Most graphics I’ve looked at show the liver and digestive organs in isolation. This one helps me grasp the liver – heart connections.  This slide, # 24, was published on Slideshare by Eman Abdallah. Brooks/Cole–Thompson Learning.

Quick note.  A private doctor has recently prescribed statins to improve my husband’s lipid numbers. Previously, safety concerns about hepatitis and statins have kept them out of his medicine kit.  I’m assuming these fears are now allayed for other people with a history of HCV.   Our amazing livers, which make cholesterol (LINK), are workaholics.  

The VA writes (LINK):

All the blood that flows from the intestines, stomach, and spleen is filtered through the liver. The blood flows into the liver through the portal vein. It filters through the liver in a system of smaller and smaller veins. As blood passes over liver cells, these cells process nutrients in the blood. This processing makes products like proteins and sugars that can be used by the body. Blood is carried out of the liver through the hepatic vein to the heart.

A large literature metastudy, Statin use and risk of liver cancer: an update meta-analysis (LINK) by was published in 2014. Chinese researchers searched the following databases with relevant keywords:

The systematic computerised search for eligible studies were performed on the database of PubMed, BIOSIS Previews, Web of Science, EMBASE, EBSCO and Cochrane Library, covering all studies published from their inception to 5 March 2014.

The full text of the study is free to read online if you want to dig into it.  Their overall conclusion, “suggests that statin is associated with a significant risk reduction of liver cancer when taken daily for cardiovascular event prevention.”  The researchers also make this surprising statement:  “Statins might be considered as an adjuvant in the treatment of liver cancer.”

Even people with a “higher baseline risk of liver cancer, defined as patients with older age, HBV or HCV infection, there was a trend towards more decrease of liver cancer risk …than in the other eight studies with general population.”  But liver cancer risk reduction was less when there were other “confounding” conditions such as alcoholic liver disease.

The FDA has a webpage devoted to statin risks (LINK) such as muscle pain.  However, the agency is upbeat:

This new information should not scare people off statins, says Amy G. Egan, M.D., M.P.H., deputy director for safety in FDA’s Division of Metabolism and Endocrinology Products (DMEP). “The value of statins in preventing heart disease has been clearly established,” she says. “Their benefit is indisputable, but they need to be taken with care and knowledge of their side effects.”

FDA: “Examples of some types of drugs that grapefruit juice can interact with are: some statin drugs to lower cholesterol, such as Zocor (simvastatin), Lipitor (atorvastatin) and Pravachol (pravastatin)”

The VA has posted information online about their research on statins, statins and exercise, drug interactions and much more.  A brief VA fact sheet on cholesterol medications (LINK) outlines some other options.  The FDA also reminds people to check to see if they have to give up grapefruit with these or other meds (LINK).

So the news seems promising for people, with or without a history of hepatitis, who want to try statins after weighing the risks and benefits.  The potential to reduce cholesterol and the risk of liver cancer at the same time is a huge plus.  I am curious to know if the VA is prescribing statins for patients with a history of hepatitis and if others have experienced negative side effects from statins that made them discontinue their use.