Statin side-effects down to negative expectations, not the drugs, say study

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Researchers hope study will end debate around statins, which could benefit over six million UK patients who are not taking them, or take low dosages

Common side-effects of statins are not down to the drugs, but are instead a result of patients’ negative expectations, research suggests.

Statins are typically prescribed to help lower levels of “bad cholesterol” – or low-density lipoprotein – in order to reduce the risk of a heart attack or stroke. A recent report estimated that the drugs prevent around 80,000 such incidents a year in the UK.

Related: The drugs work: the truth about statins and SSRIs

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Statin side-effects down to negative expectations, not the drugs, say study

A male pill matters because both partners can share the side-effects | Deborah Orr

An experimental male contraceptive jab has proved just as effective as the pill is for women. Trials were abandoned, however, because side-effects included depression, raised libido and acne. Which is weird, because the pill has similar side-effects – although sometimes it can cure acne. The pill’s other common side-effects include nausea, headaches, breast tenderness, anxiety, weight gain and, sometimes, decreased libido. However, suggesting that the pill isn’t an almost perfect form of birth control tends not to go down very well.

This is understandable. The pill has given women agency over their own lives like nothing else. And women don’t want that great freedom to be tarnished. The advantages of an equally reliable male contraceptive, of course, are much less direct. If anything, the pill freed men from worry about contraception or “getting a girl pregnant” to the extent that an unwanted pregnancy is often looked on as something that’s entirely the fault of the fool who’s enceinte. It’s hard not to look on all those anti-abortionists and morning-after pill killjoys as people determined that foolish women should pay for their own singular mistakes.

Yet a male contraceptive is simply more sensible, in biological terms, than a female one. In her book, Sweetening the Pill, and in numerous articles, Holly Grigg-Spall points out that men have no fertility cycle, while women are only fertile for six days every month. Women take a lot of responsibility for those six days, while the constant risk is not from their ova but from ever-ready sperm.

Grigg-Spall, who is a passionate advocate of raised awareness about the pill’s risks to women, believes that its side-effects are minimised not just because of feminism, which cannot help but see the pill’s advantages as outweighing its disadvantages, because they do, but also because of sexism, which tends to dismiss female problems as trivial and male advantages as important. It’s hard not to agree with her, when comparing this latest research, in which side-effects were given such emphasis, with Danish research published last month that linked the pill to depression and gained little more than shrugs.

‘Shared responsibility for reproductive freedom still seems so far away.’ Photograph: Garo/Phanie/Rex/Shutterstock

Yet it’s precisely because hormonal contraceptives have side-effects, and that these vary from person to person, that a decent male contraceptive would be such a good thing. If one partner finds the side-effects unbearable, then the other can take up the mantle. If one partner has been on contraceptive hormones for a long time, he can give his body a rest and ask his partner to take her turn. A male pill would promote the idea of shared responsibility. Which in matters of sex and reproduction still needs a lot of promoting.

The pill unleashed sexual freedom on a grateful world. It took a while for feminism to realise that this was not by any means always to the advantage of women. Ever since that time, discussion about the male pill has tended to focus on casual sex – whether a woman would trust a man who said he was on the male pill, since a lie wouldn’t leave him up the duff. But the truth is that barrier methods remain necessary for casual sex, to protect against sexually transmitted diseases, whether other contraception is being used or not. Hormonal contraception for both sexes is at its most positive as a goal in stable relationships, where it is so important for responsibility and risk to be shared.

Yet shared responsibility for reproductive freedom still seems so far away. One reason why the development of an effective male contraceptive has been painfully slow is lack of enthusiasm for the idea. Money for research isn’t there because big pharma doesn’t think men will be keen enough. The prospect of more equality, empathy and understanding between the sexes just doesn’t thrill the market.

Unlike Grigg-Spall, who had a terrible time when she was on the pill, and suffered major side-effects such as panic attacks, I’m not against hormonal contraceptives, even if they are risky. I stayed on the pill for a long time, maybe too long, and eventually I couldn’t face it any more. I’d have very much liked it if my partner could have taken his turn too. That alternative wasn’t available. But that isn’t just scientific and pharmaceutical happenstance. I’m troubled by the idea that risks women are routinely encouraged to take are risks that men are not willing also to take. There are related risks that men won’t take either. Vasectomies are at a historically low level. Addressing this particular inequality is a huge step towards addressing many others.

With double as many people willing to take a contraceptive pill, fewer women would have to suffer in silence for the sake of worry-free sex. I’m sure that some men would be happy to take a hormonal contraceptive. But the market tells us that not nearly enough are interested, while research tells us that even when they are, they’re too risk-averse for the idea to be driven forward with enough urgency.

Reliable contraception is a Great Thing for humanity. It’s about time that half of humanity stopped shirking and joined women in engaging in the physical challenges that are undertaken in embracing it.

A male pill matters because both partners can share the side-effects | Deborah Orr

Statins have almost no side-effects, study finds

But investigation published on Thursday in the European Journal of Preventive Cardiology suggests that only a little minority of reported signs are attributable to the medication.

“Almost all would take place just as regularly on placebo,” stated Dr Judith Finegold from the Nationwide Heart and Lung Institute in London at Imperial School.

“Most folks in the basic population will not really feel perfectly nicely in each and every way on every day. Why need to they all of a sudden really feel nicely when taking a tablet after becoming warned of achievable adverse effects?

“We feel that patients need to be empowered to make their very own choices, but we need to 1st make confident they have prime quality unbiased details. This is why we phone on drug regulators to highlight in the extended lists of side results individuals number of whose charge is incrementally better than that experienced with a dummy tablet.”

Statins have for years been linked to a lengthy record of side effects like nausea, renal disorder, muscle troubles and aches, insomnia, fatigue, erectile dysfunction and gastrointestinal disturbance. But of all the signs and symptoms, only the risk of diabetes was identified to be slightly raised by the drugs.

Even so Dr Aseem Malhotra, a cardiology expert registrar at Croydon University Hospital, explained numerous folks underneath-report side effects in clinical trials and claims it would be incorrect to dismiss their symptoms.

“To suggest that these symptoms are imagined is an insult to individuals who have suffered, many for months, from side results that are real and increasingly appreciated by front-line medical doctors,” he explained.

Last week a survey by Pulse magazine uncovered that the bulk of GPs would not consider statins themselves underneath the new draft guidance or advocate them to a relative.

Dr Kailash Chand, deputy chairman of the British Healthcare Association, has suffered debilitating muscle pains while taking statins.

Speaking as a GP he explained: “I feel a lot of of the benefits of statins have been hyped up and the side results ignored.”

In draft guidelines launched in February, the National Institute for Overall health and Care Excellence recommended that the “risk threshold” for statins be cut in half – so that anybody with a 10 per cent chance of developing cardiovascular disease would now be prescribed medicines.

Nonetheless statins are already the most commonly prescribed medication in Britain, presently costing the NHS £450 million a 12 months. And surveys have proven that up to half of individuals voluntarily end taking the medication right after a year, numerous reporting side results.

Nevertheless it is estimated that statins conserve 7,000 lives in the Uk each and every 12 months and charities welcomed the findings, claiming they must reassure people. Doireann Maddock, senior cardiac nurse at the British Heart Basis, stated: “Previous investigation has demonstrated the security and effectiveness of statins. Whilst all drugs have the possible for side results this study could offer even more reassurance to the many men and women in the United kingdom who are prescribed statins.

“Side results this kind of as muscle ache, which is frequently linked with statins, can also be connected to a lot of other items. If you consider you are encountering side results it’s crucial to talk about it with your doctor so that they can discover what may well be triggering them.”

Dr Shamim Quadir, investigation communications manager at the Stroke Association, additional: “This investigation might assist to avert stroke individuals from coming off statins unnecessarily.”

Statins have almost no side-effects, study finds

Side-effects danger to rise as millions much more consider statins

He will inquire Great not to depend on evidence from drug company-sponsored trials, which he claims perform down the danger of side results including diabetes, impotence, cataracts, muscle pains, mental impairment, liver issues and fatigue.

Dr Malhotra said the medicines have been needless for many, whose difficulties could be controlled with straightforward way of life and dietary modifications. He pointed to analysis displaying that eating an apple a day is as efficient as taking statins in stopping strokes and heart attacks.

The expert explained individuals with established heart ailment can advantage from statins, but the “mass medicalisation” of a more healthy group is very likely to do more harm than great and increase the cost to the taxpayer.

“Widespread prescriptions of these drugs to lower-chance groups will contribute to immeasurable further wellness care expenses.”

Dr Malhotra mentioned there was a “huge discrepancy” among reports of side results from drug firm-sponsored trials and independent investigation.

Pharmaceutical firm studies present side effects in less than one per cent of patients although independent scientific studies have proven them in at least twenty per cent.

According to Dr Malhotra, adverse effected can be minimised in the drug company trials by excluding sufferers if they fail to tolerate statins in the course of a “run-in” period, or if they have pre-present wellness circumstances.

Claims of widespread side results appear to be borne out by statistics exhibiting that up to half of individuals voluntarily end taking statins within a 12 months of prescription.

Dr Malhotra explained: “It’s time to practise medicine in accordance to what is greatest for individuals, not to feed drug organization earnings. The medication might be cheap but the question is how safe they truly are.

“We also need total transparency from the board or committee that influences Great on the question of statins, so that we know who the scientists are and whether or not they have any ties to the pharmaceutical industry.”

Dr Malcolm Kendrick, a GP and author of The Wonderful Cholesterol Con, said clinics had been set up at some hospitals to ensure patients who are struggling side results continue to take statins.

“Patients with side effects are now getting diagnosed as ‘statin-intolerant’,” he said. “There’s almost an unstoppable momentum behind the drive to preserve prescribing these drugs. It’s absolute nonsense.”

Dr Chand, a 60-yr-outdated GP from Tameside, Better Manchester, mentioned he suffered side results right after he was prescribed statins five years ago.

“After a couple of weeks I began getting terrible muscle aches which have been virtually all over the place and which would wake me up at night, “ he mentioned.

“Initially I didn’t know what was incorrect and place the signs down to stress. The drug firms were saying this drug was the best point because sliced bread and should be offered to every person.”

But soon after a year, Dr Chand, a father-of-one, discovered concerns about side effects and took himself off the medicines following a year.

“The only way to locate out is to quit taking the tablets for a couple of weeks,” he said. “Things started to increase and now I have no signs and symptoms at all.”

Dr Chand said he was speaking in a personalized capability rather than in his official BMA role in calling for a re-think.

“I’m hugely concerned about the new tips on statins. The only men and women who will advantage are drug firms.

“Statins are a wonderful drug and have a definite function. They are extremely worthwhile for individuals men and women who have heart disease. But extending their prescription to healthier individuals is only benefiting pharmaceutical companies.

“I humbly ask Great to reconsider lowering the threshold to a ten per cent risk, and to make individuals mindful of the choices of side effects.”

Fiona Godlee, editor in chief of the influential British Medical Journal, has also backed the get in touch with for greater transparency about statins investigation and alternative approaches to minimizing heart disease threat.

Professor Mark Baker, Director of the Centre for Clinical Practice at Wonderful said the advice on decreasing the threshold for prescribing statins will be published later on this month.

He said: “Drug treatment plays a key part in the management of people with high cholesterol ranges to support decrease their danger of cardiovascular illness and this is properly reflected in the draft guideline which gives clear guidance, primarily based on the ideal available study proof.

“It is the duty of GPs to describe the methods in which men and women can decrease their risk of cardiovascular ailment, presenting all the options promoted by this draft advice, including lifestyle modifications, blood pressure handle, avoidance of diabetes and lipid decreasing and let patients to make their very own decisions.

“It should be mentioned that this is draft guidance and we are presently consulting with stakeholders to get their views.”

Side-effects danger to rise as millions much more consider statins