What Are Statins Used For
Having high levels of ‘bad’ cholesterol in the blood can increase the risk of cardiovascular disease, such as heart attack and stroke. Statins are used to lower LDL cholesterol, and this helps lower the risk of cardiovascular disease.
Statins are considered the most effective group of cholesterol-lowering medicines available and work by blocking cholesterol production in the liver.
Statins are used in combination with other ways of lowering cholesterol, including eating a healthy diet, managing weight and exercising.
What Should I Consider When Deciding If I Should Start Treatment With A Statin
The balance of benefit and risk will differ for each person.
- For example, people at the highest cardiovascular risk will benefit the most from taking a statin. Any possible side effects from statins are likely to be thought of as a lower risk.
- On the other hand, people at a lower level of cardivascular disease risk will have less benefit from taking a statin but have the same risk of side effects. Therefore they may feel that the risk of taking a statin outweighs the benefit.
Your doctor will discuss your cardiovascular risk with you, any possible side effects and how these could affect you.
Bile Acid Binding Resins
For example, the FDA has approved a class of drugs known as bile acid binding resins, which were the first cholesterol drugs before statins. Studies in the 1980s showed that these medications lower heart disease risk. One reason they arent often prescribed is that patients have to take a lot of them compared to statins. Bile acid binding resins come in powder form or require taking up to six pills a day. Also, they can cause gastrointestinal side effects.
Weve known since the 1990s that statins benefit patients at high risk for stroke and heart disease. Today, several investigators are researching which complementary medications can be prescribed on top of statins to make them even more beneficial and protective.
One of these is a drug called Ezetimibe, which on its own provides a modest reduction in cholesterol. Its also been shown recently to lower heart attack and stroke risk when taken in addition to a statin.
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How Do I Know If My Cholesterol Is Too High
There are no symptoms that can warn you when your cholesterol level is high. You can have high cholesterol and never know it. A lipid panel blood test is the only way to determine whether or not you have high cholesterol.
It is generally recommended that men and women over 20 years of age should have their cholesterol levels checked every 5 years. However, if your test results are outside of the recommended range, you should check them more often. Other factors related to your health, your family medical history and your lifestyle will also affect how often you should have your cholesterol levels checked. As always, talk to your doctor about the frequency that is best for you.
Treatment For High Cholesterol
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High or abnormal cholesterol numbers can be treated by both lifestyle changes and medication.
Without treatment, high cholesterol increases your risk of severe cardiovascular disease, including heart attack and stroke.
Since high cholesterol has no symptoms, people typically find out they have high cholesterol after receiving a blood test at the doctors office known as a lipid panel.
If your lipid panel results show you have high total cholesterol, highLDL cholesterol, or low HDL cholesterol, your doctor may initially recommend that you make some lifestyle changes to get your cholesterol numbers back on track.
- LDL cholesterol: less than 100 mg/dL
- HDL cholesterol: greater than or equal to 60 mg/dL
- Triglycerides: less than 150 mg/dL
- Total cholesterol: less than 200 mg/dL
If these changes dont result in more desirable cholesterol numbers within a few months, you may need to take medication to lower your cholesterol. For people who have already developed heart disease or who have diabetes or familial hypercholesterolemia , your doctor may initially prescribe cholesterol management drugs.
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Not All Med Options Are Pricey
Cholesterol meds prices vary depending on the type, dosage, where you buy it, your insurance, and whether you’re a cash-paying customer using a coupon or discount card.
If you shop around, you might pay $5 to $10 a month for generic simvastatin . An extended-release version of fluvastatin could set you back upwards of $200 a monthâor less than half of that if you’re paying out of pocket with a discount or coupon.
If cost is an issue, talk to your doctor about less expensive alternatives or pill splitting. Prescription assistance programs could also help you afford brand-name drugs.
Cholesterol Remedies Are For Life
Once you start taking a statin or another cholesterol-lowering medication, you must continue taking them forever, or switch medications, if one isn’t working or is causing side effects.
Some people mistakenly believe they can stop taking a statin once their cholesterol comes down, but “once you stop, the cholesterol goes back up and you lose the benefit,” Dr. Gotto explains.
If you think your statin isn’t working for you, talk to your doctor about your options.
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Get Medical Advice From Your Doctor Not The Internet
There is no reason to be afraid of taking statins if you are at high risk for heart attack or stroke. Whats really scary is the amount of inaccurate information out there that keeps so many people from getting the protection they need!
The risks and side effects associated with statins are real they arent zero, but theyre very small. However, the benefits of statins for high-risk patients are substantial, and theyre invisible. Patients often dont consider that they didnt have a stroke or heart attack last year theyre too busy living and enjoying their lives while the statin medication protects them behind the scenes.
Statins are not for everyone, and there are complementary ways to lower your risk for heart disease. But for high-risk patients, the benefits of statins far outweigh the risks, and statin medications have a very important role in protecting their hearts and their lives. Its vital that you get medical advice from a doctor instead of trusting potentially misleading information on the Internet.
Though statins are incredibly effective, there are many different forms of heart disease. Heart disease is still the No. 1 killer of men and women in our country, and the epidemic is spreading throughout the world. As long as the battle continues, well continue researching new ways to prevent and treat heart disease.
Will Statins Help With Inflammation
Statin medications function like anti-inflammatory medications for your arteries.
Inflammation is the main driving factor in both heart disease and Alzheimers . . . and statins arterial inflammation. The Jupiter Trial was proof of this. In a collaborative effort involving 1315 physicians in 26 countries , the Jupiter Trial evaluated patients with normal cholesterol levels but elevated arterial inflammation . These patients were found to greatly benefit from statin therapy . . . so much so that the study was stopped early . . In the statin-treated population, there was a 54% reduction in heart attacks, a 48% reduction in stroke, and a 46% reduction in need for arterial revascularization .So clearly, there are non-lipid benefits to statins beyond just lowering cholesterol!
Of the nearly 1.7 million heart attacks and strokes that occur annually in the United States, more than half occur among apparently healthy men and women with average or low levels of cholesterol. This is why inflammatory biomarkers are so important to test in patients. One of those biomarkers is hsCRP, which was shown to independently predict CV events in women better than LDL cholesterol .
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Get The Right Medication
Statins are thought to work not only by lowering LDL cholesterol but also by stabilizing plaque deposits in the arteries, making the deposits less likely to rupture and send blood clots through the body.
People with a history of heart attack or stroke, or at very high risk of one , should start with higher doses of a potent statin: 40 to 80 mg of atorvastatin or 20 to 40 mg of rosuvastatin . Other people who need a drug should start with lower doses of those or other statins: 40 mg of lovastatin , pravastatin , or simvastatin .
Doctors use several different kinds of drugs to lower blood pressure, and for people with levels above 150 it can take a combination to control the problem. Still, it usually makes sense to start with the oldest, safest, and least expensive drug: diuretics, or water pills, such as chlorthalidone or hydrochlorothiazide. If that doesnt work, you may need to switch to or add an ACE inhibitor, calcium channel blocker, or other kind of drug.
Editor’s Note: This article also appeared in the May 2017 issue of Consumer Reports magazine.
This article and related materials are made possible by a grant from the state Attorney General Consumer and Prescriber Education Grant Program, which is funded by the multistate settlement of consumer-fraud claims regarding the marketing of the prescription drug Neurontin .
What Are The Risks
Before you start taking statins, tell your provider if:
- You are pregnant, plan to become pregnant, or are breastfeeding. Pregnant and nursing mothers should not take statins.
- You have allergies to statins.
- You are taking other medicines.
- You have diabetes.
- You have liver disease. You should not take statins if you have certain acute or long-term liver diseases.
Tell your provider about all of your medicines, supplements, vitamins, and herbs. Certain medicines may interact with statins. Be sure to tell your provider before taking any new medicines.
Overall, there is no need to avoid moderate amounts of grapefruit in the diet. An 8 ounce glass or one grapefruit can be safely consumed.
Regular blood tests will help you and your provider:
- See how well the medicine is working
- Monitor for side effects, such as liver problems
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How Often To Get Tested
According to the Centers for Disease Control and Prevention , most healthy adults should get their cholesterol checked every four to six years.
Your risk factors also determine how often your cholesterol should be checked. Adults who have a history of high cholesterol, heart disease, diabetes, or obesity need more frequent readings, as do all adults as they age.
Children should have their cholesterol checked at least once between the ages of 9 and 11 and again between 17 and 20 years of age. If a child has a family history of high cholesterol, heart disease, or is overweight or obese, their pediatrician may recommend getting checked sooner and more often.
Myth: I Cant Do Anything To Change My Cholesterol Levels
Fact: You can do many things to improve your cholesterol levels and keep them in a healthy range!
- Get tested at least every 5 years .1,2 Learn more about cholesterol screenings.
- Make healthy food choices. Limit foods high in saturated fats. Choose foods naturally high in fiber and unsaturated fats. Learn more about healthy diets and nutrition at CDCs nutrition, physical activity, and obesity website.
- Be active every day. The Physical Activity Guidelines for Americans recommends that adults get 150 to 300 minutes of moderate physical activity each week. Learn more about physical activity basics and tips.
- Dont smoke or use tobacco products. Smoking damages your blood vessels, speeds up the hardening of the arteries, and greatly increases your risk for heart disease. If you dont smoke, dont start. If you do smoke, quitting will lower your risk for heart disease. Learn more about tobacco use and ways to quit at CDCs smoking and tobacco use website.
- Talk with your health care provider about ways to manage your cholesterol if any medicines are given to you to manage your cholesterol, take them as they are prescribed. Learn more about medicines to lower cholesterol.
- Know your family history. If your parents or other immediate family members have high cholesterol, you probably should be tested more often. You could have a condition called familial hypercholesterolemia .
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How Can The Benefits And Risks Be Managed
There have been questions raised in the media over the benefits of statins. Peak health organisations have urged people who take statins to consult their doctors before stopping any prescribed medicines.
The benefits of statin treatment have been shown to outweigh the risk of possible side effects in most people at high risk of heart attack or stroke. If you are taking statins and have any concerns, talk to your doctor before making any changes.
The Royal Australian College of General Practitioners recommends that you regularly review with your doctor or specialist any medicines you are taking for high blood pressure or high cholesterol to assess the ongoing benefits and risks. For further information, visit the Choosing Wisely Australia website.
For more information, check these frequently asked questions about statins.
Healthy Cholesterol Levels By Age
The recommended ranges for your cholesterol will vary based on age and gender. As people get older, cholesterol levels rise naturally. For example, people who have gone through menopause may have higher LDL and lower HDL cholesterol levels.
The following table was adapted from the Cleveland Clinic :
| Cholesterol Levels by Age: Normal, Borderline, and High | |
|---|---|
| Age/Sex | |
| Greater than or equal to 239 mg/dL | 160189 mg/dL |
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Dietary And Lifestyle Changes
Dietary and lifestyle adjustments are key to making lasting changes in cholesterol levels.
Although they might not produce results as quickly as medications do, a person may notice their cholesterol levels drop in just a few weeks or months if they stick to a healthy diet and lifestyle plan.
Increase intake of plant foods
Plant foods are rich in vitamins and nutrients, and they do not contain cholesterol. Most plant foods also do not contain saturated fats, which may increase cholesterol in the body.
A 2017 study found that the people who ate vegetarian diets had significantly lower cholesterol levels than the participants following omnivorous diets.
The authors also note that some targeted diets using plant foods might cause stronger effects. For example, a diet rich in soluble fiber, plant sterols, and vegetable protein sources, such as soy and nuts, reduced LDL cholesterol by an average of 28.6% in just 4 weeks.
These effects continue over the long term. A 2018 study estimates that this type of diet reduces the 10-year risk of coronary heart disease by about 13%.
People who need to reduce their cholesterol quickly can work with a dietitian to create a targeted diet plan.
Increase fiber intake
While adding plant foods to the diet increases fiber intake naturally, it may also be helpful to take a fiber supplement or over-the-counter fiber drink to support the body.
Fiber keeps the digestive system healthy and may help prevent the body from absorbing cholesterol.
Exercise
Cholesterol Levels In Dialysis Patients
In a study of dialysis patients, those with higher cholesterol levels had lower mortality than those with low cholesterol.51 Yet the authors claimed that the inverse association of total cholesterol level with mortality in dialysis patients is likely due to the cholesterol-lowering effect of systemic inflammation and malnutrition, not to a protective effect of high cholesterol concentrations. Keeping an eye on further funding opportunities, the authors concluded: These findings support treatment of hypercholesterolemia in this population.
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How To Take Atorvastatin
- Before you start the treatment, read the manufacturers printed information leaflet from inside the pack. It will give you more information about atorvastatin and will provide you with a full list of the side-effects which you may experience from taking it.
- Take atorvastatin once each day. There are several strengths of tablet available, so your doctor will tell you which strength is right for you.
- You can generally take atorvastatin at a time of day to suit you, but it is best to take your doses at the same time of day each day. You can take the tablets either before or after food.
- If you have been given atorvastatin chewable tablets, you can chew the tablets to help you swallow, or you can swallow them whole with a drink of water.
- If you forget to take a dose, take it as soon as you remember. If you do not remember until the following day, skip the missed dose. Do not take two doses together to make up for a forgotten dose.
Who Can Take Statins
You might be prescribed a statin if you have heart disease or another disease of the heart and blood vessels, or if you are at risk of developing them in the next 10 years.
If you have high cholesterol
You should be offered a statin if you have high cholesterol and lifestyle changes havent been enough to bring it under control.
Depending on your cholesterol levels and how healthy you are otherwise, you and your doctor or nurse might want you to try to bring your cholesterol levels down with a healthy diet and lifestyle first, before starting statins.
If you are at risk of developing heart disease
You will probably be prescribed a statin if you are at high risk of developing heart disease or a disease of the blood vessels. For example, if you have:
- diabetes
- rosuvastatin .
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