Statins are among the most frequently prescribed drugs on the planet, and for a good reason. They’ve revolutionized the treatment of high cholesterol and prevention of heart disease. If you have ever been instructed to “watch your cholesterol,” then there’s a good chance statins were mentioned along with it. But what do these drugs do, and are they the best option for everyone?
How Statins Work
Statins reduce cholesterol by inhibiting an enzyme in the liver responsible for producing it. This decreases the amount of LDL—or “bad”—cholesterol in your blood. Meanwhile, statins may raise HDL, the “good” cholesterol, and reduce triglycerides. Because cholesterol can form in the arteries and cause severe issues such as heart attacks and strokes, controlling it is the key to maintaining your heart health.
More Than an Anti-Cholesterol Medication
Researchers have found, year after year, that statins have more to offer than their cholesterol-lowering effect. They possess anti-inflammatory effects as well, which is significant since arterial inflammation may promote heart attacks and strokes. Statins have been found in some studies to reduce levels of C-reactive protein, a marker of inflammation, particularly in individuals suffering from heart disease.
Another advantage? Statins stabilize plaque in the arteries, reducing the likelihood of the plaque bursting and causing a blockage of blood flow, one of the leading precipitants of heart attacks.
There has also been curiosity about whether statins possess antibacterial or antiviral effects, particularly in the context of the COVID-19 pandemic. Although some observational studies suggested potential benefits, the evidence is not strong enough to conclude that statins have a direct role in combating infections. Likewise, although statins do reduce blood pressure slightly in some individuals, the evidence is inconsistent and inconclusive.
Who Should Take Statins?
Statins are most beneficial for individuals who, based on recommendations by the American Heart Association and other such organizations, have:
- Existing cardiovascular disease (such as a history of heart attack or stroke)
- Very high levels of LDL cholesterol
- Type 2 diabetes with an age range of 40 to 75 years
- High 10-year risk of heart attack according to medical history and risk calculators
If there is a family history of high cholesterol or heart disease—or if lifestyle changes haven’t been effective in reducing your cholesterol—your doctor may also recommend experimenting with statins.
Possible Side Effects
As with any drug, statins can produce side effects, but most people adjust well. The most frequent symptoms are mild—such as muscle pain, nausea, or stomach discomfort—and usually disappear as your body gets used to them.
Statins may produce more severe complications in exceptionally rare instances, including:
- Muscle injury (a condition known as rhabdomyolysis)
- Inflammation of the liver
- A minor increased risk of type 2 diabetes development
Older people, individuals with kidney or liver disease, and those taking several medications are more likely to experience side effects. A lesser-known interaction: grapefruit. It can disrupt how your body breaks down statins, which might increase the risk of side effects. If you’re taking statins, it’s generally best to steer clear of grapefruit or consult with your doctor about acceptable amounts.
What If You Have Kidney Disease?
For individuals with kidney disease or kidney failure, statins are a double-edged sword. They can lower cardiovascular risk, but in certain individuals pose a risk that they may deteriorate kidney function. Therefore, physicians carefully consider the benefits and risks and keep a close eye on kidney function in patients receiving statins. If you experience symptoms of dark urine, severe muscle pain, or confusion, call your physician immediately.
Are There Alternatives?
Not everyone needs statins. For some people, lifestyle changes alone can significantly lower cholesterol. Eating more fiber-rich foods, fatty fish, nuts, and healthy oils, quitting smoking, and staying active can all make a big difference.
If statins aren’t a good fit or cause too many side effects, other medications—like cholesterol absorption inhibitors or PCSK9 inhibitors—might be options worth exploring with your doctor.
Beginning (or continuing) statin therapy is a matter of personal choice that always should be made in consultation with your health care provider. No one’s health history is the same—what is best for one individual may not be best for another. Statins are a very useful tool in preventing heart disease, but they are most beneficial when combined with healthy lifestyles and as part of an overall plan for long-term health.
Related
