Experts have differences of opinion about statin side effects

Q: I work in the pharmaceutical industry and find your articles on statin side effects scare people unnecessarily. You fail to mention the benefits of lowering cholesterol. Patient stories do not qualify as evidence.

A: Your perspective is echoed by a recent analysis in the European Journal of Preventive Cardiology (online, March 12, 2014). The authors analyzed data from randomized controlled trials comparing cholesterol-lowering statin treatment to placebo. They concluded: "Only a small minority of symptoms reported on statins are genuinely due to the statins: almost all would occur just as frequently on placebo."

People who have had a heart attack reduce their risk of premature death by taking statins. For healthy people whose only risk factor is elevated cholesterol, taking a statin does not seem to offer a survival advantage.

A different analysis of clinical trial data concluded that "statin therapy prevents one serious cardiovascular event per 140 low-risk people … treated for five years. Statin therapy in low-risk people does not reduce all cause mortality or serious illness and has about an 18 percent risk of causing side effects that range from minor and reversible to serious and irreversible" (BMJ, Oct. 22, 2013).

These authors state that muscle pain and weakness in statin users is not imaginary; it appears to be far more common than clinical trial data suggest. Clearly, experts do not agree about the benefits and risks of statins.

Q: I take amlodipine, lisinopril and metoprolol for high blood pressure. My readings are 115/56. I get terribly dizzy, especially when I first stand up.

My doctor says low blood pressure is not dangerous, but I feel bad and cannot function normally. Are there any other ways to control blood pressure that won't make me so dizzy?

A: Low blood pressure can become a problem if it causes dizziness upon standing (orthostatic hypotension). This can be quite hazardous, especially if it leads to a fall.

Dutch researchers found that when diastolic blood pressure is lowered below 70, brain shrinkage may result (JAMA Neurology, August 2013). You should discuss your symptoms with your doctor and see whether you can modify your treatment program.

Q: I have seborrheic dermatitis on my face. Countless prescriptions and home remedies did not work. I became so self-conscious and depressed, I hated to leave the house.

Then I applied Vicks VapoRub on the affected areas and saw good results that same day. I couldn't believe it! This second day, it's 50 percent better already. I'm amazed!

A: Seborrheic dermatitis, sometimes referred to as facial dandruff, has been linked to a yeast infection of the skin. Readers report that Vicks applied to red, flaky areas can be helpful because of its antifungal ingredients.

Others find that a thin layer of milk of magnesia smoothed on the face before bedtime may ease symptoms. Some people achieve success by washing their faces with selenium sulfide shampoo (Selsun Blue) while showering.