‘Statin side effects overstated…benefits of treatment outweigh risks’

Unverified health information spread through social media

Clinical benefit increases for patients at greater cardiovascular risk

The growing perception online that statins cause muscle damage or diabetes has led to a new issue - delayed treatment for patients with dyslipidemia

Experts emphasized that while the risks of statin side effects are often exaggerated, the drug's efficacy in preventing myocardial infarction and stroke has been confirmed through large-scale clinical trials, underscoring the need for evidence-based treatment decisions.

On June 10, Viatris Korea held a media session in Seongsu-dong, Seoul under the theme "Statin Myths and Facts," highlighting changes in the health information landscape and the importance of managing dyslipidemia.

Dyslipidemia is a major chronic disease affecting approximately half of the adult population in Korea. Although it is a major risk factor for cardiovascular and cerebrovascular diseases such as myocardial infarction and stroke, many patients fail to recognize the need for treatment because the condition is often asymptomatic. Recently, the spread of unverified health information through social media platforms such as YouTube has led some patients to defer or discontinue treatment.

Viatris media session

Spread of "Don't take statins" messages raises concerns about treatment delays

Dr. Min-wook Jang of the Jang Min-wook Brain Navigation Neurology Clinic noted that distorted information about statins is being repeatedly shared online.

Common claims include denying the need to manage LDL cholesterol or suggesting that statins cause muscle damage and diabetes, making them more harmful than beneficial.

Dr. Jang said, "An increasing number of younger patients have been deferring treatment because of unverified information. Postponing statin therapy can ultimately lead to irreversible outcomes such as heart attacks or strokes. Treatment decisions should be based on accumulated clinical evidence."

He shared cases from his practice in which patients discontinued statin therapy after receiving misleading information and later suffered strokes, stressing the importance of relying on verified medical evidence rather than sensational online content.

According to experts, the key goal of statin therapy is LDL cholesterol management.

Multiple large-scale clinical studies and meta-analyses have shown that every 1 mmol/L (approximately 38.8 mg/dL) reduction in LDL cholesterol lowers the risk of major cardiovascular events, including heart attack and stroke, by about 22%.

Among high-risk populations, which includes patients with diabetes, higher LDL cholesterol levels are associated with increased cardiovascular risk. Statin therapy has been shown to significantly reduce the risk of major cardiovascular events in these patients.

The timing of treatment is also important. Delaying therapy after diagnosis prolongs exposure to elevated LDL cholesterol, thereby increasing cardiovascular risk. In contrast, initiating treatment relatively early can provide long-term preventive benefits.

Experts also noted that concerns regarding statin side effects differ from what is observed in actual clinical data.

From left: Prof. Nan-do Kim (Emeritus Professor, Consumer Science, Seoul National University), and Dr. Min-wook Jang (Director, Jang Min-wook Brain Navigation Neurology Clinic).

Muscle-related adverse events have not shown significant differences compared with placebo groups in randomized controlled trials, while the risk of severe muscle damage such as rhabdomyolysis remains extremely low. The possibility of a nocebo effect—where patients experience or perceive symptoms more strongly because they expect side effects—has also been raised.

In studies involving patients who considered discontinuing statin therapy because of muscle symptoms, no significant difference in muscle-related adverse events was observed between statin and placebo groups. Presenters suggested that some reported symptoms may be influenced more by patient perception than by the medication itself.

Although some studies have reported a potential increase in diabetes risk, current clinical guidelines conclude that the overall benefits outweigh the risks when considering its effect in reducing heart attacks, strokes, and cardiovascular mortality.

Dr. Jang explained that the annual risk of new-onset diabetes mellitus (NODM) associated with long-term statin use is approximately 0.1%, which is relatively low. In contrast, the benefits of LDL cholesterol reduction, stabilization of coronary plaque, and prevention of major atherosclerotic cardiovascular disease (ASCVD) events have been clearly demonstrated.

Another meta-analysis found that treating 255 patients with statins for 4 years resulted in one additional case of new-onset diabetes. Dr. Jang noted that while the risk exists, the absolute risk remains relatively low.

Dr.Jang said, "Patients at higher cardiovascular risk derive substantially greater clinical benefits from statin therapy. Rather than delaying treatment because of vague concerns about side effects, patients should assess their individual risk and begin treatment at an appropriate time."

'Health intelligence' becomes more important amid the flood of health information

The event also featured discussions on changes in health information consumption.

Prof. Nando Kim, Emeritus Professor of Consumer Science at Seoul National University, argued that in an era overflowing with health information, the ability to search for, evaluate, and utilize health information has become increasingly important.

Dr. Kim said, "We have moved beyond the era of IQ and EQ into the era of Health Quotient (HQ), the ability to understand one's health status, seek and evaluate health information, and choose appropriate medical interventions. As more people acquire medical knowledge through artificial intelligence, the ability to critically interpret information and make careful decisions becomes even more important."

He added, "For conditions such as dyslipidemia, patients need to obtain science-driven information and take a proactive approach to management amid widespread misconceptions and misinformation."