The U. 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.
Lifestyle changes are key for reducing your risk of heart disease, whether you take a statin or not. To reduce your risk:. If your cholesterol — particularly the LDL "bad" type — stays high after you make healthy lifestyle changes, statins might be an option for you.
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.
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. 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.
When thinking about whether you should take statins for high cholesterol, ask yourself these questions:. 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. There is a problem with information submitted for this request.
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We're trying our best to stay safe and away from each other. So, bear with us if the quality is a little Zoom-ish. There's a lot of information out there that would make people want to shy away from statins. I've heard they affect memory, muscles, even your chances of getting diabetes. These are commonly prescribed medications, but the more I looked into it, I wondered if they really should be.
Joining us today is Dr. Ian Neeland. First, thanks for joining us, Dr. Let's talk about what cholesterol is exactly. I mean, we all have it. What purpose does it serve in our bodies? Well, cholesterol is a fat-like, waxy substance that helps your body make cell membranes, many hormones and vitamin D.
So, it's a very important component of the body's metabolism. And the cholesterol in your blood comes from two sources: the foods you eat and your liver. Your liver actually makes all the cholesterol your body needs. So, any excess cholesterol you get in your diet is on top of what your needs really are. Now, cholesterol and other fats are carried in your bloodstream as round particles called lipoproteins. And the two most commonly known lipoproteins are low density lipoproteins or LDL and high density lipoproteins or HDL.
Now, you may have heard of these terms. LDL or bad cholesterol to contribute to the formation of plaque buildup in the arteries. That's called atherosclerosis. And this is linked to higher risk for heart disease and stroke. On the other hand, HDL stands for high density lipoprotein, and that's considered a good cholesterol.
Now, HDL levels should be around 50 milligrams per deciliter in an individual, but you can raise your HDL by several means, including exercising for at least 30 minutes five times a week, quitting smoking, avoiding saturated fats and losing weight. So, there are medications out there that can lower our LDL or bad cholesterol sometimes by 50 percent. So, I guess the question is, why wouldn't we take these medications? I heard one of your presentations that an Internet search of statin myths turned up 30 million results online.
So, before we break down some of those myths, I guess the first question is why is there so much negativity about them? Well, you know, I think there's a lot of misinformation out there on the Internet. And people are really confused about what's true, what's a myth.
And then they don't necessarily speak to their doctors about these questions all the time. So, I think that it's really important to get the facts straight.
Now, I do think there is, you know, generally a low desire to take medications long-term in most people. And also, I've heard, you know, because the medicine doesn't make you feel any differently, why should I take it?
Many people have that myth. And the other thing is that a lot of people think that once your cholesterol is better on a statin that you can stop taking the statin. Unfortunately, what happens is your cholesterol will go right back to where it was previously in many situations. And perhaps the biggest myth of all is that they don't even work in the first place when it comes to preventing heart attacks.
So, obviously, Doctor, you disagree. But what is the science behind that disagreement? We do know over decades of research that statins and other lipid lowering therapies are very effective in reducing the risk for major vascular events, such as death from cardiovascular causes, myocardial infarction, which is heart attack, stroke, or needing a coronary stent or bypass surgery. We have data now from over 20 statin trials of over , patients that show that statins compared with placebo or no medication result in a 23 percent reduction in heart attacks, 17 percent reduction in fatal or non-fatal stroke, 19 percent reduction in death from cardiovascular causes and a 12 percent reduction in all-cause mortality.
So, they definitely work. They're definitely effective for heart disease and death. And those are data that have been around forever.
And I think that myth should definitely be dispelled. So, it sounds like someone with higher cholesterol, for example, my cholesterol is around , That's considered high.
So, you know, there's a lot of other stuff out there, right? Like statins cause dementia, or maybe people with a family history of dementia should avoid taking statins. Are there people who shouldn't be, who have high cholesterol and then who shouldn't be taking statins? You know, certainly if you're allergic to the statin or the components of the statin medication, that will be a situation which you would want to choose an alternative medication.
You mentioned about memory or dementia. Well, you know, the truth is that memory issues tend to occur in the same age group in people that take statins. So, it's really difficult to know if it's the statin or it's other factors. The initial concerns about dementia came from self reports to the Food and Drug Administration, but it turned out that many reports where people who took the drug for really one day only.
So, it's unlikely that drug had had any effect whatsoever. And we do know that we have more reliable data that come from other studies, including over 20, people taking statins. And the result of that is that there's really no effect of statins on thinking or memory issues.
And so, in general, although there are some potential side effects long-term for statins, in most cases, if your doctor has identified you as having high cholesterol and needing a statin, the risks greatly outweigh, or sorry, the benefits greatly outweigh the risks. It really amazes me how many people out there picking on statins based on what you're telling us right now.
But the fact of the matter is they are. I mean, we touched on this already. But I want to ask you again, Doctor, why is that? Why is there so much negative information out there? Well, I think, you know, a lot of people may have some questionable side effects that that come up when they start a statin, and they've heard, you know, negative reports or anecdotal information or stories from friends and family. And a lot of times these are about muscle aches. So, you know, generally muscle aches are not dangerous and really there is only some discomfort.
There are rare instances of severe muscle breakdown, could be dangerous for organs such as the kidneys, but these cases are extremely infrequent. And I haven't even seen a case since medical school many years ago. Now, there's some fair evidence that repletion of vitamin D, thyroid regulation and perhaps the medicine Coenzyme Q may help decrease the muscle side effects of statins. And it's certainly reasonable to try them, but we know that most of the supposed side effects of statins are actually not due to statins.
So, in one recent study published in the New England Journal of Medicine just this past month showed that in patients who had discontinued statin therapy because of reported side effects, in truth, 90 percent of the symptom burden elicited by a statin challenge was also elicited by placebo.
So, most of the people who reported a symptom on statin of a side effect had the same side effect on placebo. And half of the trial patients were able to successfully restart their statins.
This means grapefruit can cause an increase to the side effects of the drug, which could put you at risk for muscle breakdown, liver damage, and kidney failure. More mild cases can cause painful joints and muscles. In November , the American Heart Association and the American College of Cardiology released new guidelines that identified groups who would benefit the most from statins. Taking statins is often but not always a lifelong commitment.
Even if your cholesterol levels decrease, you may still need to take the medication. However, if you change your lifestyle significantly, you may be able to go off the medication.
This might include losing a significant amount of weight or radically changing your diet. There are other ways you can help decrease your cholesterol. Many of these involve lifestyle changes. Certain foods have been found to help lower cholesterol and the risk of vessel disease:.
If you smoke, stopping can help improve your cholesterol levels, lower your blood pressure, and decrease your risk of a heart attack. The benefits of quitting smoking begin within hours, adds Dr. Losing excess weight — even 5 to 10 pounds — and regularly engaging in physical activity can help improve your cholesterol numbers. Walk, bike, swim, or do anything to get your heart pumping. Talk with your doctor before starting a new fitness routine.
A cholesterol absorption inhibitor helps to limit this absorption of the cholesterol you consume. Ezetimibe is one type of cholesterol absorption inhibitor.
These receptors then regulate how much LDL cholesterol goes into your bloodstream. The liver makes bile acids, needed for digestion, using cholesterol. Sequestrants bind to bile acids, making the liver use the extra cholesterol to produce more bile acids. That lowers the cholesterol in the blood. Statins are prescription drugs used to lower cholesterol. However, they can have side effects and might not be right for everyone. Learn about…. Statins are a common treatment for high cholesterol.
Learn about the latest FDA guidelines and recommendations about the use of statins for this…. Statins are among the most popular medications prescribed in America today, but how do they lower cholesterol?
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