High cholesterol is a familiar warning sign for cardiovascular disease. While some people can control their cholesterol through diet and exercise, others also may need medication. That’s where statins come in.
Statins are commonly used to lower cholesterol levels and reduce the risk of heart attack and stroke. Millions of people who have heart disease or are at high risk take them and help protect their hearts that way.
Treatment for high cholesterol is based on overall risk for cardiovascular disease.
“Your doctor will consider all your risk factors, including cholesterol levels and medical conditions,” says Todd Hitchcock, MD, a cardiologist at Scripps Clinic Carmel Valley. “If you doctor recommends statins, it’s because you are at risk for heart disease or stroke.”
Other risk factors include smoking, lack of exercise, high blood pressure, diabetes, high blood sugar levels, excess weight or obesity, family history of heart disease and older age.
Statins are also recommended for people who’ve had a heart attack or stroke even if they don’t have high cholesterol.
Cholesterol is a fatty substance made by the liver that travels through the blood. There are two types of cholesterol. One is good. The other is bad.
HDL cholesterol (high-density lipoprotein) is the good cholesterol. It helps remove the bad cholesterol and protect the arteries.
LDL cholesterol (low-density lipoprotein) is the bad cholesterol that can clog your arteries. Saturated fats, such as those in beef and full-fat dairy, can increase LDL cholesterol and increase the risk for heart attack or stroke.
“When you eat a lot of these foods, especially those that are high in saturated and trans fats, your liver produces more cholesterol than the body needs — and that can lead to serious problems,” says Dr. Hitchcock.
When there is too much bad cholesterol in your blood, plaque builds up along the walls of the arteries and raises the risk of a heart event.
“It can disrupt the normal flow of oxygen-rich blood to the heart, which is why it’s important to know your risk factors,” Dr. Hitchcock says. In addition, “high cholesterol has no signs or symptoms, which is why it’s important to have your doctor check your cholesterol levels. All it takes is a simple blood test.”
About 38 percent of American adults have high cholesterol, according to the Centers for Disease Control and Prevention (CDC).
Statins work by cutting the amount of bad cholesterol the body makes. They reduce the amount of fatty deposits in the arteries and stop any more from building up. They also make existing fatty deposits less likely to break off and cause a blood clot. A blood clot can cause a heart attack or stroke.
Studies show the risks of long-term use of statins is low and the benefits are high.
Studies show most people don’t have side effects from statins. And when they do happen, they tend to be mild. The most common side effects include constipation, nausea or indigestion, headache and muscle aches.
“Talk to your doctor if you have concerns about side effects. When side effects do happen, it may just be a matter of changing your statin to a different one that works better for you,” Dr. Hitchcock adds.
For some people, simple lifestyle and nutritional changes may be all they need to do to bring down bad cholesterol.
“The primary ways heart attack and stroke risk can be reduced are by leading a healthy lifestyle,” Dr. Hitchcock says. “This includes managing high blood pressure, not smoking, eating healthy and getting plenty of exercise.”
“But sometimes a pill in combination with lifestyle adjustments can create the best treatment,” he says.