Episode 4: Should You Take a Statin? (Cardiovascular Series: Part 4)

In this episode, we dive deep into statins—the most widely prescribed cholesterol-lowering drugs—and ask the hard questions: 

Do they really prevent heart disease? Are the benefits worth the risks? What does the data really say? 

Topics include: 

• The history of statins and how they were discovered
• The role of LDL in healing vs. harm
• Risks: muscle pain, cognitive issues, diabetes, mitochondrial dysfunction, and more
• Benefit vs. risk by ASCVD score
• Major trials like JUPITER, FOURIER, and the CTT meta-analysis
• The role of PCSK9 inhibitors and anti-inflammatory effects
• Why relative risk reduction numbers can be misleading
• How to make an informed, individualized decision about statins

🔢 Start Here: ASCVD Risk Calculator

Use this tool during the episode to estimate your 10-year cardiovascular risk.
https://tools.acc.org/ascvd-risk-estimator-plus/#!/calculate/estimate/
 

📚 References & Resources 

Statins for Primary Prevention – NNT Review 

Summary of evidence on statins for people without prior heart disease. 

ASCVD Risk Calculator 

Estimate your 10-year cardiovascular risk using standard clinical inputs. 

CTT Collaboration – NEJM 2017 PCSK9 Trial (FOURIER) 

Evaluated evolocumab’s impact on major cardiovascular outcomes. 

Statins and Myopathy – PRIMO Study 

Real-world observational study showing 10.5% statin-associated muscle problems. 

Statins and Mitochondrial Dysfunction 

Statins impair CoQ10 and heme synthesis, disrupting cellular energy production. 

Therapeutics Initiative – Statins for Primary Prevention 

Independent review finding no mortality benefit for low-risk individuals. 

Dr. Kumar’s Breakdown – JUPITER Trial and Inflammation 

How rosuvastatin lowered CRP and what that might mean. 

ASCVD Risk Calculator Overestimation 

Real-world data shows the tool often inflates predicted risk. 

Statins and Cognition – Pilot Withdrawal/Rechallenge Study 

Cognitive function improved in dementia patients after statin withdrawal. 

LDL Lowering vs. CVD Risk – Regression Model Critique by Ravnskov 

Analysis showing how excluding trials distorts the LDL-CVD link. 

Statin Use and Mortality Trends in Europe 

Statin utilization did not consistently correlate with mortality reduction. 

JUPITER Trial Results 

Reported a 44% relative risk reduction but only 1.2% absolute difference. 

CTT Meta-Analysis – 2012 Lancet Paper 

Meta-analysis of 27 statin trials, stratified by baseline risk. 

JAMA Meta-Analysis – Statins in Primary Prevention 

Found no mortality benefit from statins in low-risk patients. 

Niacin and Statin Alternatives – JNRBM Review 

Survey of other lipid-lowering therapies and their efficacy. 

NNT Review – Statins for Low-Risk Individuals 

Found minimal benefit and higher risk of side effects. 

BMJ Open – Industry Bias in Statin Trials 

Analysis of how pharmaceutical sponsorship shapes outcomes. 

Dr. Kumar’s Review – Statin Effectiveness and Safety 

A blog summary aligning with this podcast episode. 

Dr. Kumar’s Blog – Cognitive Side Effects of Statins 

Observational insight into brain fog and memory decline. 

Mitochondrial Effects of Statins – Golomb 2006 Review 

Review of mitochondrial dysfunction and muscle symptoms from statins. 

 
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Thanks for joining me on this journey to cut through the noise and uncover the truth in medicine. I’ll see you in the next episode.