Statin side effects: Cardiologist addresses diabetes fears and dementia questions

Cholesterol itself is a waxy substance produced mainly by the liver and it is vital for keeping cell membranes healthy, making hormones and helping digest fatty foods.

A Consultant Cardiologist at New Victoria Hospital, London, Dr Zoe Astroulakis, said: "While we might agree that not everyone needs to be on a statin, they offer huge health benefits where they are indicated and have unfortunately received a lot of bad press, reducing the risk of heart attacks and strokes by 25 to 30 per cent."

Dr Astroulakis explained these medications get to work remarkably quickly.

"But did you know that within 48 hrs of taking a statin, your arteries are already more relaxed, allowing more blood and therefore oxygen to reach your vital organs?

"Did you know that they exert anti-inflammatory effects on the lining of the arteries?" she said.

The drugs work by lowering LDL-cholesterol in the bloodstream, which stops it from building up in artery walls and forming dangerous plaques.

There is also evidence they strengthen the protective caps over existing plaques, making them less likely to rupture suddenly, which is what triggers a heart attack.

For patients who genuinely can't tolerate any statin, Dr Astroulakis noted there are now other options available, from tablets to injections.

One question that often comes up is whether statins might cause diabetes.

Dr Astroulakis acknowledged that studies have shown a small uptick in type 2 diabetes cases among statin users, but she stressed we do not actually know if the medication is to blame.

"It's true that studies have shown a slight increase in the numbers of patients taking statins who go on to develop type 2 diabetes, but what is important to note is that we do not know whether this is simply an association or a causal link," she said.

The research simply was not set up to answer that question properly.

Interestingly, it appears patients who develop diabetes while on statins often already had raised blood sugar levels before they started the medication.

This is why checking your HbA1c alongside your cholesterol is so important.

There is furthergrowing interest in whether statins might help protect against dementia.

Dr Astroulakis pointed out dementia is actually an umbrella term covering various conditions, with Alzheimer's and vascular dementia being the most common in people over 65.

"There is some evidence that statins may reduce the risk of dementia, with the most noticeable benefits in type 2 diabetes, but the relationship is complex and not entirely clear as yet," she said.

A recent meta-analysis looking at roughly seven million patients across 55 observational studies found statin users had a lower overall dementia risk compared to non-users, with type 2 diabetics seeing the biggest benefit.

So when your cardiologist recommends a statin, the advantages typically far outweigh any potential downsides.