You hear about statins all the time from ads or from friends who are taking them to lower their blood cholesterol. Maybe your doctor has recommended them for you.
But you may have heard there’s some question about how well they work.
What are statins? Who should use them? What are the risks? What else can you do to keep your cholesterol in check? We have answers:
Statins are drugs (pills) used to lower cholesterol levels in the blood. While they aren’t the only drugs that do it, they are the only ones that have been shown directly to lower the risk of premature death, heart attack and stroke. Currently, there are seven statin drugs in use.
Some statins reduce inflammation in the blood vessel walls. That keeps plaque from developing or breaking off into the bloodstream. Others block an enzyme in the liver and keep it from releasing cholesterol into the blood.
The science is pretty clear that statins help reduce cholesterol and the risk of heart attack and stroke in people with risk factors. That includes individuals with:
It’s a little fuzzier whether statins do as much for people at lower risk. For a fourth category of individuals (described below), a statin recommendation is more controversial. For one thing, it uses a different risk calculator. Some doctors and scientists think it over-estimates the risk and could result in statins being over prescribed for healthy people. People in the category described below should talk to their health care professional to make the best decision:
This last recommendation is prompting doctors to pay more attention to selecting the right dose to lower risk of cardiovascular problems, and not just to lower cholesterol numbers. So when you talk about “the numbers,” the conversation now goes beyond cholesterol numbers and includes the risk calculator numbers.
Some people who don’t fit any of these categories might benefit from statins. Individuals are unique, so doctors and patients should always engage in a discussion about risks and benefits for you.
At one time some health care providers advocated statins for everyone. But of course, all medications have side effects, and should only be used in people who might benefit. The common risks are:
Most of these problems go away when people change the kind of statin or dose. For people who have to stop, there are other drugs to help lower cholesterol.
Most people who take statins keep taking them for life, because when they stop, cholesterol levels can return to where they were before.
High cholesterol can be a problem at any age, so the first step is to get yours checked with a blood test every five years or so called a “lipoprotein profile.” It measures total cholesterol, LDL or bad cholesterol, HDL or good cholesterol and triglycerides. The desirable levels are:
|Desirable cholesterol levels|
|Total cholesterol||Less than 200 mg/dL|
|LDL (“bad” cholesterol)||Less than 100 mg/dL|
|HDL (“good” cholesterol)||40 mg/dL or higher|
|Triglycerides||Less than 150 mg/dL|
The first priority in getting cholesterol back in line or keeping it there is always taking lifestyle action, with or without statins.
The National Heart, Lung and Blood Institute has an excellent guide to lowering your cholesterol with therapeutic lifestyle changes.