Bad Info May Be Scaring Patients Away From Heart-Healthy Statins
More than a quarter of people who could benefit from taking statins don't, and a new survey suggests that while not enough doctors are prescribing the cholesterol-lowering drugs, fears about side effects also play a part.
"There is so much misinformation about statins in the media that it's clearly permeated and now is affecting people's ability to take these medications and improve their cardiovascular health," said lead author Dr. Corey Bradley. She's a researcher at the Duke Clinical Research Institute in Durham, N.C.
The new survey focused on almost 5,700 older adults who'd been recommended for statin therapy, based on data kept in a national registry that tracks cholesterol management and heart disease treatment.
Popular prescribed statins include atorvastatin (Lipitor), rosuvastatin (Crestor), pravastatin (Pravachol) and simvastatin (Zocor).
More than 26 percent of the patients, 1,511, were not taking statins even though they'd benefit from them, the survey revealed.
About 31 percent of those not taking statins said they'd tried the drugs but stopped, and another 10 percent said they turned down the medication outright when a doctor recommended it, researchers found.
Side effects were the most common reason given by these folks, and they were less likely to believe statins are safe than people who used the medication.
However, there's also strong evidence that doctors aren't doing everything they can to prescribe these medications for those who need them.
Fifty-nine percent of adults not taking statins said they weren't because a doctor had never offered them a prescription.
It's possible that some of these people were offered statins and forgot, but that in itself is damning, Bradley said.
"If a patient didn't remember the conversation, it likely wasn't an effective one," she said. "We need to improve the way we frame these conversations and continue to have them."
The findings were published March 27 in the Journal of the American Heart Association.
Bad or misleading information circulating about statins is overwhelming doctors' efforts to get patients to take the cholesterol-fighting medications, said Dr. Nieca Goldberg, who wasn't involved with the study. She's a cardiologist and medical director of the NYU Langone Joan H. Tisch Center for Women's Health in New York City.
Estimates are that about 1 in every 10 patients have a side effect from statins, Goldberg said. Muscle aches are the most commonly reported side effect.
Despite this, clinical trials have shown that the difference in muscle ache symptoms between people on statins and those taking placebos is less than 1 percent, and about 0.1 percent for people who stopped taking statins due to muscle pain, according to a December review published in the journal Arteriosclerosis, Thrombosis, and Vascular Biology.
"When patients get a new medicine, they discuss it with their friends or they look it up online, and they get so much information," Goldberg said. "Some of patients who really are concerned about taking the medicine are really only focused on the side effects. They go online and get the side effects of the medicine, and that data is not put into perspective for them by anyone."
Patients were more likely to report never being offered a statin if they were female (22 percent higher odds), black (48 percent higher), or uninsured (38 percent higher). Those seen by a cardiologist were more likely to be offered a statin than those in primary care.
Bradley and Goldberg said doctors need to come up with better ways to talk with patients about statins and the drugs' perceived side effects, especially if the person has stopped taking them.
Despite their concerns, about 60 percent of the patients who stopped taking a statin would consider retrying it, the survey showed.
"We have a tendency to view that if a patient stops a medication they were previously on, then that's a closed door," Bradley said. "This study suggests we should re-engage with the patient and discuss their concerns."
Goldberg said she encourages her patients to forward their questions and concerns through a secure internet portal, "so there's a continuing dialogue.
"We don't start the day wanting to prescribe medicine to everyone, but we do want to lower a person's risk, and sometimes lowering risk for heart disease involves not only diet and exercise, but needing a medication," Goldberg said.
The Mayo Clinic has more about statin side effects.
SOURCES: Corey Bradley, M.D., researcher, Duke Clinical Research Institute, Durham, N.C.; Nieca Goldberg, M.D., cardiologist and medical director, NYU Langone Joan H. Tisch Center for Women's Health, New York City; March 27, 2019, Journal of the American Heart Association