So, other than the, you know, possibility of muscle aches, the remote possibility of diabetes, there really aren't any significant side effects of statins that occur in most people.
There are rare situations of a liver or muscle injury, but again, those cases are extremely rare. And certainly the benefits in people who are at high risk for getting heart attack and stroke who have high cholesterol, who may have family history of heart disease will definitely outweigh those risks in the long-term.
You know, what we do know is that from genetic studies, the longer your LDL cholesterol is as low as it can be, the better the risk, the lower the risk for heart disease.
So, for example, 10 years on a statin with low LDL cholesterol might decrease your risk by 20 percent; 30 years by 40 percent; 50 years by 60 percent. So, there are people out there and families with genetic changes that make them have very low LDL cholesterol, less than Is quitting these prescription medications mid-treatment or perhaps without even consulting physician a big issue in the medical community? I think that is a big issue. I mean, people quit medications a lot of times without addressing it with their physician.
You know, the most important thing is to discuss your questions and concerns with your doctor. And even if you're thinking about experiencing side effects, you want to be sure to talk it over with your physician. There are things that your doctor can recommend such as checking and restoring blood levels of vitamin D and thyroid, tweaking the dose of your statin or switching to a different statin medication that might have other effects.
And many of these things can address the side effects that you're worried about. But the important thing is that, to keep taking your statin if your doctor has determined that it's beneficial for you in the long run. I always say that prevention is the best medicine. And statins are certainly one of the most important tools we have in cardiology to prevent heart attacks and strokes.
What's the magic number? I mean, I mean, we know that you can lower your cholesterol with changing what you eat or getting some exercise. Obviously, genetics play a role there. And sometimes you're just a little bit out of luck. But is there a magic age? Is there a magic number? Like, OK, I'm 49 years old right now. And my cholesterol is , No doctor's ever told me that I need a statin.
Every time I've been to my doctor, which isn't as often as I should go, but once every year plus, they've said, you know, change what you eat a little bit or get a little bit more exercise. But never has anyone said you should be taking a statin. And then I'm guessing I'm not old enough. Or my cholesterol is not too high. There has to be some factor.
Well, I think it starts first of all with suspicion and knowledge. You know, I'm a preventive cardiologist, and so I focus highly on risk and long-term risk. And so, in order to, you know, to have an indication to be on a statin, you have to understand that in the context of someone's risk. So, you know, people who have heart disease already, people who have diabetes, people whose LDL cholesterol is very high, it's called severe hyperlipidemia, so that would be an LDL cholesterol greater than equal to And then people with premature history of coronary disease, such as familial hypercholesterolemia, those people should really be on a statin.
And so, those people who don't, you know, if patients do not meet those criteria, then it's all about what your long-term risk of developing a heart attack or stroke would be. And then that helps us guide whether or not you should be on a statin. So, in general, you know, people who are younger, who don't have any risk factors for heart disease can usually get away with lifestyle changes, diet and exercise. But as you age or develop any risk factors like high blood pressure, diabetes, obesity, inflammatory diseases, such as lupus or rheumatoid arthritis, all those things can enhance your risk for getting heart disease and would be an indication to go on a statin.
Now, you mentioned, you know, diet and exercise. So, you know, to a moderate degree, changing your eating habits and getting some exercise can lower your bad cholesterol, specifically decreasing saturated fat in your diet, decreasing dietary cholesterol and increasing soluble fiber and plant sterols in your diet can lower your LDL cholesterol. On the other hand, exercise and weight loss can improve your triglycerides and raise your HDL cholesterol, that good cholesterol.
But, you know, in general, the effects are relatively modest, usually about a 10 to 20 percent change, whereas statins can decrease your LDL cholesterol by over 50 percent in many cases. So, if you put me on a statin, I can just go on eating my cheeseburgers and fried chicken all the time.
I wouldn't really put it that way. You know, diet has a lot of components in it. And even though the statin will help lower your cholesterol, a poor diet that's high in saturated fat, high in sodium or salt, you know, and low in potassium and essential nutrients can have negative effects on your health way beyond the cholesterol.
First of all, high sugars are stored in your body as fat. So, even though you're not eating a high-fat diet, you will definitely gain weight by eating sugary drinks, like, you know, non-diet sodas, sugar-sweetened beverages. Things that are high in fat and cholesterol and sodium will cause blood pressure to go up and cause your triglycerides to go up.
And triglycerides, you know, I mentioned briefly, but are another, you know, lipid risk factor that many people overlook. And so, we know that even if you could get your LDL cholesterol down to low levels with a statin, there are many other, these lipoproteins out there in your blood that contribute to heart disease that are not necessarily lowered by the statin, and the diet plays a really important role in that.
So, you're not off the hook eating the cheeseburgers and fried chicken just yet. So, conventional wisdom has always told us that what we eat affects our health, and it does. But what I'm hearing from you is that genetics play a huge role as well. And when it comes to high cholesterol, could you actually break that down for us? Check with your doctor whether there's a particular time of day you should take your statin. You usually have to continue taking statins for life because if you stop taking them, your cholesterol will return to a high level within a few weeks.
If you forget to take your dose, do not take an extra one to make up for it. Just take your next dose as usual the following day. If you accidentally take too many statin tablets more than your usual daily dose , contact a doctor or pharmacist for advice or call NHS Statins can sometimes interact with other medicines, increasing the risk of unpleasant side effects, such as muscle damage.
It's very important to read the information leaflet that comes with your medicine to check if there are any interactions you should be aware of. Find out more things to consider when taking statins. For those who are borderline diabetic, the mild increase in blood sugar can lead to a diabetes diagnosis about five weeks earlier than it would be otherwise.
Truth: In , the FDA changed statin drug labels to include information that some people had experienced memory loss and confusion while taking the medications. But in fact, the brain makes its own cholesterol.
If anything, long-term use of statins might have a beneficial effect on the brain since they help prevent strokes and protect the health of arteries in the brain. Truth: Some studies have indicated that there may be a relationship between statin drugs and an increased risk for developing cataracts.
In the first three groups, doctors do not need to estimate the risk of cardiovascular events. These people automatically qualify for statins. For the fourth group, which includes people without any strong symptoms of heart disease, the guidelines committee used data from the latest scientific studies to develop a risk calculator.
This tool allows doctors and patients to determine both their year and lifetime risk of cardiovascular disease, including heart attack or stroke and death from either of those causes. In spite of its strong basis in science, the risk estimator has drawn criticism from some doctors. That was a source of confusion for a lot of people. In fact, a recent study in JAMA Internal Medicine found that up to 97 percent of people between the ages of 66 and 90 qualify for statins under the new guidelines and according to the accompanying risk calculator.
This highlights one major area of debate — the apparently large increase in the number of people, especially asymptomatic people, who will be prescribed statins. Statins are not without side effects. These include muscle pain, confusion, flushing, and rarely liver damage or memory loss. The guidelines are clear about which groups of people could benefit most from therapy — both medications like statins and lifestyle changes like eating better and exercising more — but in the fourth group, the guidelines leave room for doctors and patients decide together how best to lower cholesterol levels.
Of course, that is the very nature of guidelines, something that has been lost in the media shuffle over the past year.
Another aspect of the guidelines that has created some confusion is the belief that, because there are no more LDL targets, doctors no longer need to do ongoing monitoring of LDL blood levels after a patient starts taking a statin. This is not the case.
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