Statins have documented efficacy in decreasing cardiovascular events in patients who have established CV disease and in those who are at high risk of developing CV disease. However, 25% to 50% of patients who are started on a statin stop taking the statin within a year, and by 2 years that number may increase to 75%.¹ Common adverse reactions to statins include myalgias, GI side effects, and neurologic side effects. They may also increase the risk of diabetes. Often, when patients stop their medication and are rechallenged with a statin, their symptoms do not return. The current study shows that 30% of patients stop taking statins due to a presumed side effect, but patients who continued to receive statins had a 10% to 20% lower incidence of CV events and death from any cause. In addition, of patients rechallenged with a different statin, only about one-fourth of them continued to have an adverse effect. The conclusion here is clear: while we do not want patients to be made miserable from medication side effects, most of the side effects from statins are relatively mild and do not return when another statin is tried. Furthermore, patients who continue to receive a statin have a lower rate of CV events than those who do not. —Neil Skolnik, MD

1. Phan K, Gomez YH, Elbaz L, Daskalopoulou SS. Statin treatment non-adherence and discontinuation: Clinical implications and potential solutions. Curr Pharm Des. 2014;20:6314-24.