Benefits Versus Costs of Statin Drugs

Statins have been prescribed to the masses as primary and secondary prevention for coronary disease caused by hypercholesterolemia after their initial discovery in the late 1980s. Their actions in reducing low-density lipoproteins and increasing high-density lipoproteins are well documented; however, many negative effects have been reported related to muscle pathology and kidney function. The goal of this study is to investigate whether the benefits of this class of drugs outweigh the costs. Intense review of the literature was conducted using scholarly articles with original research findings that were located via electronic databases such as Medline, Science Direct, Proquest Medical Library, and Google Scholar. Research findings on the benefits of statins extended beyond their lipid-related effects and included benefits to the immune system and inflammatory response, sepsis prevention, and improved endothelial cell functions, among others. Negative side effects of statins are many, including damage related to skeletal muscle tissue, such as rhabdomyolysis, myofiber necrosis, myotoxicity, myopathy, myalgia, reduced muscle resting chloride membrane potential (gCl), vacuolization of the Ttubule system, sarcolemma detachment, and targeting of the muscle’s mitochondria. Differences between type I oxidative myofibers and type IIB glycolytic myofibers are discussed as well as the lipophilic and hydrophilic tendencies of the statins in relation to the damage inflicted on skeletal muscle tissue. In some rare cases of statin administration, motor neurons displayed Amyotrophic Lateral Sclerosis (ALS)-like symptoms that progressed up until muscle denervation. Additional negative side effects were seen to the circulatory and excretory systems, including altered chemical composition of both the blood plasma and urine, and rare renal failure due to rhabdomyolysis. The inquiry as to whether statins affect cardiac muscle as they do skeletal muscle is also addressed with the minimal findings that seemed to indicate that cardiac muscle is not targeted by statins. After taking into account the benefits versus the costs of statins, in addition to the lack of a better drug on the market for combating coronary disease, it was suggested that statin administration should continue due to its proven cholesterol-related effects. However, statin users should be limited to patients with coronary disease triggered by high cholesterol. Patients with proven treatment options, such as patients with cancer or autoimmune diseases, were cautioned not to take statins for the possible benefits of unproven pleiotropic effects due to the likelihood of damage to skeletal muscle and kidney functioning. Monthly blood work and urinalysis were also suggested for patients on statins, and patients should be advised to speak to their physicians if they feel muscle pain or encountered changes in the ease of manipulating their muscles, as these are possible signs of muscle and nerve problems