Statin Study: Should Patients Eat an Apple Instead?

Bellingham, WAWhen it comes to discussions of risks versus benefits, few drugs have as much controversy as Crestor and other drugs in the statin category. Concerns about Crestor side effects and other statin side effects have led some critics to argue that statins are in fact over-prescribed. Meanwhile, new guidelines from health agencies about managing cholesterol have not simplified the debate.

One recent study weighing in on the debate was published December 17, 2013, in BMJ (British Medical Journal). The study, titled “A statin a day keeps the doctor away,” examined the comparative benefits of either using a statin or eating an apple a day to decrease a patient’s vascular mortality. Based on death attributed to vascular disease, researchers estimated the annual reduction in deaths when patients took a statin a day compared with patients who ate an apple a day.

Researchers found that both a statin a day and an apple a day had a similar effect of decreasing vascular mortality in patients over the age of 50. But, they noted that apples, as opposed to statins, would not also increase cases of myopathy and excess diabetes.

“With similar reductions in mortality, a 150 year old health promotion message [‘An apple a day keeps the doctor away’] is able to match modern medicine and is likely to have fewer side effects,” researchers concluded. Writing further on, researchers noted “Choosing apples rather than statins may avoid more than a thousand excess cases of myopathy and more than 12 000 excess diabetes diagnoses.”

Researchers did note that many adults in the UK do not get the recommended servings of fruits and vegetables in a day and that taking a pill is less time-consuming than eating an apple.

In November 2013, the American Heart Association and the American College of Cardiology issued new guidelines regarding cholesterol. The result of those guidelines, according to some experts, is that many patients who are currently healthy will be prescribed statins. In an argument against this move, John Abramson and Rita Redberg, writing an opinion in the New York Times (11/13/13), note that the new guidelines would “increase the number of healthy people for whom statins are recommended by nearly 70 percent.”

The problem, the authors note, is that statins are proven effective in patients who have known heart disease, but they have not been shown to reduce the risk of death or serious illness in people with less than a 20 percent risk of heart disease in the next 10 years. And, while not obtaining benefit from the drug, healthy people given a statin would be put at risk of suffering side effects, including muscle pain, diabetes or cataracts.

And keeping in tune with the study on apples and statins, the article’s authors express concern that taking a statin might stop patients from taking other steps to positively affect their health, such as walking or changing their diets - steps that may provide just as much benefit, but without the side effects.