If you have high cholesterol,
you would have heard
of a cholesterol-lowering
Statins are used to reduce
“bad” cholesterol (low-density
lipoprotein, or LDL). Too much of
this waxy, fat-like substance in the
blood can lead to plaque build-up
in the walls of the arteries.
This plaque build-up narrows
arteries, reduces blood flow to the
heart or brain, and increases the
risk of strokes and heart attacks.
Studies, including a
meta-analysis of data from
26 randomised trials published in
the renowned medical journal
The Lancet in 2010, have proven
that statin therapy reduces the
risk of major vascular events by
25 per cent for 1mmol/L reduction
in LDL cholesterol.
While some side effects in
relation to statin use have been
reported, these are rare.
The use of statins is often
misunderstood. Unproven claims
about its side effects could be
why it is underutilised among
those at increased risk of heart
attacks and strokes.
One common myth is that
statin use leads to a range of
side effects, such as muscle aches, liver and kidney damage,
memory loss, and confusion.
But muscle aches are likely to
be due to misattribution, resulting
from a phenomenon known as the
Researchers have found
that patients on statins were
more likely to think they were
experiencing muscle-related side
effects, while those who were
unaware that they were on the
medication reported no increase
in such symptoms.
There is little evidence to
prove that statins adversely
affect the kidneys, memory,
and cognition. On the contrary,
results from randomised
controlled trials suggest that
statin therapy may slow down the
progression of renal impairment.
Studies have also found that
statins may protect against
dementia and cognitive changes,
especially with long-term use.
While statin therapy may
lead to a mild increase in liver
enzymes, this can be managed by
lowering the dose or changing to
Statins are associated with a
small increase in risk of diabetes,
mainly in those who are already
at risk of diabetes. The benefits
of reducing cardiovascular risk
outweigh the slight increased
risk of diabetes. Patients with diabetes benefit greatly from
statins, which reduces their risk of
heart attack, stroke, and death.
Supplements vs statins
There is currently no reliable
evidence to prove that health
supplements can safely prevent
Unlike prescription medication,
supplements generally do not
undergo stringent clinical trials.
In Singapore, they are not subject
to approval and licensing by the
Health Sciences Authority for
importation, manufacture, and sale.
Even if supplements are
marketed as “natural”, it does not
necessarily mean they are safe for
everyone. Some may even cause
harm, depending on a person’s
health and whether they are taken
with other medication.
Patients with elevated risk of
cardiovascular events will benefit
from a high-intensity statin regime,
even if their LDL cholesterol levels
are average or below average.
Studies have shown that
patients who took statins
lowered their LDL cholesterol
and reduced their overall risk of
getting heart attack and stroke,
regardless of their pre-existing
If you have concerns about
statins use, it is advisable to seek
your doctor’s opinion.
Adapted from an article “Clearing up myths on statins” in Murmurs, a publication of the National Heart Centre Singapore, and contributed by Dr Ho Jien Sze, Consultant from Department of Cardiology, National Heart Centre Singapore (NHCS).