Touted as miracle drugs capable of significantly reducing the risk of heart attacks and strokes , their prevalence in modern medicine has soared .

Yet , as mounting evidence and expert opinions emerge , it ’ s time to scrutinise whether the enthusiasm for statins has outpaced their actual benefits .

STATINS AND HEART HEALTH

Dr Jeyarajah Sivalingam , a seasoned consultant physician with extensive experience in cardiology , articulated a growing concern among medical professionals regarding the statin narrative .

Early studies heralded statins as drugs that could lower low-density lipoprotein ( LDL ) cholesterol , a type of cholesterol that is often referred to as ‘ bad ’ cholesterol and is a significant risk factor for heart disease .

These studies suggested that statins could reduce heart attack risk by up to 50 per cent . However , subsequent analyses reveal a more nuanced picture .

While statins effectively lower LDL levels , their role in improving health outcomes — particularly among individuals deemed healthy — has come under increasing scrutiny .

Dr Jeya explained : “ Statins have been marketed primarily based on their ability to lower LDL cholesterol ,

“ But we must ask ourselves : does lowering cholesterol directly translate to better health outcomes ? The answer is not as clear-cut as we once believed .”

His sentiments echo a growing scepticism within the medical community regarding the efficacy of statins in preventing cardiovascular events , especially in patients with no prior history of heart disease .

Dr Jeyarajah Sivalingam

“ Statins have been marketed primarily based on their ability to lower LDL cholesterol .”

– Dr Jeyarajah Sivalingam

Dr Mohd Shawal Faizal Mohamad , another prominent voice in the field of cardiovascular health from Hospital Canselor Tuanku Mukhriz ( HCTM ) Universiti Kebangsaan Malaysia ( UKM ) Kuala Lumpur , shared these concerns and emphasised the ethical implications of expanding statin prescriptions .

Initially reserved for high-risk individuals , the guidelines have broadened over the years to include patients with only marginally elevated cholesterol levels , regardless of their overall health profile .

“ More and more patients are being told they need statins simply because their cholesterol numbers are slightly elevated ,

“ We have to ask whether this is genuinely in their best interest .

“ Are we treating a number on a chart , or are we considering the patient ’ s overall health and risk factors ?” asked Dr Shawal .

He also mentioned : “ As a second preventive , statins are almost required for heart attack and stroke patients .

“ However , only patients with CVS ( cardiovascular risk ) factors like DMII ( Diabetes Mellitus type II ), Hypertension ( HPT ) and smoking will benefit from statin prescription for primary prevention .”

According to Dr Jeya , this shift has led to a staggering 600 per cent increase in statin eligibility from 1987 to 2016 , prompting questions about the appropriateness of such widespread prescribing .

This question highlights a fundamental dilemma in contemporary

healthcare : the tension between clinical guidelines and personalised patient care .

EVIDENCE-BASED APPROACHES

Critics argue that the benefits of statins are often exaggerated .

Dr Jeya cited a study from 2022 led by Dr Paula Byrne ( Evaluating the Association Between Low-Density Lipoprotein Cholesterol Reduction and Relative and Absolute Effects of Statin Treatment : A Systematic Review and Meta-analysis ), who reviewed data from over 140,000 participants to determine whether lowering LDL cholesterol directly correlates with a reduced risk of heart attacks or mortality .

Surprisingly , the findings indicated a weak and inconsistent relationship between LDL reduction and these outcomes .

Dr Jeya also highlighted that the pharmaceutical industry ’ s marketing strategies often emphasise relative risk — claiming a 50 per cent reduction in the risk of dying — while downplaying absolute risk , which may be negligible in practice .

“ When they say your chance of dying has been reduced by 50 per cent , they ’ re using what ’ s called relative risk ,” Dr Jeya clarified .

“ In absolute terms , the actual reduction might only be 0.1 per cent . But when framed as relative risk , it sounds much more impressive .”

This tactic , according to Dr Jeya , makes the drug seem far more effective than it actually is .

He noted that while relative risk