Cholesterol-Lowering Drugs: Is There a Link Between Genes and Side Effects?

It’s National Cholesterol Education Month, so let’s talk about statins (drugs like Lipitor and Zocor), which are widely prescribed to help lower cholesterol—especially as we age. As highlighted in a recent NPR article, some people are concerned about adverse effects of statins, noting that the drugs might not be beneficial for everyone because of our different genetic backgrounds. This is a complicated issue, so we’ll break it down for you here.

What’s the Issue?
Approximately 25% to 50% of patients using statins may discontinue taking them at some point. A major reason for this is side effects like muscle aches and pains, which can be more severe in people whose bodies don’t absorb and metabolize statins well. This process depends on the liver, and research shows that variations in specific genes affect the liver’s ability to absorb statins. One of these genes is called SLCO1B1, and people with certain versions of this gene may be more likely to experience statin side effects.

Why It Matters

More than 100 million Americans have high cholesterol, and 35 million of them are at high risk for heart disease. As a result, doctors often prescribe statins. In fact, from 2003 to 2012, statin use increased by 28% in adults over age 40. Geneticists estimate that roughly one in four Americans carries a variant of the SLCO1B1 gene that reduces statin absorption, so many of these statin users could be at risk for side effects.

Expert Insight

Everyone’s body is unique, and not all drugs affect people the same way. The author of the mentioned NPR post sent a vial of saliva to Boston Heart Diagnostics, a company that offers genetic testing for statin sensitivity. From the DNA in her saliva, the company determined that she had a version of SLCO1B1 that codes for reduced statin absorption, and suggested she take a lower dose of a different statin. That’s just one person’s experience, but research on how genetics may affect your response to drugs such as statins is evolving, so tests like these may become more and more common. Something to keep an eye on!

Marcel Davidse

Marcel Davidse was an intern with the Healthy Aging Project in the fall of 2016, and graduated in December 2016 from the Department of Integrative Physiology at the University of Colorado Boulder.