SHOULD YOU BE TAKING A STATIN?
When I visited my primary doctor for my annual checkup last year, she told me I should consider taking a statin drug. I know that the main reason people take statin is to lower cholesterol. However, (so far-so good) my cholesterol-level readings have been okay: under 200 for total, and under 100 for LDL—the “bad” cholesterol. (To learn more about cholesterol, please refer to my September 2018 post Clearing Up Cholesterol Confusion.)
Since I’m over 75, my doc tells me I now have a greater chance of a heart attack or stroke; And a statin—like Lipitor—might be a good idea to decrease the chances of possible blood clots.
I wanted to find out more about statin drugs: I found this great online article by the Mayo Clinic Staff, Statins—Are these-cholesterol lowering drugs right for you? to share with you. Here are excerpts
Statins are drugs that can lower your cholesterol. They work by blocking a substance your body needs to make cholesterol.
Lowering cholesterol isn’t the only benefit associated with statins. These medications have also been linked to a lower risk of heart disease and stroke. These drugs may help stabilize the plaques on blood vessel walls and reduce the risk of certain blood clots.
A number of statins are available for use in the United States. They include:
- Atorvastatin (Lipitor)
- Lovastatin (Altoprev)
- Pitavastatin (Livalo, Zypitamag)
- Pravastatin (Pravachol)
- Rosuvastatin (Crestor, Ezallor)
- Simvastatin (Zocor)
Sometimes, a statin is combined with another heart medication. Examples are atorvastatin-amlodipine (Caduet) and ezetimibe-simvastatin (Vytorin).
Should you be on a statin?
Whether you need to be on a statin depends on your cholesterol levels and other risk factors for heart and blood vessel (cardiovascular) disease. Your doctor will consider all of your risk factors for heart attacks and strokes before prescribing a statin.
Knowing your cholesterol numbers is a good place to start.
- Total cholesterol.Most people should try to keep their total cholesterol below 200 milligrams per deciliter (mg/dL), or 5.2 millimoles per liter (mmol/L).
- Low-density lipoprotein (LDL) cholesterol.Aim to keep this “bad” cholesterol under 100 mg/dL, or 2.6 mmol/L. If you have a history of heart attacks or you’re at a very high risk of a heart attack or stroke, you may need to aim even lower (below 70 mg/dL, or 1.8 mmol/L).
The most important thing your doctor will keep in mind when thinking about statin treatment is your long-term risk of a heart attack or stroke. If your risk is very low, you probably won’t need a statin, unless your LDL is above 190 mg/dL (4.92 mmol/L).
If your risk is very high — for example, you’ve had a heart attack in the past — a statin may be helpful even if you don’t have high cholesterol.
Cholesterol guidelines
Not everyone with a heart condition needs to use a statin. Guidelines from the U.S. Preventive Services Task Force, American College of Cardiology and American Heart Association suggest four main groups of people who may be helped by statins:
- People who don’t have heart or blood vessel disease, but have one or more cardiovascular disease risk factors and a higher 10-year risk of a heart attack.This group includes people who have diabetes, high cholesterol or high blood pressure, or who smoke and whose 10-year risk of a heart attack is 10% or higher.
- People who already have cardiovascular disease related to hardening of the arteries.This group includes people who have had heart attacks, strokes caused by blockages in a blood vessel, ministrokes (transient ischemic attacks), peripheral artery disease, or prior surgery to open or replace coronary arteries.
- People who have very high LDL (“bad”) cholesterol.This group includes adults who have LDL cholesterol levels of 190 mg/dL (4.92 mmol/L) or higher.
- People who have diabetes.This group includes adults 40 to 75 who have diabetes and an LDL cholesterol level between 70 and 189 mg/dL (1.8 and 4.9 mmol/L), especially if they have evidence of blood vessel disease or other risk factors for heart disease such as high blood pressure or smoking.
The U.S. Preventive Services Task Force recommends low- to moderate-dose statins in adults ages 40 to 75 who have one or more risk factors for heart and blood vessel disease and at least a 1 in 10 chance of having a cardiosvascular disease event in the next 10 years.
Consider statins a lifelong commitment
You may think that if your cholesterol goes down, you don’t need a statin anymore. But if the drug helped lower your cholesterol, you’ll likely need to stay on it long term to keep your cholesterol down. If you make significant changes to your diet or lose a lot of weight, talk to your doctor about whether it might be possible to control your cholesterol without medication.
Side effects of statins
Statins are tolerated well by most people, but they can have side effects. Some side effects go away as the body adjusts to the medication.
But tell your doctor about any unusual signs or symptoms you might have after starting statin therapy. Your doctor may want to decrease your dose or try a different statin. Never stop taking a statin without talking to your doctor first.
Commonly reported side effects of statins include:
- Headaches
- Nausea
- Muscle and joint aches
However, studies comparing statins to a fake pill (placebo) have found a very small difference in the number of people reporting muscle aches between the groups.
Also, ask your doctor if the statin you use will interact with any other prescription or over-the-counter drugs or supplements you take.
Weighing the risks and benefits of statins
When thinking about whether you should take statins for high cholesterol, ask yourself these questions:
- Do I have other risk factors for heart and blood vessel disease?
- Am I willing and able to make lifestyle changes to improve my health?
- Am I concerned about taking a pill every day, perhaps for the rest of my life?
- Am I concerned about statins’ side effects or interactions with other drugs?
It’s important to consider your medical reasons, personal values, lifestyle choices and any concerns when choosing a treatment. Talk to your doctor about your total risk of heart and blood vessel disease and personal preferences before making a decision about statin therapy.