Your cholesterol levels are an important health marker — in fact, if you’re a healthy adult, you should have them checked every four to six years. That’s because high cholesterol levels may increase your risk for serious health conditions like heart disease, stroke and peripheral artery disease (PAD).
If your cholesterol levels are high, your health care provider may recommend that you start taking a statin drug to lower them. “Statins are a class of medications that lower your total cholesterol, predominantly by reducing the production of ‘bad’ LDL cholesterol and triglycerides,” said Ojas Bansal, MD, a cardiologist with Banner Health.
Statins pack a strong punch against cholesterol
Statins work by blocking a liver enzyme (HMG-CoA reductase) that helps produce LDL cholesterol in your body. Lowering these cholesterol levels can help keep plaque from building up in your arteries, reducing your risk of heart attack and stroke. Statins also increase the amount of cholesterol your liver removes and raise your HDL (“good”) cholesterol levels.
Statins may also:
- Improve the function of the lining of your blood vessels (endothelial function).
- Reduce inflammation in the arteries.
- Keep plaque from building up further.
- Protect the heart muscle and reduce the risk of heart failure.
“Statins also play a significant role in improving longevity in patients who have had a prior cardiac event like a heart attack or a stroke,” Dr. Bansal said.
Who should take statins?
Your provider may recommend statins for you if you have:
High LDL cholesterol levels, especially if they haven’t come down with lifestyle changes.
High risk of developing cardiovascular disease, even if your cholesterol levels aren’t high. You could be at high risk if you are older, have a family history of cardiovascular disease, smoke, have high blood pressure, have diabetes, have obesity or have a sedentary lifestyle.
Before prescribing statins, your provider will evaluate your cholesterol levels, overall risk, health history, potential benefits and risks and your preferences, goals and lifestyle.
You can get brand name or generic versions of these medications. Common types include:
- Lipitor (atorvastatin)
- Crestor (rosuvastatin)
- Zocor (simvastatin)
- Pravachol (pravastatin)
- Altoprev (lovastatin)
- Livalo (pitavastatin)
- Lescol (fluvastatin)
You and your health care provider can talk about the pros and cons of different types of statins so you can find one that’s right for you.
How to take statins
It’s important to take statins the way your provider prescribes them. You will probably start with a low dose and gradually increase it until it’s lowering your cholesterol as it should. Your provider will review your dosage regularly to check that it’s managing your cholesterol levels and that your overall health is good.
You should take prescribed statins at the same time every day so the level of medication in your blood is consistent. Pay attention to any instructions on the medication label.
It’s usually a good idea to take statins at bedtime. Be careful about consuming grapefruit and grapefruit juice — they could interact with statins and increase your risk of side effects.
You need to take statins consistently. Talk to your provider if you have trouble sticking with your treatment plan.
Side effects of statins
Most people tolerate statins well. “Statin-related side effects are infrequent and rare,” Dr. Bansal said. In some cases, they may cause:
- Muscle pain, aches or weakness (myopathy), which is usually mild.
- Digestive issues such as nausea, diarrhea or constipation.
- Headaches, which are relatively common but usually mild and temporary.
- High levels of liver enzymes, which could be signs of liver inflammation or damage.
There are also some rare but serious side effects:
- Rhabdomyolysis: This is a severe form of muscle injury where muscle tissue breaks down and muscle proteins enter the bloodstream. Symptoms include severe muscle pain, weakness, dark urine and kidney damage. This condition requires immediate medical attention.
- Liver damage or liver failure: Theses conditions may lead to elevated liver enzymes, jaundice (yellowing of the skin or eyes) and other symptoms of liver problems.
- High blood sugar: Increased blood sugar levels could increase the risk of type 2 diabetes, especially for people who are already at high risk.
Side effects are more likely in people who are:
- Diagnosed with neuromuscular disorders, liver disease or kidney disease
- Of Chinese descent
- Living with untreated hypothyroidism
- Tested and have low vitamin D
- Over 80 years old
- Frail
- Female
If you experience any side effects from statins or have any concerns, talk to your health care provider. Your provider can address the side effects, adjust your medication or dosage and treat any possible risks. Don’t stop taking statins without talking to your provider, even if you have side effects. Stopping them suddenly can increase your risk of heart attack or stroke.
Lifestyle changes that can help lower cholesterol
Taking statins isn’t the only thing you can do to help improve your cholesterol levels. You can also:
- Choose a heart-healthy diet centered around fruits, vegetables, whole grains, lean proteins and healthy fats. “Try to get three to four servings of fish per week,” Dr. Bansal said. Limit saturated fats like butter and red meat and be careful with cholesterol and sodium.
- Make regular exercise a part of your lifestyle. Aim for at least 150 minutes of moderate aerobic activity per week or 75 minutes of vigorous activity plus muscle-strengthening physical activity at least two days a week.
- Lose excess weight if you need to, since maintaining a healthy weight can improve your heart health.
- If you smoke, try to quit. It’s one of the most important steps you can take to improve your heart health.
- Try stress reduction techniques such as mindfulness meditation, deep breathing, yoga or hobbies that help you relax, since stress can impact your heart health.
- Avoid or limit alcohol consumption. If you choose to drink alcohol, Dr. Bansal says to limit it to one drink per day for both men and women.
Follow up with your provider
Visit your health care provider regularly to see how well statins are working. They may want to check your blood to measure your cholesterol levels, liver function and other health markers.
Make sure your provider knows about other medications you’re taking, including over-the-counter (OTC) supplements and herbal remedies. They could interact with statins or affect your cholesterol levels. Your provider may adjust your dosage or recommend other medications based on how well statins are working for you.
Common questions about statins
- Does CoQ10 counteract side effects from statins? “There is very little evidence to support this. Some may still choose to try this since it is safe,” Dr. Bansal said.
- Is there a link between statins and dementia or memory loss? Some research has found potential memory issues with some fat-soluble statins, but there’s no clear consensus. If memory loss is a concern, you may be able to switch to a water-soluble statin. “Since we know that statins help improve longevity in people with heart disease and stroke, we should make every attempt to continue the medication safely,” Dr. Bansal said.
- Is red yeast rice a good natural alternative to statins? Red yeast rice contains a compound similar to lovastatin and can lower LDL cholesterol levels by 20 to 30%. But there’s not a lot of data about its clinical outcomes. It could contain contaminants, and, like statins, it can cause muscular side effects.
The bottom line
If you have high cholesterol levels, you could be at risk for heart attack, stroke or peripheral artery disease (PAD). So your health care provider may recommend statins to help control your cholesterol.
Statins are generally safe and effective, and there are a lot of different types. If you’re concerned about one kind, there may be others you can try.
If you would like to know more about managing your cholesterol levels and keeping your heart and blood vessels healthy, talk to your provider or reach out to an expert at Banner Health.
