Cholesterol gets a lot of bad press these days but despite its bad rap, it’s a necessary component of your cells. Nevertheless, if you have too much in your blood, it can stick to your arteries and narrow or block them, which can lead to a heart attack. If diet and exercise don’t reduce your cholesterol, you may need to take medication. Quite often, this medication is a statin.
Statins first became available in 1987 and have since been followed by numerous other statin medications. Today, it is estimated that 30 million people worldwide are taking statins.
And yet – many people do not take their medication, based on unfounded fears that statins are dangerous or overprescribed.
“Unfortunately, bad news about drugs travels fast,” says Dr. James Joslin, central division medical director for Southwest Medical. “What’s more, reports of side effects are rarely presented in a way that is genuinely helpful or informative to people who might be affected.”
Dr. Chinenye Ezeanolue, Western division medical director for Southwest Medical, agrees that incorrect information is pervasive, and it can be hard to sway patients who are otherwise convinced.
“Thanks to mailings, social media posts and websites claiming that statin medications are harmful or unnecessary, many patients are confused about whether they should take them,” says Ezeanolue. “Medical societies or your own doctor are where you will get accurate information.”
Statins are relatively safe for most people – and of course, there are always exceptions: they aren’t recommended for pregnant patients or for those with active or chronic liver disease. Some statins also interact adversely with other drugs. You may have fewer side effects with one statin drug compared to another statin.
“It’s so unfortunate when patients do not adhere to their statin medication,” says Chang-Hoon Ahn, Eastern division medical director for Southwest Medical. “Statins not only help prevent heart attacks and strokes but also lower the chance of developing peripheral arterial disease, a condition where the arteries in the feet and legs become so narrow the tissues don’t get enough oxygen. Statins really are a wonder drug that have made the difference between life and death for so many patients.”
What does this mean for you?
There is no question that statins can protect those who’ve already had a heart attack or stroke and thus face a significant risk of a recurrence that could prove fatal. The longer someone is on statin therapy, the greater the reduction in the risk of a cardiovascular event.
Keep in mind that when you begin to take a statin, you’ll most likely be on it for the rest of your life. If you experience side effects, talk to your doctor about the prospects of decreasing your dose or trying a different statin. Don’t stop taking a statin without talking to your doctor first.
To avoid confusion over conflicting information online, patients should always get medical advice from their doctors or reliable sources.
Statins cause diabetes
There have been some studies that have shown that statins may increase a patient’s blood sugar, perhaps predisposing a patient to diabetes. While statins may increase blood sugars, this does not offset the overall benefit that statins provide. People with diabetes benefit the most from statins, which reduce their risk of heart attack, stroke and death. If you take statins, be sure to work closely with your doctor to monitor your blood sugar levels, watch your diet and be sure to include regular exercise in your routine. Often people are put on statin medication and treat this as if it were a license to eat whatever they want. This leads to weight gain, which is highly related to developing diabetes.
High cholesterol is not a bad thing
Sorry, no. High blood cholesterol almost always results in a plaque buildup in the arteries. Is there the occasional lucky individual who has won the genetic lottery and nothing bad will happen to them? Yes. Chances are that’s not you. Uncontrolled high cholesterol over time will in almost every case lead to very bad outcomes.
Statins destroy muscle tissue
Statins have been tested in over one million patients. Overwhelmingly, research shows that they do not cause muscle damage. However, statins can cause mild muscle ache for a small number of people. Even more rarely, statins can cause severe muscle pain — which is a sign to talk to your doctor, who will have you stop your statins immediately. Of course, you should tell your doctor if you are feeling any muscle pain or weakness.
Statins don’t really prevent vascular disease
Yes, they do. Statins primarily keep arteries with some plaque from getting any worse and also play a critical role in reducing inflammation, which is a key cause of cardiovascular disease. While statins can’t “clean out” the arteries, there are instances where statins can cause the plaque to shrink.
Doctors just want to give everyone a statin
Public debate on statins almost without fail will eventually mention the specter of “big pharma.” There are of course legitimate concerns regarding the prospect of pharmaceutical companies overselling the benefits of their drugs, while dismissing potential risks.
Independent scientific study has clearly established that statins are safe and effective. Conspiracy theories are simply poisoning reasonable discussions, tarnishing legitimate criticism with pseudoscientific conspiracy-mongering and frightening people in medical need away from effective treatments.
“Legitimate debate focuses on where to draw the line – who gets treated?” said Ahn. “Every patient should have that discussion with their own physician. A patient’s risk factors, other medical issues and age are all important considerations.”
Ezeanolue agrees. “Of course, first-line treatment for high cholesterol should be diet and exercise. Maintaining a lean body mass, regular exercise and not smoking are the most effective ways to prevent heart disease for most people. Unfortunately, lifestyle interventions are not very effective.” This isn’t because they don’t work, but because it is very difficult for most patients to maintain these lifestyle changes over the long term.