Nearly 30% of adults 40 years and older in the United States are on a statin. Their widespread use heightens the importance of careful consideration of their varied effects on the body. Although randomized controlled trials have not confirmed cognitive impairing effects with statins, continuing evidence suggests statins have the ability to cause reversible cognitive impairment in some patients. Paradoxically, statins have also been shown to decrease the risk of dementia, Alzheimer’s disease, and improve cognitive impairment in some cases. However, randomized controlled trials have similarly failed to find the beneficial effect. Supporting evidence for both claims is compelling whereas known limitations of the clinical trials may explain the lack of findings. This narrative review aims to explain why there is still controversy and how both effects can, and may, be possible. The mechanisms that have been hypothesized for each effect are seemingly independent from one another and may explain the contradicting results. Being mindful of the complex effects of statins, health care providers need to be able to identify patients who are at risk for or already experiencing cognitive impairment from statin use while also identifying those who could potentially decrease their risk of dementia with statins.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5830056/ (Background section)Over 32 million people in the United States (10% of Americans) are currently on a statin with an estimated 56 million people (24% of Americans) eligible to consider a statin. Fourty-1 % of patients on statins are 75 years and older, 42 % are between 65 and 74 years, and 17 % are between 45 and 64 years . The widespread use of statins heightens the importance of careful consideration of their effects on the body.
https://www.medscape.org/viewarticle/496144_3 "The Forgotten Cardiac Risk Factor: Noncompliance With Lipid-Lowering Therapy: Why We Should Strive to Improve Compliance".More recent studies have suggested that only ~50% of patients who receive a prescription for a lipid-lowering drug continue to take the medication 6 months later. This proportion falls to ~40% after 12 months and to ~15%-30% after 5 years.
cwicker wrote:I think the research is pretty robust as to the cardiovascular benefits of statins. But, these are population studies and we don't know what individuals do benefit. The ASCVD calculator helps, but I don't feel it is robust enough. I think looking at genetics to determine such things, like the APOE allele is useful.
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