written by Michael O’Leary
The good news is intensive treatment with high doses of cholesterol-lowering statin drugs do reduce your chances of chest pain, heart attack or other cardiovascular problems. The bad news is the higher the statin dose the greater your chance of developing diabetes.
That’s the finding of a pooled-data study involving 32,752 nondiabetic people who participated in five clinical trials and were followed for five years. The analysis of previously conducted studies by David Preiss of the University of Glasgow, United Kingdom was published this week in the Journal of the American Medical Association.
During the five years of follow-up 2,749 participants in these trials (8.4 percent) developed diabetes. Of these, 1,449 were taking intensive doses of statins, and 1,300 were taking moderate statin doses. That worked out to about a 12 percent increased risk of developing diabetes for those in the intensive therapy group compared to the moderate group.
Whenever researchers find that the incidence of something rises with an increasing exposure to something else, they are relatively confident that that the exposure is at least a contributory cause of the effect. This is called dose-dependent effect. In this case they are fairly certain that increasing the dose of statins does increase the risk of developing diabetes.
“Our findings suggest that clinicians should be vigilant for the development of diabetes in patients receiving intensive statin therapy,” the authors write. “In conclusion, this meta-analysis extends earlier findings of an increased incidence of diabetes with statin therapy by providing evidence of a dose-dependent association.”
It is significant to note that 6,684 of the 32,752 participants (20.4 percent) experienced a major cardiovascular event. Of those, 3,134 were in the intensive dose group and 3,550 were in the moderate-dose group. In other words, 416 fewer patients in the intensive statin group experienced cardiovascular events compared to the moderate group.
Overall, the study reinforces the need to weigh the risks and benefits of any given treatment regimen.