Statin medications lower “bad” cholesterol and help ward off heart disease. But the drugs may also have other wide-ranging and sometimes negative effects on the body. That doesn’t make statins unique: Any medication entering the bloodstream can affect different body systems. Nor does it mean that worry about side effects should stop you from taking a needed prescription.
然而，意识到潜在的副作用可以帮助你及早发现任何问题。然后，如果必要的话，你可以跟你的医生关于更改他汀类药物的剂量或切换到不同的药物。
从约翰·霍普金斯Ciccarone中心心脏病预防研究人员最近的一篇综述评价了非心血管危害，并与他汀类药物的相关利益的证据。研究人员检查了自1994年至2014年间发表的随机对照试验和系统评价结果下面是他们的研究结果发表在英国医学杂志，2015年，确定关于与他汀类药物服用相关的风险。
1. Muscle pain
肌肉相关的问题可能是他汀类药物的最知名的副作用。在研究中，从5％到他汀类药物的用户超过20％的任何地方报告肌病一种肌肉疾病的总称。大多数情况下，人们抱怨疼痛和疼痛，肌肉无力，或夜间抽筋。很少有他汀类药物用户体验所谓的肌肉纤维，可导致永久性肾损伤的横纹肌溶解症击穿病情严重。除了肌肉症状，横纹肌溶解症可导致尿液呈现红色或可乐色的肌肉蛋白排出体外。
It’s not clear why statins affect muscle, but it’s possible the drugs can lower a natural substance called coenzyme Q, which helps muscle cells use energy. However, muscle problems appear largely confined to high-dose statins, particularly 80 mg doses of simvastatin (which are no longer recommended).
2. Diabetes
Another side effect,type 2 diabetes, arises when the body can no longer properly use the hormone insulin. There is evidence that statins can reduce the body’s insulin production or its sensitivity to the hormone.
Fortunately, the risk seems small. An analysis of 13 studies found that 4.9 percent of statin users developed diabetes over four years, versus 4.5 percent of participants given placebo pills. The risk is also largely seen in people who already have risk factors for diabetes, such as obesity or chronically high blood sugar.
The best way to protect yourself is to have your blood sugar checked as recommended by your doctor, further improve your dietary and exercise habits, and lower your weight about 5 pounds or more if you are overweight.
3. Memory loss
Since 2012, statin labels have included a warning about the possibility of “ill-defined memory loss” and “confusion.” But the caution is based on case reports and small studies, and the evidence is mixed as to whether statins truly create a mental fog.
从理论上讲，过多的胆固醇降低可能会削弱脑细胞膜。在另一方面，他汀类药物可以降低中风的风险，并改善血液流向大脑，这可能有助于预防老年痴呆症的一种形式叫vascular dementia.
The jury is still out on whether statins are the culprit here. And on another reassuring note, in the very few cases where people have reported memory issues, the problem has typically cleared up within a few days or weeks of stopping the medication.
4. Liver injury
Statins are thought to affect liver chemistry by changing lipid metabolism, and the Food and Drug Administration used to advise doctors to regularly monitor statin users’ liver enzymes. But recent research has shown that actual liver injury is rare, and now the standard of care is to measure liver enzymes before a patient starts a statin— and repeat the test only if there are symptoms of liver damage (such as jaundice, fatigue, and appetite loss).
5.白内障
Cataractsare a clouding of the eye’s lens, and animal research hints that statins can contribute to cataracts—possibly by hindering proper cell development within the lens, which needs a certain amount of cholesterol to remain transparent.
Results from human studies have been mixed, however. One study of more than 46,000 people found that statin users were 27 percent more likely than nonusers to have cataracts. But other studies have found no such link—and have even seen a lower risk among statin users. For now, any statin-cataract connection remains unclear.
6. Other questions
There is evidence, though nothing definitive, that statins can affect some other organs. One large study found that people on high-dose statins were more likely to suffer sudden kidney failure than people on low doses. However, that may be because less-healthy people tended to be on higher statin doses.
在其他情况下，已经出现了好处提示：他汀类药物的用户已经表明腿部血液凝块的风险较低，而在一项研究中，男性erectile dysfunctionreported an improvement after starting a statin.
Our advice
Now that statins have been so widely used, for so many years, researchers are learning more about the potential for unintended effects. In general, the heart benefits far outweigh any risks. But every patient should discuss his or her individual benefit-risk ratio with a doctor before starting on statin therapy. And if you notice new or unusual symptoms after you begin a statin, tell your doctor. A change in dose, a different statin, or another type of cholesterol drug may be in order.