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Old News: Statins and Your Brain

Scientific American called out statins in 2010 in an article titled, "It's not Dementia, It's Your Heart Medication.  Valuable information, and I disagree with the title: it IS dementia and it may be your statins.  The article opens with a 1999 anecdote of a 68-year old astronaut with a rather acute onset of dementia in a healthy man (an astronaut!) following initiation of treatment with Lipitor. Statins reduce total body cholesterol which some believe lowers your risk of heart disease, though that is controversial. Unfortunately, when brain cholesterol is lowered, nerve cells in the brain are impaired and nerve function is slowed or blocked. Research on the connection between lipids and dementia has found mixed results, but I suspect that there is a high-risk subset: those with the ApoE4 gene , those on the more potent statins and perhaps those with other metabolic challenges to their brain, such as insulin resistance. Perhaps most worrisome is the increased risk of diabetes associated with statins—in my mind a more potent threat to your heart than your cholesterol level.

Statins are “the most widely prescribed medications in the world” with the spottiest of records when it comes to efficacy. The independent website, The  scanned countless studies to reveal that in folks without prior heart disease, five years of treatment saved no lives, prevented one heart attack out of every 60-104 statin users, and one stroke out of 154-268. The price paid? 1 out of every 50 people developed diabetes and 1 out of 10 suffered muscle damage. 98% of statin consumers saw no benefit. In patients who had known heart disease, 96% saw no benefit, but 1.2% were saved from death, 2.6% from repeat heart attack, and 0.8% from a stroke.

There are many risk factors for heart disease: I recommend addressing all those other factors and leaving statins at the pharmacy. (Many people do: failure to refill medications is common among statins--usually fine but equally common among anti-hypertensives: not such a good idea.)

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