Don't be afraid of statins, they work better than dietary supplements

Although statins are effective in lowering LDL cholesterol levels, many fear their side effects and take dietary supplements. A study shows that this approach is not beneficial.

Key take-aways:

• A randomized trial compared the cholesterol-lowering effects of statins and placebo to dietary supplements.
• The drug was significantly superior to the supplements in LDL-C lowering.
• Adverse effects did not occur more frequently under statin therapy.
• These data can and should be used to alleviate patients' fear of cholesterol-lowering medication.

Statins work - that's nothing new

The fact that statins effectively lower LDL cholesterol levels has been known for quite some time and is not a new insight for physicians. However, physicians are also well aware that people with elevated blood lipid levels are reluctant to take statins.

Although lowering LDL-C can minimize and prevent cardiovascular events, many patients are afraid of the side effects of this drug class. As a result, quite a few opt to take supplements, which are supposed to have the same effect - and the health business is booming: in the US, around 77 % of the adult population take various supplements; in Germany, the figure is about 30 %.

Dietary supplements failed to lower cholesterol in study

Very few nutraceuticals have sufficient studies to prove their efficacy. Some even lack any research to support them. This can have various reasons, for example the cost associated with a good study. At the November 2022 American Heart Association (AHA) Congress, a study compared the cholesterol-lowering effects of different therapeutics. This study showed that:

1. 199 patients were treated with either a statin, a placebo, or a dietary supplement.
2. People in the statin group took 5 mg of rosuvastatin daily.
3. In the nutraceuticals group, fish oil, cinnamon capsules, garlic capsules, turmeric powder, plant sterols, or red rice were used.
4. Under rosuvastatin, LDL-C levels decreased within 28 days by an average of 38%.
5. In the other two study arms, there was no reduction in LDL-cholesterol load.
6. Similarly, total cholesterol and triglycerides decreased only under statin therapy.
7. The results were statistically significant.

No increased risk of side effects

Furthermore, rosuvastatin therapy was not associated with an increased incidence of side effects. In particular, muscle pain and neurological manifestations were completely absent.

Conclusions for medical practice

These data can be used by treating physicians to inform patients about the efficacy and tolerability of the drugs, so that they can make well-informed choices. Especially for patients who tend to be treated with dietary supplements, the results of the study can be helpful and support their personal decision-making process.