Statins against cholesterol: Still debated

For some people, statins are a major weapon for preventing cardiovascular disease. These drugs hould be more widely prescribed, even when cholesterol is normal. Recently, British doctors have even proposed to make available in fast-food restaurants, next to condiments supposed to neutralize the damage that food does to the arteries.

For others, their benefits are exaggerated by pharmaceutical companies, which skew the clinical studies and would influence the recommendations of experts responsible for the prescription. Faced with such heated debate in the scientific community, how to find the right answer?

Discovered in the 1980s, from fungus, these drugs neutralize a liver enzyme that helps make cholesterol. Gradually, statins have emerged as a prevention tool against cardiovascular diseases that kill thousands of people worldwide.

Extensive studies have demonstrated benefits in secondary prevention (that is to say after a heart attack, a stroke...) and also in primary prevention, in the presence of risk factors like diabetes or hypertension. This year, a statin even got permission to be put on the market in the U.S. and in Europe to treat individuals without apparent cardiovascular disease or high cholesterol, but who are considered at risk.

The favorable effects are also suggested in other diseases (multiple sclerosis, osteoporosis, rheumatoid arthritis ...), but remain to be confirmed. With years of hindsight, the tolerance is good. The severe side effects are less than 1% of cases. They often involve the muscles or liver. A link with cancer has been suggested, but is not established. A recent analysis of 170,000 patients even leads to "very reassuring" conclusions. The question remains to what population statins are useful, which molecule and in what dose.

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