Don't panic about statin side-effects; Dear Miriam.

Byline: MIRIAM STOPPARD 

I'm in no doubt that statins are "miracle" drugs - and that's a term I don't use lightly.

In fact, I've probably only used it about three times in my life - the other two being about penicillin and insulin, drugs that have saved millions of lives worldwide.

That's why I'm keen that people don't panic when they hear that five "undesirable effects" are now being listed in leaflets issued with packets of statins.

These effects include sleep disturbance, memory loss, sexual dysfunction, depression and, rarely, interstitial lung disease.

Hearing this news out of context is guaranteed to put people off taking these drugs so it's vital that any side-effects are put into context and balanced against the very real risk of not taking the drugs if you're a likely candidate for heart disease.

What statins do

Statins work by reducing blood cholesterol, especially the type known as LDL, or "bad" cholesterol, which contributes to furring up of the arteries - a major risk factor for coronary heart disease and strokes.

Doctors prescribe them to anyone considered to have a one in five risk of having a stroke or heart attack in the coming 10 years, though brands containing weaker doses are available over-the-counter from pharmacies.

Around six million people in the UK are taking statins, which are credited with saving thousands of lives a year. Around seven out of 10 people over 45 in the UK suffer from high cholesterol, and heart disease is by far the nation's biggest killer.

And while everyone with high cholesterol isn't overweight or obese, the current epidemic of obesity means this drug could practically save the human race.

I take statins and have done for around seven years, even though I don't have a high risk of heart disease. That's because I'm a great believer in preventive medicine.

Side-effects

Firstly, every drug has side-effects. Just look at the leaflets that come with any medication in your bathroom cabinet, whether it's prescription or over-the-counter. Even the widely used painkiller ibuprofen includes stomach ulcers, headache and dizziness in what sounds like an alarming list of potential side-effects, plus a long list of circumstances in which it shouldn't be taken. Statins have been very widely studied and, as drugs go, are considered to be well tolerated overall. Muscle pain is the most common noted side-effect but is often temporary.

The fact that these newly listed sideeffects have only just come to light shouldn't be a cause for concern either. As the number of people taking statins increases, it's inevitable that more side-effects will be noted. It's also common practice for them to be regularly updated and the fact that this has happened should be reassuring rather than alarming as it means that the system is working as it should. Next, just because a side-effect is listed, it certainly doesn't mean you'll get it.

The result of one clinical trial suggested that slightly more than one in 10 may suffer sleep disturbances and depression. Put another way, that means that nine out of 10 won't.

In the same trial, increased risk of memory loss was cited at a mere three in 100. I've worked on lots of trials, where the effects (and side-effects) of drugs are compared to placebos, otherwise known as dummy pills. The patients have no idea whether they're taking the active drug or the dummy pill and, interestingly, patients report sideeffects regardless or which pill they're taking. Part of the reason may be because people expect something different to happen and may be taking more notice of their body than they normally would.

Interestingly, many of these sideeffects are increasingly common with age and those taking statins are mostly middle-aged and over.

Do you need statins?

The only way to know for sure is to see your GP for a heart health assessment, which should include cholesterol, blood pressure, weight and measurement checks, plus questions about your family history of heart disease and your lifestyle.

High cholesterol and high blood pressure usually have no obvious symptoms, so it's important that all adults are tested regularly.

Don't assume that just because you're slim with a healthy lifestyle, you're not at risk. Although lifestyle is a major cause of heart disease risk factors, high cholesterol and high blood pressure can also be hereditary.

Who shouldn't take them?

There are actually very few people for whom statins aren't suitable, though it's not advisable to take them if you're pregnant or breastfeeding, you have liver disease or abnormal liver function or tests reveal muscle damage. However, your liver function should be tested before you start taking statins and then reviewed a few months later.

As with any drug, check with your doctor or pharmacist before taking alongside other medication to avoid clashes.

If you have side-effects

Don't stop taking the drugs without consulting your doctor first. Make an appointment so you can discuss the side-effects. It could be that changing the dose, changing the time of day you take your pill or switching to another type of statin could stop or reduce the side-effects. Statins vary in strength and different types have slightly different chemical structures.

This means that if you're sensitive to one, you might not be to another. Your doctor can find one that suits you, according to your cholesterol target and your medical history.

Otherwise, it may be a case of weighing up the benefits of statins against the discomfort of the side-effects.

Additional research: MADELEINE BAILEY