Statin intolerance is overestimated, according to a large study

Statin intolerance, which has discouraged many patients from taking this prescribed blood cholesterol treatment, is in fact grossly overestimated.

This is indicated by a large study on the subject published on Wednesday in the

.

Statins are drugs widely used to prevent heart disease and stroke.

For fear of side effects – which may exist – up to one in two patients interrupts or modifies their treatment.

This potentially exposes these patients to an increased risk of serious heart problems.

A 9.1% intolerance

Work taking into account 176 studies on the subject and based on the analysis of four million patients, puts an end to received ideas.

The authors of the research point out that statin intolerance is overestimated and overdiagnosed.

Patients are more likely to have heart and blood vessel problems, including death, caused by high cholesterol, than to be at risk of side effects from taking statins.

Until now, different reports or studies indicated that intolerance to statins could vary from 5 to 50%.

According to the data compiled by the meta-analysis, it would in fact be 9.1%.

The prevalence would be even lower according to certain international standards.

The “nocebo” effect

These results "mean that approximately 93% of patients on statins can be treated effectively, with very good tolerance and without any risk", says the study's lead author, Professor Maciej Banach, of the Medical University of Lodz and the University of Zielona Góra, Poland.

"We have to assess patients' symptoms very carefully," he noted.

First to see if these symptoms are actually caused by statins.

And second, to assess whether patients' perceptions of the harmfulness of statins might in fact be responsible for more than half of all symptoms, rather than the drug itself."

In a 2017 study published in

, researchers from Imperial College London already believed that several studies on the side effects of statins seemed to convince people to experience them themselves.

A psychological phenomenon called the “nocebo” effect.

People more likely to be intolerant

Another contribution of the meta-analysis published on Wednesday: the elderly, of female sex, of black skin or of Asian origin, obese or suffering from diabetes, underactive thyroid glands or chronic hepatic or renal insufficiency are more likely to be intolerant to statins.

Medicines to control irregular heartbeats (arrhythmia), calcium channel blockers (often prescribed for chest pain and high blood pressure), and alcohol consumption also increase the risk of intolerance.

Very useful information, notes Maciej Banach.

Because in the event of a high risk of intolerance, it may be necessary to decide on a reduction in doses or to consider the prescription of other drugs instead of statins.

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