Statins: Miracles for Some, Menace for a Few

Statins have been hailed as miracle drugs for their ability to prevent deaths from heart attacks by lowering cholesterol. Some doctors go so far as to say the statins have had a greater effect on heart disease than anything else introduced in the last 50 years. Last year, a national group of experts issued guidelines saying statins should be prescribed to some 36 million Americans, three times as many as were taking them then, to reduce their risk of heart disease.

In addition to protecting people at high risk, statins protect people who have already suffered one heart attack. Three large studies have shown that statins reduce the risk of second heart attacks by 30 percent and the risk of death from second heart attacks by 40 percent.

There are also strong hints that statins may protect against strokes, Alzheimer's disease and osteoporosis and may perhaps one day be For useful in treating multiple sclerosis and other autoimmune diseases.

Given their apparent wide range of actions, statins have been called the modern-day equivalent of aspirin. Some experts have even suggested that they be sold over the counter.

But like aspirin and all other drugs, statins sometimes cause serious side effects. The most serious involves the muscles, a disorder called rhabdomyolysis, rare but debilitating and deadly if not detected in its early stages. Statins may also cause a liver disorder in about 1 percent of patients. Because of that, everyone taking them should have a periodic blood test to spot early signs of trouble.

The five statins now on the market are Lipitor (atorvastatin), Mevacor (lovastatin), Zocor (simvastatin), Pravachol (pravastatin) and Lescol (fluvastatin).

Statins should be stopped in anyone soon to have major surgery. Anyone experiencing muscle pain of unknown origin while taking statins should contact the doctor without delay. If a blood test shows a very high level of creatine kinase, the drug should be stopped immediately.

All patients taking statins should have periodic blood tests for the liver enzyme transaminase, which is elevated when the liver is being damaged.

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