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How Statins Lower Cholesterol and Protect Your Heart

It’s likely you’ve had your cholesterol levels checked, probably many times. They are an important health marker—high cholesterol levels put you at risk for heart disease and stroke. The Centers for Disease Control and Prevention (CDC) recommend cholesterol screening every four to six years for healthy adults.

If your cholesterol levels are high, your doctor might recommend changes to your diet that can help bring them into normal ranges. Cecilia Hirsch, MD, a cardiologist at Banner Health in Colorado, said it can help to:

  • Eat lots of vegetables, fruits, and whole grains
  • Limit red meat, added sugar, and alcohol
  • Replace some unhealthy fats with healthy fats
  • Choose smaller portions and eat more slowly
  • Balance your calories with your needs and activities

Exercise can also help improve your cholesterol levels. But it can take 6 to 12 months for diet and exercise to make a difference. And changing your lifestyle doesn’t always succeed. So, along with your lifestyle modifications, your doctor might prescribe statins to help lower your cholesterol levels.

The statin-cholesterol connection

Statins are medications that can reduce your low-density lipoprotein (LDL) or “bad” cholesterol. LDL cholesterol can cause fatty deposits in your blood vessels that can lead to heart disease, heart attack, strokes, or peripheral artery disease.

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Statins typically have “statin” in their name. You might see:

  • atorvastatin (Lipitor)
  • rosuvastatin (Crestor)
  • lovastatin
  • simvastatin
  • pravastatin
  • pitavastatin
  • fluvastatin

Statins pack a strong punch against cholesterol

Statins affect your cholesterol levels in two ways. They decrease the amount of cholesterol you produce, and they increase the amount of cholesterol your liver removes.

“They reduce LDL cholesterol levels by as much as 25 to 55 percent,” Dr. Hirsch said. They also lower triglycerides, which are a type of fat in your blood that can increase your risk for heart disease, especially when combined with high LDL cholesterol levels.

Statins may also reduce inflammation, which can further lower your risk for heart attack and stroke.

How to find out if statins might help you

You can ask your doctor whether taking statins is a smart choice. If you have a history of heart attack or stroke, statins can lower your risk of a repeat.

If you don’t have a history of cardiovascular disease, your doctor can estimate your risk based on your age, sex, medical history, and other factors. You and your doctor can use that information to decide if statins are right for you.

The possible side effects of statins

“While most people tolerate statins well, there are some potential side effects,” Dr. Hirsch said.

Some people notice muscle pain, aches, or weakness. These side effects are more likely in people who:

  • Have neuromuscular disorders, liver disease, or kidney disease
  • Are Chinese
  • Have untreated hypothyroidism
  • Have very low vitamin D
  • Are over age 80
  • Are frail
  • Are female

If you notice side effects from statins, don’t simply stop taking them. Ask your doctor about alternatives. “There are a wide variety of medications available today, which should make it possible for most people to find an option that works for them,” Dr. Hirsch said.

Also, make sure to tell your doctor about any prescription or over-the-counter medications you take. Some medications interact with statins so you may need a lower dose.

Common questions about statins

Dr. Hirsch answers these common questions about statins and their effects:

  • Does CoQ10 counteract side effects? There’s not much evidence to indicate the CoQ10 works, she said.
  • Is there a link between statins and dementia or memory loss? There’s no data to support that link, she said. And other studies have found the opposite—statins could help prevent dementia.
  • What’s the best time to take statins? It depends. Pay attention to the dosing instructions. Some are best at bedtime, while you should take others with a meal. And be careful with grapefruit and grapefruit juice—they could increase your risk of side effects.
  • Is red yeast rice a good natural alternative to statins? Red yeast rice contains a compound that’s similar to lovastatin and can lower LDL cholesterol levels by 20 to 30 percent. But she doesn’t recommend it. That’s because 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 your cholesterol levels are high, talk to your doctor to see if statins might help reduce your risk of cardiovascular disease. “Statins are one of the best-studied classes of medications,” Dr. Hirsch said. “They are the most effective drugs for preventing coronary heart disease, heart attack, stroke, and death.”

To dig deeper into cholesterol and how it affects your health, check out:

Colesterol Salud del corazón

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