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Abstract
Statins are effective cholesterol-lowering drugs that reduce the risk of cardiovascular
disease events (heart attacks, strokes, and the need for arterial revascularisation).
Adverse effects from some statins on muscle, such as myopathy and rhabdomyolysis,
are rare at standard doses, and on the liver, in increasing levels of transaminases,
are unusual. Myopathy--muscle pain or weakness with blood creatine kinase levels more
than ten times the upper limit of the normal range--typically occurs in fewer than
one in 10,000 patients on standard statin doses. However, this risk varies between
statins, and increases with use of higher doses and interacting drugs. Rhabdomyolysis
is a rarer and more severe form of myopathy, with myoglobin release into the circulation
and risk of renal failure. Stopping statin use reverses these side-effects, usually
leading to a full recovery. Asymptomatic increases in concentrations of liver transaminases
are recorded with all statins, but are not clearly associated with an increased risk
of liver disease. For most people, statins are safe and well-tolerated, and their
widespread use has the potential to have a major effect on the global burden of cardiovascular
disease.