therapy,” she says.

Patients who had at least one risk factor for diabetes were 28% more likely to develop diabetes when using statins, compared to patients in the control group. However, there was no discernible increase in the risk of developing diabetes for patients who did not have any risk factors for diabetes.

Although the use of statins clearly increased the likelihood of developing diabetes in patients already at risk of the disease, these patients were still 39% less likely to develop cardiovascular illness while using statins, and 17% less likely to die over the trial period.

Patients who were not already at risk of developing diabetes experienced a 52% reduction in cardiovascular illness when taking statins, and had no increase in diabetes risk.

According to Professor Ridker, "Our results show that in participants with and without diabetes risk, the absolute benefits of statin therapy are greater than the hazards of developing diabetes. 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."

In a linked Comment, Professor Gerald Watts of the University of Western Australia's Cardiometabolic Research Centre, Royal Perth Hospital, suggests that if further work confirms the findings from the new Lancet study, the FDA may wish to consider restricting their warning about the increased risks of diabetes to people with existing major risk factors for the disease.

However, according to Professor Watts, "A major take-home message for the clinician involved in either primary or secondary prevention of cardiovascular disease is that all individuals on a statin who have major risk factors for diabetes, particularly impaired fasting glucose, need to be informed about the risk, monitored regularly for hyperglycemia, and advised to lose weight and take regular physical exercise to mitigate the emergence of diabetes."


Links to more Archived Stories on Statins

Statin Study Finds Cholesterol-Lowering Drugs Save Lives of Flu Patients

Patients not receiving statins were almost twice as likely to die from influenza - Dec. 16, 2011

New Drug, Evacetrapib, Increases Good Cholesterol, Decreases Bad – Alone or With Statin

The combination of a statin and evacetrapib resulted in greater reductions in LDL but no greater increase in HDL - Nov. 15, 2011

High Doses of Statins Lipitor, Crestor Reduce Plaque, Reverse Coronary Artery Disease

Either rosuvastatin or atorvastatin reduced plaque, reversed the progression of coronary artery disease: plaque fell 0.99% with atorvastatin, 1.22% with rosuvastatin - Nov. 15, 2011

Better Management of Cholesterol in Senior Citizens May Help Fight Depression

Study of elderly men and women find unexpected links between depression and LDL, HDL levels - July 21, 2010

Heart Association Still Wants You to Take Statins, But Acknowledges Side Effects

Says persons having myopathy with a statin should discuss other alternatives with their physician - March 24, 2010

Statins Get Credit for Big Reduction of Bad Cholesterol, Protection from Alzheimer’s Disease

American Heart Association reports percentage meeting cholesterol standards has doubled in decade; study from Netherlands finds statins can protect nerve cells against damage known to occur in Alzheimer's - June 22, 2009

Seniors Warned to Avoid Red Yeast Rice Sold Online to Treat High Cholesterol

FDA says tested products contain unauthorized drug, lovastatin - Aug. 10, 2007

 

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