Statins are prescribed to people who have a high risk for heart attack and stroke. They are thought to prevent these conditions by reducing the amount of cholesterol in the blood, but they come with side effects such as muscle pain, weakness, and rashes that may also be reduced by healthy living choices.
This article will provide an overview of what statins do and to help you better discuss the subject with your physician.
What Are Statins?
Statins are a class of drugs called HMG-CoA reductase inhibitors. There are several other classes of drugs within this category that include some commonly prescribed cholesterol lowering medications such as Zocor and Zetia. They work by blocking an enzyme called 3 hydroxymethylglutaryl CoA reductase (HMG-CoA reductase), which is responsible for the conversion of LDL cholesterol to the more harmless HDL cholesterol. This allows more LDL cholesterol to be cleared from your blood, making less available for the body to attack and damage. The idea is that this in turn will reduce the amount of plaque build up in your arteries and help prevent heart attacks and strokes. Some studies suggest that taking statins may help people live longer as well.
How Do I Know If I Need Statins?
You’re probably wondering how you know if you need statins. This class of drugs is typically only prescribed to people who have a 10-20% chance of having a heart attack or stroke within 10 years.
Weighing the benefits and side effects of statins vs. healthy lifestyle choices can be a difficult task. You’ll want to consider the following information before you decide on a course of action:
How Do I Take Statins?
There are a few ways to take statins: There is a pill form (such as rosuvastatin or pravastatin), which have to be taken once per day. There are injected forms like Zocor, or there is a topically applied form such as Atorvastatin.
Why Do Some People Not Need Statins?
There is evidence that people who have certain risk factors for heart attacks and strokes are less likely to need statins.
These include patients with:
- High blood pressure in the left ventricle (Elevated left ventricular ejection fraction)
- Coronary artery disease(CAD) or angina pectoris (chest pain) before the age of 60, or diabetes before the age of 30. Patients with CAD, angina pectoris or diabetes who were prescribed statins were already at a higher risk for heart attack and stroke than those without those risk factors.
But having these conditions does not necessarily mean you should take statins. Weigh the benefits and side effects of taking statins vs. lifestyle changes before you decide to take them.
Will Statins Help Prevent Heart Attacks?
A 2005 report in the journal “New England Journal of Medicine” found that patients who took a statin for five years had a 69% lower risk of heart attack than patients who did not take statins. The study also showed that patients with high amounts of good cholesterol (HDL-C) while taking statins had a 35% lower risk of heart attack than patients who did not take statins, suggesting that it is the good cholesterol that protects against heart attacks and bad cholesterol that puts one at greater risk for heart attacks. But the study also shows that if statins used for five years are stopped, the risk of a heart attack increases.
Do Statins Prevent Stroke?
The evidence that statins reduce the risks of stroke is also very mixed, with some studies showing that they help and others showing no effect. So whether these drugs prevent strokes or not depends on whether you are taking them or not. And there is no good data to suggest that they do. But it does not appear to be harmful and may in fact be beneficial to reduce cholesterol levels while taking statins for blood pressure control. Again, it depends on whether you take them or not.
Will Statins Improve Your Cholesterol Levels?
A study in the “Journal of the American Medical Association” found that patients who took a statin had their LDL-C levels fall from an average of 136 to 112. Patients who did not take a statin saw their LDL-C increase from 132 to 142. The study also showed that patients who took a statin had a 37% lower risk of heart attack and that those with high cholesterol levels saw their good cholesterol (HDL-C) rise by 23%. Overall, it appears as though statins can improve cholesterol levels, which lowers your risk for heart attacks.
Are there other additional positive reasons to take Statins?
Cancer. Statins have anti-cancer activity. Statins “recently” (i.e., a week ago) were shown to lower prostate cancer risk by 45%. This is good news for men who take statins! What’s even more interesting is the observation that taking statin drugs delays the progression of prostate cancer by 41%. While this result was in mice and not humans, it’s still an intriguing finding.
Diabetes. We know that cholesterol is a major component of atherosclerosis, and it’s only going to increase over time if you don’t take a statin drug. But, if you do take statins, it’s probably not going to help your diabetes! Why? Because statins don’t actually reduce the amount of cholesterol in your body!
Gout. Gout is an inflammatory arthritis that is caused by too much uric acid in the body. It affects around 1% of the population, and its treatment with steroids leads to weight gain and hair loss. Statins have shown some promise in reducing gout flares by 25%.
What Are the Side Effects of Statins?
Side effects of statin use can be mild or severe. Most patients do not experience side effects, but as the number of statin users increases, the number of side effects is sure to rise.
Some of the mild side effects of statins include:
- Muscle pain
- Back pain
- Headache
- Feeling tired or unwell.
More severe side effects include:
- Muscle pain (especially in the back)
- Swelling of face, legs, and hands
- Headache lasting more than 24 hours.
- Feeling anxious or agitated.
- muscle weakness and swelling with the potential to develop muscle fibrosis (muscle thickening) causing joint pain and inability to walk.
- It may limit your mobility, cause an increased risk of falling, and lead to a clinical diagnosis of muscular rhabdomyolysis (severe muscle breakdown).
It is sometimes difficult for patients to take statins because of their side effects. As such, patients often elect to stop taking statins after a few weeks of use. But this can be dangerous! Something important to note is that most side effects appear when you first start taking statin drugs and decrease with continued use. In fact, if you have muscle pain while you’re taking statins, it means that your LDL-C levels are too low and should be corrected before you can consider stopping statin drugs.
How Do Statins Work?
Statins (HMG-CoA reductase inhibitors) work by blocking an enzyme found inside the liver that is involved in making cholesterol. By blocking this enzyme, statins keep the liver from making as much cholesterol. The liver is still able to use its existing supply of cholesterol, but it creates less new cholesterol. The net result is lower blood levels of LDL-C and total cholesterol. It has been shown that by lowering LDL-C levels in many people, statin drugs are heart attack preventative. However, there are other factors involved such as smoking and weight gain. It is important to understand that if you have chronic kidney disease, statins will not reduce your risk of heart attack or stroke! Statins can raise your cholesterol levels (LDL-C), which puts you at a greater risk for having a heart attack. However, patients with chronic kidney disease may be able to lower their LDL-C with certain drugs that work by blocking an enzyme found inside the liver that is involved in making cholesterol.
Are you wondering whether to take Statins or no? try now our interactive tool to help you make your decision: Should I Take Them to Prevent a Heart Attack or Stroke?