Statins are one of the most widely prescribed drugs in the world. If you have high cholesterol or are living with heart disease, chances are, you take a statin to help manage those conditions. But how statins work – and how they have become one of the best defenses we have in healthcare for preventing heart conditions – isn’t as commonly understood.
Gerald Koenig, M.D., PhD, an interventional cardiologist at Henry Ford Health, explains what statins are and the cardiovascular benefit of taking them.
Q: What are statins?
Dr. Koenig: The drug class of statins are actually derived from fungi that have been found to block the creation of cholesterol in the liver. As a result, taking a statin can help lower your cholesterol. Over the years, statins have been pharmaceutically developed into seven different formulas – each with unique properties and potency.
Q: Why are statins prescribed?
Dr. Koenig: Statins can be prescribed for many reasons, but they are often used in cases where a patient has atherosclerosis, a thickening or hardening of the arteries caused by plaque buildup. This occurs when cholesterol and other fatty substances accumulate along the walls of your arteries. Having atherosclerosis puts patients at a greater risk for cardiovascular disease, coronary artery disease, peripheral artery disease and stroke. Taking a statin can help lower your risk of these conditions.
Q: How do statins protect your heart?
Dr. Koenig: Statins help to lower the levels of low-density lipoprotein (LDL) or “bad” cholesterol in the body by as much as 21-63% and can also raise high-density lipoprotein (HDL) or “good” cholesterol levels by 4-16%. As a result, this can boost vascular function, have anti-inflammatory effects and can stabilize plaque buildup in the body. The result? Reducing your risk for cardiovascular events such as a heart attack or stroke by as much as 25-40%.
Q: Who are statins prescribed to?
Dr. Koenig: Organizations like the American College of Cardiology and the American Heart Association provide recommendations for when statins are prescribed. These recommendations are based on the age of the patient, if they have any clinical diagnoses already (such as heart disease or diabetes), their cholesterol levels and risk for heart disease in the future. Statins are generally prescribed to three different groups of patients:
- Those with genetically high cholesterol levels
- Those with pre-existing heart disease
- Those at high risk of developing heart disease in the future
Newer statin guidelines now focus on including a patient’s risk of having a heart attack or stroke in deciding if a statin prescription would be helpful. The higher the risk, the greater the potential benefit.
Q: Once prescribed, how often should you take statins?
Dr. Koenig: Statins are designed to be taken daily. There is some data to support taking a statin every other day, however, to maintain the same effects, a higher dose is needed, which can increase possible side effects. Patients may need to take some statins at specific times of the day to get the most benefit from them, but typically they are taken in the evening.
You will likely need to take statins indefinitely. In many cases, when you stop taking statins, your cholesterol levels go up, increasing your risk for a heart attack or stroke. Patients should not stop taking statins without a doctor’s approval first.
Q: What are statin side effects?
Dr. Koenig: All medicines can have side effects, and statins are no exception. Most commonly, statin use can cause muscle pain, muscle weakness and cramping. Typically, patients that are taking low-dose statins are less likely to experience any adverse effects. If you are experiencing these side effects or others including constipation, diarrhea, nausea, headaches or fatigue, talk with your doctor. They may be able to help by switching you to a different statin, lowering your dose or suggesting an alternative dosing schedule.
In some rare cases, statins can cause a small increase in high blood sugar in patients that have diabetes or obesity. Additionally, statin labels warn of possible confusion and memory loss while taking the drug, though larger studies have revealed none of these effects caused by statins. At the end of the day, the health benefits of statin use often outweigh the risks.
Lifestyle Changes To Benefits Your Heart Health
Statins remain the gold standard to help those with high cholesterol manage their cholesterol levels and reduce the risk of cardiovascular events. However, in some cases, patients are unable to use statins due to adverse effects. Fortunately, there are studies and ongoing clinical trials to explore the effectiveness of non-statin cholesterol lowering drugs.
Whether or not you choose to take a statin, how you live your life can make a significant impact on your heart health by preventing or delaying heart disease. Some things you can do:
- Exercise regularly
- Eat a heart healthy diet
- Avoid smoking and limit alcohol use
- Manage your weight
Talk with your doctor to determine if taking a statin could be beneficial to your heart health in the long run.
To find a cardiologist at Henry Ford, visit henryford.com or call 1-800-436-7936.
Dr. Gerald Koenig is the director of the Cardiac Catheterization Laboratory at Henry Ford West Bloomfield Hospital and the director of clinical research in the Cardiac Catheterization Laboratory at Henry Ford Hospital.
