Regarding long-term statin therapy: are we trading stronger hearts for weaker brains?

Med Hypotheses. 2014 Sep;83(3):346-51. doi: 10.1016/j.mehy.2014.06.010. Epub 2014 Jun 16.

Abstract

Ideally, the benefits of long-term statin therapy should outweigh the risks in all populations. However, some data suggest that long-term statin therapy might promote cerebral small vessel disease and impair myelination, perhaps resulting from cholesterol depletion and pleiotropic effects on amyloid-β metabolism and oligodendrocyte function. The clinical ramifications can be problematic and have a negative impact on the quality of life. Questions are proposed and the answers should be found by analysis of randomized prospective trials specifically investigating the effects of statin therapy on brain structure and function. Those trials should not be funded by drug companies and the investigators should not have financial ties to the pharmaceutical industry. The relevance of the aforementioned is amplified in light of the new cardiovascular guidelines that might culminate in more than a billion people receiving statin therapy worldwide.

MeSH terms

  • Blood-Brain Barrier
  • Brain / drug effects*
  • Brain / physiopathology*
  • Cardiovascular Diseases / physiopathology
  • Cerebral Amyloid Angiopathy / physiopathology
  • Cholesterol / metabolism
  • Heart / drug effects*
  • Heart / physiology*
  • Homeostasis
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Long Term Adverse Effects
  • Magnetic Resonance Imaging
  • Oligodendroglia / pathology
  • Prospective Studies
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Synaptic Transmission
  • White Matter / pathology

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Cholesterol