Cholesterol Meds May Help Bones

The cholesterol-lowering treatment that thousands of Americans take daily may also make their bones stronger, according to a new study that confirms earlier findings about the side benefits of statins.

Harvard Instructor in Medicine Dr. Richard E. Scranton’s new study of elderly patients boasts a far larger sample size than previous studies on the topic, surveying 91,052 subjects.

The study “Statin Use and Fracture Risk,” which appeared in the Archive of Internal Medicine on Sept. 26, concluded that those who take statin cholesterol pills are 32 percent more likely not to endure a bone fracture than those on lipid-lowering therapy, a common alternative to statin use. They are also 36 percent more likely not to endure a break than those receiving no cholesterol therapy.

Scranton said that while some previous studies had found an association between statins and bone fractures, others had not.

“We wanted to open this up again,” he said.

The study came to similar conclusions as a 2000 study conducted by Assistant Professor of Health Care Policy Philip S. Wang.

The studies “are more similar than different,” Assistant Professor of Medicine Dr. Daniel H. Solomon, who was a co-author of both studies, wrote in an e-mail.

But this study’s large subject pool allowed Scranton to discard many subjects who might have confounded the study’s results, including patients who had previously received prescriptions for cholesterol-lowering medication and those who had fractured a bone within their first month in the health care system.

Solomon said the “$64,000 question” raised by his findings is why post hoc clinical studies—which look at patients already receiving statins as part of a larger patient group—find no association between statins and the frequency of bone fractures, while observational studies—which administer statins and lipid-lowering drugs to patients—find such an association.

Solomon said that while the observational studies might just be wrong, a number of factors cast doubt on the findings of the clinical studies.

“The post-hoc analyses...are often small and only include a restricted population,” he wrote. These studies typically focus on “high-risk cardiac patients” who “may not be the group of patients likely to benefit from statins with respect to bone mineral density,” he added.

To control for the possibility that subjects who knew they were receiving some medication might change their lifestyle in ways that would improve their health and consequently strengthen their bones, Scranton gave some patients statins and others lipid-lowering therapy, so that “they would change their life too,” Scranton said. Scranton found that patients taking lipid-lowering therapy were 32 percent more likely to fracture a bone, so he concluded that statins must be accountable for the discrepancy.

Scranton said that he hopes more research will help to definitively resolve the question.

“Our study doesn’t prove it 100 percent, but it’s our best attempt” he said, adding that “we need much more research to prove or disprove there’s an association.”