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Statins: Should You Take Them?

Statins: Should You Take Them?
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Statins are drugs that lower your cholesterol by blocking an enzyme needed by the body to produce it. They also go after the cholesterol that has built up in plaques on the walls of arteries. They are prescribed to reduce the risk of heart attack or stroke but have been found most effective in those already diagnosed with cardiovascular disease. A study published in 2014 by the New England Journal of Medicine found that new guidelines for taking statins could add almost 13 million Americans to the ranks of those already taking the drug or eligible to do so.

The guidelines removed the fixation on cholesterol numbers and considered a broader range of risk factors. Statin use is recommended for those without cardiovascular disease who are 40 to 74 years old and have a 7.5 or higher risk of having a heart attack or stroke in the next 10 years, those with a history of a cardiovascular event, those ages 21 and older with a high level of LDL (or bad cholesterol), and those with Type 1 or Type 2 diabetes who are 40 to 75 years of age.

Are statins overprescribed? Some doctors are concerned that the guidelines will cause many to start taking statins that don’t really need them with some believing that only those with evidence of cardiovascular disease stand to reap the most benefit. Others state that the guidelines will save lives.

Should you take them?

How do you decide whether or not taking a stain is right for you? According to the Mayo Clinic, if your only risk factor is high cholesterol you may not need to. In my opinion, if the patient has committed to lifestyle changes; diets high in fiber and consisting mostly of fruits and vegetables with lean protein, regular exercise and smoking cessation, statin therapy should be strongly considered only if they are at a high risk for heart attacks and strokes, says Rani G. Whitfield, MD, a spokesperson for the American Heart Association.

Factors that should be considered include your family history of high cholesterol or cardiovascular disease and whether or not you have high blood pressure, suffer from diabetes or liver disease, or have been diagnosed with peripheral artery disease. What it boils down to is a discussion with your personal health care provider about whether or not taking a statin is right for you.

Side Effects

As with any medication, there are side effects with taking statins. Some common ones which often subside after your body adjusts to the medication) include muscle and joint aches, nausea, gas, diarrhea and constipation. In some cases muscle pain goes beyond an ache to pain, tiredness or weakness which can be severe enough to find climbing stairs or even walking to be difficult. There are other possible side effects as well. Headache, rashes or flushing, memory loss or confusion, indigestion, hyperglycemia (elevated blood sugar) and the onset of Types 2 diabetes, and peripheral neuropathy are all less known/talked about side effects of statins, says Dr. Whitfield.

A small risk of liver injury has also been documented. Liver injury is rare but can occur, says Stephen King, an FDA spokesperson. Patients are advised to consult their health professional if they have symptoms that include unusual fatigue, loss of appetite, right upper abdominal discomfort, dark urine or yellowing of the skin or whites of the eyes. While blood monitoring of liver enzymes was once standard while taking a statin, it has no longer been found necessary. Another risk is kidney damage caused when muscle cells break down and release a protein into the bloodstream. This has been most often associated with taking high doses of statins.

Side effects can be alleviated by switching to a different statin drug. The drug simvastatin (Zocor) has been thought to cause muscle pain at high doses more than other statins. Lowering your dose may also help. You may want to consider taking other types of cholesterol-lowering medications as well. Doctors caution that you should not try to treat muscle aches with over-the-counter pain relievers without asking a doctor first because muscles aches from statins won’t respond to common pain killers.

It’s very important that you provide your doctor with a list of other medications you are taking. Before taking a statin, be sure to check with your doctor on how it may interact with any prescription medications or over-the-counter products you currently use. Some medications, when taken with statins, can increase your risk or intensity of side effects. Some medications, for example, interact with lovastatin (Mevacor) reports the FDA, and can increase your risk of muscle damage. All statins, for example, can create more severe side effects when taken with an antifungal medication, some antidepressants and some immunosuppressant medications. Grapefruit juice and grapefruit can interfere with the enzymes that metabolize statins reducing their effectiveness.

An increased risk of suffering from side effects has been associated with being female, having a small body frame, being age 65 or older, taking more than one medication to manage cholesterol, drinking too much alcohol, having Type 1 or 2 diabetes, or suffering from kidney or liver disease.

On the bright side, it’s suspected that some additional benefits may be reaped from taking statins including a reduced risk of arthritis, bone fractures, dementia, kidney disease and some forms of cancer. The journal Lancet just reported that the statin drug simvastatin (Zocor) seems to slow brain shrinkage and restore some function to those suffering with advanced multiple sclerosis.

Proceed with Caution

If your doctor does decide you should take a statin, do some research on what’s out there. A large meta-analysis did show that simvastatin (Zocor) and pravastatin (Pravachol) were the safest, however an informed discussion between the doctor and the patient is still the best way to determine which drug is best, says Dr. Whitfield. Of course you should never stop taking any medication before talking to your doctor. Once you start taking a statin, it’s likely that you will continue to do so, unless you are able to achieve healthy cholesterol levels through lifestyle change.


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