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Adverse Effects of Statins - Myths and Reality
Abstract
Statins reduce cardiovascular mortality and morbidity as well as cardiovascular events in patients with a very high risk of cardiovascular disease (CVD) and also in subjects with high or moderate risk by reducing the levels of low-density lipoprotein cholesterol (LDL-C). Although they are considered to be drugs with a very good safety profile, because of their wide use there are many concerns that their adverse effects might compromise their proven beneficial effects. Therefore this article reviews all the data and provides an evidence- based insight what are the proven adverse effects of statins and what are the "myths" about them. The most important side effects include myopathy and rhabdomyolysis. Another side effect is increased activity of liver tests which occurs occasionally and is reversible. However, recent studies even suggest that statin therapy can improve hepatic steatosis. It is beyond any doubt that statins do slightly increase the incidence of type 2 diabetes mellitus in people with two or more components of metabolic syndrome but the cardiovascular benefits of such a treatment by far exceed this risk. Statin therapy has also been associated with some adverse renal effects, eg. acute renal failure, but recent data suggest even a possible protective effect of these drugs on renal dysfunction. Concerns that statins might increase cancer have not been proven. On the contrary, several studies have indicated a possible benefit of these drugs in patients with different types of cancer. Early concerns about cognitive dysfunction and memory loss associated with statins use could not be proven and most recent data even suggest a possible beneficial effect of statins in the prevention of dementia. Systematic reviews and clinical guidelines suggest that the cardiovascular benefits of statins by far out-weight non-cardiovascular harms in patients with cardiovascular risk.
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In the citing paper
“the use of high-intensity statins increases side effects”
From Nutraceuticals in the Management of Dyslipidemia: Which, When, and for Whom? Could Nutraceuticals Help Low-Risk Individuals with Non-optimal Lipid Levels? (2021) · cites this paper as [102]
In the citing paper
“these are associated with reduced therapy adherence and compliance”
From Nutraceuticals in the Management of Dyslipidemia: Which, When, and for Whom? Could Nutraceuticals Help Low-Risk Individuals with Non-optimal Lipid Levels? (2021) · cites this paper as [102]
In the citing paper
“statins are the drugs of choice in patients with high LDL-C levels and moderate to high CV risk”
From Nutraceuticals in the Management of Dyslipidemia: Which, When, and for Whom? Could Nutraceuticals Help Low-Risk Individuals with Non-optimal Lipid Levels? (2021) · cites this paper as [102]
In the citing paper
“The use of high-intensity statins increases the risk of adverse effects and, therefore, worsens adherence (11,124).”
From The Role of Nutraceuticals in Statin Intolerant Patients (2018) · cites this paper as [124]
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Items 101–127 of 127
Zheng, G., Cao, X., Jing, Y., Wang, L., Yan, R., Ji, Y., Zhang, Y., Li, H. T., Wang, Y., Shi, Y., et al. (2025) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2025.119450 · Cited by 3
Moridpour, A. H., Goodarzi, M., Kavyani, Z., Nademi, N., Daneshvar, M., Musazadeh, V., & Faghfouri, A. H. (2023) · PharmaNutrition · doi:10.1016/j.phanu.2023.100366 · Cited by 3
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Tang, X., & Gong, J. (2022) · Cardiology Research and Practice · doi:10.1155/2022/7674366 · Cited by 2
“However, statins may have adverse effects on skeletal muscle [34] and renal function and cause increases in liver enzymes susceptibility to type 2 diabetes mellitus [35, 36].”
BackgroundGuanxinping ameliorates atherosclerosis via MAPK/NF-κB signaling pathway in ApoE −/− mice
Zhang, S., Zhang, S., Liang, X., et al. (2022) · Perfusion · doi:10.1177/02676591211068311 · Cited by 2
“myopathy, rhabdomyolysis, liver damage, and renal failure.(6) Hence, innovative researchers turn to utilizing hypotoxic or nontoxic Chinese herbs for AS treatment.”
BackgroundAşkın, S., & Umudum, F. Z. (2024) · Food Science & Nutrition · doi:10.1002/fsn3.4471 · Cited by 2
“considered very safe drugs, there are many studies that, due to their wide use, their side effects may overshadow their proven beneficial effects (Simic & Reiner, 2015).”
Feng, T., Zhang, X., Xu, J., Gao, S., & Yu, X. (2025) · International Journal for Equity in Health · doi:10.1186/s12939-025-02391-9 · Cited by 2
“Statins have proven effective in preventing ASCVD, but their use is linked to a higher incidence of diabetes, posing challenges for policymakers, healthcare providers, and patients [43, 44].”
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“Statins are widely recognized as the first-line treatment for dyslipidemia in individuals at moderate to very high cardiovascular risk [53–55].”
Zyryanov, S. K., Fitilev, S. B., Vozzhaev, A. V., Ивановна, Ш. И., Klyuev, D. A., Stepanyan, L. N., Danilova, A. A., Tsai, A. T., Landyshev, N. N., & Voronko, Y. G. (2020) · CARDIOVASCULAR THERAPY AND PREVENTION · doi:10.15829/1728-8800-2020-2609 · Cited by 2
Study on Mechanism of Portulacae Herba in Treatment of Atherosclerosis Based on Network Pharmacology
王, 霞. (2021) · Traditional Chinese Medicine · doi:10.12677/tcm.2021.103060 · Cited by 2
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Non-Alcoholic Steatohepatitis Patient Characterization and Real-World Management Approaches in Italy
Bugianesi, E., Miele, L., Donnarumma, G., Grau, K., Mancuso, M., Prasad, P., Leith, A., & Higgins, V. (2024) · Pragmatic and Observational Research · doi:10.2147/por.s472468 · Cited by 1
“However, due to concerns over statin treatment safety in NAFLD patients, 36–38 many patients are not given statins, which leads to increased cardiovascular risks.”
BackgroundSu, Z., Liao, Z., Chen, X., Tang, J., & Wang, Y. (2024) · Expert Opinion on Drug Safety · doi:10.1080/14740338.2024.2438753 · Cited by 2
“Moreover, long-term statin therapy is associated with adverse effects that often lead to treatment discontinuation [6,7].”
Dietary Bioactives and Bone Health
Wallace, T. C. (2018) · MDPI eBooks · doi:10.3390/books978-3-03842-846-6 · Cited by 1
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Early Signal Detection: Data Mining of Mental Disorders with Statins
Jiménez-Serranía, M.-I. (2022) · IntechOpen eBooks · doi:10.5772/intechopen.105504
Kothari, C. S., & Shah, M. (2022) · IntechOpen eBooks · doi:10.5772/intechopen.100957
Interaction of Anti-COVID-19 Drugs with Cardiovascular Therapy
Dunja, L., Pećin, I., & Reiner, Ž. (2022) · Contemporary cardiology · doi:10.1007/978-3-031-15478-2_15
Self-citationStatin therapy and sex hormones
Chiti, H., Parsamanesh, N., Reiner, Ž., Jamialahmadi, T., & Sahebkar, A. (2023) · Principles of Gender-Specific Medicine · doi:10.1016/b978-0-323-88534-8.00012-2 · Cited by 1
Self-citationFeng, T., Zhang, X., Xu, J., et al. (2023) · medRxiv · doi:10.1101/2023.08.03.23293584
Biology of time: The temporal distance between cause and effect
Saido, T. C. (2024) · Elsevier eBooks · doi:10.1016/b978-0-443-28979-8.00003-6
Cai-ying, Y., Wang, X., Linying, Q., Qing, Y., Chen, Y., Li, Q., Zhu, X., Lihong, Y., Cheng, L., & Yu, D. (2025) · Current Drug Metabolism · doi:10.2174/0113892002387343250807080059
Functional Components of Foods: Health Effects and Therapeutic Mechanisms in Metabolic Syndrome
Estefes-Duarte, J. A., Hernández-Peña, N., Hernández-Soto, I., Cabrera, G. B., Muñoz‐Pérez, V. M., & Fernández‐Martínez, E. (2026) · Current Nutrition & Food Science · doi:10.2174/0115734013441158251212074509
Metadata
- Authors
- Simic, I., & Reiner, Z.
- Venue
- Current Pharmaceutical Design
- Publisher
- Bentham Science Publishers Ltd.
- Published
- 2015-01-03
- Volume
- 21
- Issue
- 9
- Pages
- 1220-1226
- ISSN
- 1381-6128 (ISSN-L)
- OpenAlex
- W1980114153
- Cited by
- 126
- References
- 0
- Citations by year
- 2026: 1 · 2025: 9 · 2024: 9 · 2023: 13 · 2022: 18 · 2021: 17 · 2020: 14 · 2019: 11 · 2018: 9 · 2017: 9 · 2016: 11 · 2015: 5
- FWCI
- 8.26
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Pharmaceutical Design (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Toxicology › Pharmacovigilance and Adverse Drug Reactions
- Keywords
- statins, adverse drug reactions, myopathy, rhabdomyolysis, hepatotoxicity, hepatic steatosis, type 2 diabetes, metabolic syndrome, renal effects, acute kidney injury, cancer risk, cognitive impairment, dementia prevention, cardiovascular risk, LDL cholesterol lowering
- MeSH terms
- Humans, Muscular Diseases, Rhabdomyolysis, Risk Assessment, Hydroxymethylglutaryl-CoA Reductase Inhibitors
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