The story with fibrates is more complicated. Fibrates help to reduce triglycerides, an unhealthy blood fat, while boosting HDL ("good") cholesterol. But studies on whether reducing levels of triglycerides using fibrates leads to a reduction in heart attacks and stroke have been mixed, experts said.
And very high triglyceride levels on their own are a risk factor for pancreatitis.
About 1 percent to 3 percent of people who develop pancreatitis die from it, Eckel said. Symptoms of pancreatitis include severe belly pain, nausea, vomiting and fever.
In the review, researchers examined data from seven randomized clinical trials of fibrates that included data on more than 40,000 participants. Patients, who were followed on average for more than five years, had slightly elevated triglyceride levels -- between 145 mg/dL to 184 mg/dL. (Normal is below 150 mg/dL, Eckel said.)
Among those patients, the analysis showed a slightly increased chance of developing pancreatitis while on fibrates, but it wasn't statistically significant.
Based on that finding, the authors said statins appear to be better than fibrates at preventing pancreatitis in people with slightly elevated triglyceride levels.
What's not covered in this review is what effect fibrates would have on people with higher triglycerides. Typically, when Eckel sees patients with very high triglyceride levels (above 1,000 mg/dL), he first puts them on a low-fat diet to bring down the levels to the 500 to 1,000 mg/dL range before prescribing fibrates.
"The fibrate trials gives us a hint that maybe there was a relationship between the fibrates and pancreatitis, but that wouldn't keep us from using fibrates to treat high triglycerides," Eckel said.
Overall, whether they were taking statins, fibrates or placebo, the number of people who developed pancreatitis in the trials was small -- less than 1 percent.
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