To Statin or not to Statin? That is the Question asked by Christopher Roper

It has never been easier to find advice on how to maintain one’s health, nor harder to decide what advice to accept and act on, and what to reject. I recently received a letter from our general practice, recommending me to take statins, on the grounds that they can reduce my chance of suffering heart disease and strokes.
Whether or not you receive such a letter depends on your QRisk2 score, which is partly determined by your cholesterol levels, but overwhelmingly by your age. It is quite likely that a high proportion of Marshwood Vale readers that are aged 70 or more will be taking a daily statin. The letter, on first reading, seemed quite convincing, but one sentence bothered me:
“The current evidence suggests that if we treat 20 people who have a risk of 10-19% for ten years then we would prevent one person from having a heart attack or stroke”. At 83, in reasonably good health, my chance of living for another 10 years must be worse than 50:50. So improving my chances by half a percent a year doesn’t seem to be a great result.
Furthermore, I have heard anecdotal evidence that statins bring side effects, notably muscle pains and an increased chance of diabetes. I know of one person in our village who stopped taking the pills because they affected his ability to work. However, it is very hard to argue with your doctor who is only doing her job and following national guidelines.
I began to collect further information and a recently retired doctor suggested I read two books by a Scottish doctor, Malcolm Kendrick, who has been raising warnings about statins for many years. Both books are readable and require no more than a fleeting acquaintance with organic chemistry, and some numeracy, to follow his reasoning. I first read A Statin Nation, which convinced me not to accept the proffered pills, and then A Clot Thickens, which suggests that doctors have been barking up the wrong tree for the past 70 years in their search for the cause of heart disease and how to prevent it.
I have tried in vain to find a book, aimed at the lay reader that counters Dr. Kendrick’s arguments with the same level of lucidity and numeracy. All one finds are unsupported assertions that Dr Kendrick and other statin sceptics are risking lives. Dr Kendrick thinks the argument is driven by money, and he could be right. The annual value of the statin market globally is 14 billion dollars today and projected to reach 17 billion dollars by 2027.
Two parallel examples are provided by the cigarette makers, who spent millions of dollars asserting that cigarettes didn’t harm your health, even after Professor Richard Doll and his colleagues had conclusively proved otherwise, and the oil companies which have only recently slowed their efforts to deny the role of the human use of hydrocarbons in climate change. Possibly statins don’t have malign consequences on the same scale, but the parallels are quite significant.
I should say that I hugely appreciate the value of modern medicine. Without the care I have received at Dorset County Hospital, I would be dead twice over, and not sitting at home writing this article. Without two cataract operations, I would be functionally blind. So I find myself in a bind when I doubt my doctor’s advice.
If I tried to précis Dr Kendrick’s arguments, I would almost certainly oversimplify, and possibly misrepresent them. However, if you are taking statins, or have been recommended to take them, I urge you to read his books. You will certainly have a more informed view of the statin controversy.