Statins Lower Pancreatitis Risk

Primary Care Blog

Pancreatitis.  The diagnosis (inflammation of the pancreas) raises hackles on the back of interns & residents' necks attempting to care for patients with this sudden onset of mid-epigastric abdominal pain, typically associated w/alcohol consumption to excess, gallstones and/or extremely elevated triglycerides. 
In the past, when confronted with hypertriglyceridemia in the face of hypercholesterolemia, we've always focused on lowering triglycerides in order to minimize risk of pancreatitis.  Once that's been accomplished, then we refocus our attention on lower LDL-cholesterol.  However, in a meta-analysis of randomized controlled trials published last week in JAMA, the authors concluded that statins lowered risk of pancreatitis in those w/normal-to-mildly elevated triglycerides.

Clearly, statins are not first line therapy for treating hypertriglyceridemia.  But once triglycerides have been controlled to less than 500mg/dL, it's time to add a statin to optimize the rest of the lipid panel, notwithstanding all the other bad press that's been written about statins lately. 

So is it worth placing your liver, muscles, glycemic control, cognition, energy (in women only), and vision on the line?  Before we throw the baby out with the bath water, let's recall that statins lower all-cause mortality.  And more importantly, just because a side effect can happen doesn't mean that itwill happen. 

So if you can't achieve your LDL goal by dietary measures alone (as noted a year ago), that's when I consider adding a lipid lowering agent to your regimen.  But I'll typically give you the benefit of the doubt first.

Alvin B. Lin, MD, FAAFP
Dr. Lin is an associate professor of family and community medicine at University of Nevada School of Medicine and an adjunct professor of family medicine and geriatrics at Touro University Nevada College of Medicine. He also serves as an advisory medical director for Infinity Hospice Care and as medical director of Lions HealthFirst Foundation. Dr. Lin maintains a small private practice in Las Vegas, NV. The posts represent the views of Dr. Lin, and in no way are to be construed as representative of the above listed organizations. Dr. Lin blogs about current medical literature and news at