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Statins: Should I take them?

Statins: Should I take them?

www.mayo.edu/center

Your Options -

  • The most effective – Start taking a medicine called a statin to lower your risk of heart attack and stroke
  • Less effective – Don’t take a statin.  Try lowering your risk with lifestyle changes, like making changes in what you eat and getting more exercise

2 kinds of Cholesterol:

  • Low density lipoproteins (LDL) are the “bad” cholesterol.  LDL can clog your arteries.  LDL should be low.  Your LDL goal depends on your risk of heart attack and stroke.
  • High density lipoproteins (HDL) are the “good” cholesterol.  HDL helps clear fat from your blood.  HDL should be high.  A good HDL goal is 40 or higher.  An HDL level of 60 or higher is linked to a lower risk of heart disease.  A high HDL number can help offset a high LDL number

Triglycerides:  

  • Another type of fat in your blood.  If you have high triglycerides and high LDL, your chances of having a heart attack are higher.

Risk Factors for heart attack and stroke you may be able to control:

  • Diabetes, High Cholesterol, High Blood Pressure, Smoking Cigarettes, Being Overweight, Not Exercising

Risk Factors for heart attack and stroke you can’t control:

  • Your age.  Men age 45 or older and women age 55 or older have a higher risk.
  • Having one or more close relative who have had or had early heart disease.

Points to remember- the benefits of taking a statin

  • Medicines called statins are proven to lower your risk of having a heart attack or stroke.
  • Statin use is associated with a 22% reduction in deaths from various cancer types in women and a 55% reduction in deaths from bone/connective tissue cancers.
  • Statin use with Metformin found a 40% reduction in prostate cancer mortality, with the effect more pronounced in men with obesity/metabolic syndrome.
  • Your doctor may want your goal to be less than 70 based on your risk factors.
  • People who have diabetes have a higher risk of heart attack or stroke than people who don’t have diabetes.  The goal LDL for diabetics is < 100.  Heart disease is a leading cause of death in people with diabetes.  Also, in people with diabetes, heart attacks occur earlier and are more likely to cause death.
  • A heart-healthy lifestyle is important for lowering your risk whether you take statins or not.  This includes eating healthy foods, being active, staying at a healthy weight, and not smoking.
  • Your doctor uses your cholesterol levels plus other things to find out your risk of heart attack or stroke.  You and your doctor can decide whether you need to lower your risk and what treatment is best for you.
  • For some people, it’s not as clear if they need to take a statin.  You and your doctor will need to look at your overall health and any other risks you have for heart attack and stroke.
  • Statins side effects are low in most people.  When side effects happen, they tend to include problems such as muscle aches and tiredness.  A much less common but more serious side effect is diabetes

How do statins lower your risk?

  • Statins are a type of medicine used to lower the amount of cholesterol in your blood.  Statins reduce the body’s natural production of cholesterol.
  • Cholesterol is a type of fat in your blood. If you have too much, it starts to build up in blood vessels called arteries.  This problem is called atherosclerosis.  It is the starting point for most heart and blood flow problems, including heart attacks and strokes.
  • Along with lowering cholesterol levels in the blood, statins reduce inflammation around the cholesterol build up (called a plaque).  This may lower the risk that the plaque will crack apart and cause a blood clot that can lead to a heart attack or stroke.

What are the risks and side effects of statins?

  • Statins don’t cause side effects in most people.
  • When side effects happen, they tend to include minor problems.  For example, some people who take statins feel muscle aches.  It’s hard to know from studies how often statins cause this problem.  This evidence is inconclusive.
  • A less common but more serious side effect of statins is diabetes.  Statins may raise the risk of diabetes in some people, not often dangerous.

Evidence shows that statins help people with heart disease & diabetes by reducing the risk of heart disease.

 

Evidence shows that statins may be helpful for some people who don’t have heart disease.

Your doctor is likely to recommend statins for you because the evidence is clear that the stain will reduce your risk of heart attack and stroke if you have the following:

  • Have heart disease
  • Have peripheral arterial disease.
  • Had a heart attack
  • Had a stroke
  • Your LDL Cholesterol is 190mg/dL or above.
  • You have diabetes and you are age 40 to 75.
  • Your 10-year risk of heart attack or stroke is 7.5% or above and you are age 40-75