Your Good Health: Patient concerned that statins increase the risk of dementia

Dear Dr. Roach: I am a 74-year-old woman who is five foot three, 120 pounds. I live a healthy, active lifestyle. At age 59, during a regular doctor appointment, I was told that I had unknowingly had a heart attack. I had an angiogram, which showed no blockages. I was also given a nuclear imaging test to ascertain if there were any blockages in the smaller arteries to the heart. There were none. It was several weeks before I was cleared to resume physical exercise.

I have heard there is some evidence that statins can adversely affect dementia. What are your thoughts?Vasospastic angina, also called variant angina, is a cause of chest pain in both women and men due to low blood flow when the blood vessels to the heart constrict. Heart attacks often happen in combination with blockages in the arteries to the heart, but they can occur with no blockages at all.

Statin drugs like atorvastatin have been proven to help prevent a coronary spasm, so it does help prevent symptoms . It would be best for you to keep taking it, but I understand why you would be concerned if it really did increase the risk of dementia. On the other hand, some people taking certain statins may have memory effects as a result of the statin. Although memory loss is not a common side effect, when it is reported, it’s almost always with “lipophilic” statins like atorvastatin and simvastatin. It’s almost never with “hydrophilic” statins like pravastatin and rosuvastatin. I tend to prescribe rosuvastatin preferentially because of this concern with new patients, but I do not change my patients who are doing well on atorvastatin.

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