Statins are a safe and useful drug for combatting cholesterol, say researchers.
Statins are considered some of the safest drugs. Prof. Børge Nordestgaard, co-author of the current study and chief physician at Copenhagen University Hospital in Denmark, describes statins as "a success story in modern medicine, and currently [...] the most effective way to prevent cardiovascular disease."
However, side effects can occur, particularly within the first 6 months, including muscle aches and, very rarely, rhabdomyolysis, when skeletal muscle is broken down. These side effects, or fear of them, can cause patients to discontinue their medication in the early stages.
Prof. Nordestgaard and his colleague Dr. Sune Nielsen, a senior scientist at Copenhagen University Hospital, wanted to know how negative news stories about statins affect patients' decisions about whether to continue their medication or not.
The study focused on 674,900 people aged 40 and older, across the entire Danish population, who were using statins between January 1995 and December 2010. The researchers tracked them until the end of 2011.
The team also identified 1,931 statin-related news stories from January 1995 onward in the Danish media and graded them as negative (110 stories), neutral (1,090 stories) and positive (731 stories).
In addition, they analyzed relationships between use of statins and having cardiovascular disease or diabetes when usage began, the passing of years, statin dose, being male, living in cities and being of non-Danish ethnicity.
Each negative story raises the risk of stopping by 9%
From 1995-2010, the proportion of people using statins increased from less than 1% to 11%, while early statin discontinuation increased from 6% to 18%.
The number of all statin-related news stories (positive, neutral and negative) increased from 30 per year in 1995 to 400 in 2009, and for every negative nationwide news story about the cholesterol-lowering group of medicines, there was a 9% increased risk of people deciding to stop taking statins within 6 months of first being prescribed the drug.
The risk of abandoning the therapy early was also higher with every passing calendar year (4%), increased daily dose (4%), being male (5%), living in cities (13%) and for being of non-Danish ethnicity (67%).
In contrast, the risk of discontinuation fell after exposure to positive news stories (8%), having cardiovascular disease at the time the statins were first prescribed (27%) or having diabetes at that time (9%).
Prof. Nordestgaard says:
"We found that exposure to negative news stories about statins was linked to stopping statins early and explained 2% of all heart attacks and 1% of all deaths from cardiovascular disease associated with early discontinuation of statins. People who stop statins early have a 26% increased risk of a heart attack and an 18% increased risk of dying from cardiovascular disease when compared to people who continue to use them."
Although it is not certain that negative news stories cause people to stop taking statins, the findings suggest that this is likely; and the indication that early discontinuation leads to unnecessary heart attacks and deaths is of concern.
The authors stress the need to adhere to the drugs or face cardiovascular health problems, and they call for ways to encourage continuation.
Prof. Nordestgaard says ways must be developed to ensure that people stick to the therapy, especially in the first 6 months.
Positive news stories tend to be evidence-based, explaining how statins can prevent heart disease and early death. In contrast, negative news stories tend to focus on relatively rare and moderate side effects.
If there were no negative statin-related news stories, 1.3% of the population would continue to take their medications, the authors conclude.
Medical News Today recently reported that statins can reduce the effectiveness of the flu vaccine.