From the Research
Patients with hypermobile Ehlers-Danlos Syndrome (hEDS) can generally take statins like atorvastatin, rosuvastatin, or simvastatin when clinically indicated for managing cholesterol levels, but caution is warranted due to potential increased risk of muscle-related side effects. The decision to prescribe statins should be made on a case-by-case basis, considering the individual's cardiovascular risk factors and potential benefits of statin therapy.
Key Considerations
- Individuals with hEDS may have an increased risk of experiencing muscle-related side effects from statins, such as myalgia, muscle weakness, or rarely, rhabdomyolysis, as noted in general clinical practice 1.
- The underlying connective tissue abnormalities in hEDS could potentially affect muscle function and repair mechanisms, leading to increased sensitivity to statins.
- If a statin is prescribed, it's advisable to start with a lower dose (such as 5-10mg of atorvastatin or rosuvastatin) and gradually increase as tolerated while monitoring for side effects, as suggested by clinical experience and expert opinion 2, 3.
- Patients should promptly report any unusual muscle pain, weakness, or tenderness to their healthcare provider.
- Coenzyme Q10 supplements (typically 100-200mg daily) may help mitigate muscle-related side effects in some patients, although evidence is limited 4, 5.
- Alternative cholesterol-lowering medications like ezetimibe or PCSK9 inhibitors might be considered if statins are not tolerated.
Management and Monitoring
- Regular follow-up with both a cardiologist and a physician familiar with EDS is recommended to balance cardiovascular risk reduction with symptom management.
- A holistic approach to managing hEDS, including physical therapy, psychological support, and self-management, is essential for improving quality of life and reducing symptoms, as supported by recent studies 2, 5.