Statins lower cholesterol levels, reduce the risk of heart attack and stroke, and improve overall heart health.

In the late 1970s, researchers found that a substance called mevastatin, isolated from a type of mold, could inhibit an enzyme involved in cholesterol production. This discovery led to the development of the first statin drug, lovastatin.

Since then, researchers have developed several other statins, each with its strengths and benefits. Healthcare professionals widely use these medications to help lower cholesterol levels and reduce the risk of heart disease.

Let’s explore why doctors prescribe statins, how they work, and their benefits and potential side effects.

Doctors prescribe statins to people who have high cholesterol levels in their blood, especially if they have other risk factors for heart disease. They help lower low-density lipoprotein (LDL) cholesterol, often referred to as “bad” cholesterol, and reduce the risk of heart attack and stroke.

Who is a good candidate for statins?

Good candidates for statins are individuals with a high risk of cardiovascular disease, including those with high cholesterol levels, a history of heart attacks or strokes, diabetes, or other risk factors for heart disease.

Experts recommend initiating statin treatment for those with LDL cholesterol levels of at least 190 milligrams per decilitre (mg/dL).

Who is not a good candidate?

Statins may not be suitable for people who have certain medical conditions or are taking medications that could interact with statins. People with active liver or kidney disease or a history of significant muscle-related side effects from statins may not be good candidates.

In addition, pregnant people or those planning to become pregnant should not take statins, as they could harm the unborn baby.

Statins lower cholesterol by inhibiting the liver enzyme, HMG-CoA reductase, which is essential for cholesterol production.

Blocking this enzyme reduces cholesterol levels in the blood, particularly LDL cholesterol, which can cause plaque buildup in arteries, raising the risk of heart disease and stroke.

Lowering cholesterol with statins helps decrease this risk and improves heart health.

Benefits of statins for heart health

Statins offer several benefits for heart health, including:

  • Reducing LDL cholesterol: Statins are highly effective at reducing levels of LDL cholesterol, often referred to as “bad” cholesterol. High levels of LDL cholesterol can lead to a buildup of plaque in your arteries, increasing the risk of heart disease.
  • Reducing the risk of heart attacks and strokes: By lowering LDL cholesterol levels, statins can help reduce the risk of heart attacks, strokes, and other cardiovascular events in people at risk.
  • Stabilizing plaque: Statins may help stabilize plaque in your arteries, making it less likely to rupture and cause a heart attack or stroke.
  • Anti-inflammatory effects: Research shows that statins have anti-inflammatory effects, which may also benefit heart health by reducing inflammation in the arteries. However, not all statins have the same ability to reduce inflammation.
  • Improving endothelial function: Research suggests that statins can improve the function of the endothelium (the inner lining of blood vessels), which is important for maintaining healthy blood flow.

The dosage of statins can vary depending on the specific medication and your individual needs, so it’s important to follow your doctor’s instructions carefully.

The average dosages for two commonly used statins, namely atorvastatin and rosuvastatin:

Atorvastatin (Lipitor):

  • Starting dose: 10 mg to 20 mg once per day
  • Maximum dose: 80 mg once per day

Rosuvastatin (Crestor):

  • Starting dose: 5 mg to 10 mg once per day
  • Maximum dose: 40 mg once per day

You usually take statins once per day, either in the evening or at bedtime, as this is when the body typically produces more cholesterol. However, you can take some types of statins at any time of the day, so it’s best to follow your doctor’s advice.

You can take statins with or without food. Doctors generally recommend taking them with a meal for better absorption and lowering the risk of stomach upset. It’s also important to take statins with a full glass of water to help swallow the tablet and prevent throat irritation.

If you miss a dose of statin, take it as soon as you remember. However, if it’s almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Statins are generally well-tolerated, but like all medications, they can cause side effects in some people.

Common side effects of statins include:

  • muscle pain, tenderness, or weakness (myalgia)
  • joint pain
  • headache
  • nausea or vomiting
  • constipation
  • diarrhea
  • rash or flushing

Rare but serious side effects of statins can include:

  • liver damage (elevated liver enzymes)
  • muscle breakdown (rhabdomyolysis), which can lead to kidney damage
  • increased blood sugar levels or the development of type 2 diabetes
  • neurological side effects such as memory loss or confusion

According to a review by the US Preventive Services Task Force, statin therapy for preventing heart disease in adults without prior heart events has an association with low risk of death and cardiovascular issues.

However, high intensity statin use had links with a higher risk of diabetes in one study. Overall, statins do not have an association with serious side effects like muscle pain or liver issues.

How to track side effects

To track side effects of statins, you can:

  • Keep a journal: Note any symptoms you experience, when they occur, and how severe they are.
  • Use a medication tracking app: Many apps allow you to log your medications and side effects, making it easier to track patterns over time.
  • Speak with a healthcare professional: Report any side effects to your doctor promptly, as they can determine if they’re related to the statin or due to other causes.

To manage and prevent side effects of statins, consider these tips:

  • Stay informed: Educate yourself about statins and their potential side effects so you can recognize and address any issues promptly.
  • Regular monitoring: Regular checkups and monitoring of your cholesterol levels and liver function are important. Inform your doctor about all medications, supplements, and vitamins you’re taking to prevent potential interactions with statins.
  • Follow instructions: Take your statin medication exactly as prescribed, including the dose, timing, and whether to take it with food or water. It’s also important to be aware of drug interactions and to follow guidelines about what drugs you should avoid when taking statins.
  • Healthy lifestyle: Maintain a balanced diet, engage in regular physical activity, avoid or limit smoking (if you smoke), and limit alcohol (if you drink) to support overall health and minimize side effects.
  • Consider alternatives: If you experience intolerable side effects, discuss alternative treatment options with your healthcare professional.

Reporting side effects to your doctor

Reporting side effects to your doctor is crucial for managing your health effectively. Be open and honest about any symptoms or concerns you experience while taking statins. Your doctor can help determine if the side effects are related to the medication and recommend appropriate actions.

If you’re experiencing side effects, ask about alternative medications or lifestyle changes that may help manage your condition.

Starting to take statins can be a positive step in managing your heart health, especially if you’re at high risk. Statins effectively lower cholesterol and reduce the chances of heart attack and stroke.

However, it’s important to use them as prescribed and speak with your doctor to monitor for any side effects. With proper monitoring and care, statins can be an effective tool in managing your cholesterol levels and reducing the risk of heart disease.